Convenience for Cancer Patients: Cooper Pavilion
When Lisa Antoun was first treated for can-cer, she received fine medical care—but, in the process, she faced many obstacles not uncommon in older hospitals, among them long corridors, crowded waiting areas, and lack of centralized services. So, in addition to fighting cancer, Lisa found herself fighting for appointments, getting lost while moving from wing to wing, hand-carrying documents to doctors, and checking into various units, over and over.
When Lisa's cancer recurred this year, though, her experience was different. She received treatment in the new Hillman Cancer Center in Pittsburgh, the flagship facility of the University of Pittsburgh Cancer Institute (UPCI) and the University of Pittsburgh Medical Center (UPMC). This state-of-the-art comprehensive care center houses both the UPCI Research Pavilion and the William M. Cooper Pavilion, the ambulatory wing where patients, like Lisa, receive clinical services.
Cooper Pavilion is a five-story, 149,300-square-foot building dedicated to cancer outpatient treatment. The guiding concept behind the project was to offer outpatients integrated, accessible services—treatment, diagnosis, prevention and early detection, nutrition, education, genetic counseling, and behavioral medicine—under one roof, the goal being to maximize patient convenience and comfort.
“Architects have an unconscious tendency to be interested in what the building looks like and what it is made of,” observes John Radelet, AIA, principal of Radelet McCarthy, the Pittsburgh-based firm that designed Cooper Pavilion. “Our firm tries very consciously to remember that the building is not the focus, but what goes on inside the building after it's finished. At Cooper Pavilion, that means patient care, family support, and staff satisfaction had to be the focus during planning, design, and construction.”
Space Planning and Design
Radelet notes, “Working very closely with users and administrators, we designed the space with a total focus on vertical organization. As you move up the floors, there are increasing levels of privacy. On the ground floor you find public spaces, such as the library, conference center, and outpatient pharmacy. On the first floor you find the café, the gift shop, and imaging; above that are the exam and treatment rooms. Half of the top floor has been assigned to the highly confidential Clinical Research program.
“The space is designed for privacy and accessibility,” Radelet says. “The flow ensures that patients can easily and intuitively move through the building for their consultation, testing, diagnosis, and treatment.”
“An overriding feature of our design was the recognition that people spend a great deal of time in the building and it therefore needs to be a pleasant space,” adds Doug Schlauch, AIA, Radelet McCarthy architect. “Once we finished the programming, space planning, and design documents, we focused on the interior details. We attempted to enhance patient comfort and confidence with interesting artwork, subtle colors, ambient lighting, soft seating, warm wood detailing, and quality materials.”
The importance of convenience is apparent at the entrance, which features covered patient drop-off space and valet parking. Inside, the ground level includes an information desk, conference center, retail pharmacy, home care showroom, patient and family library, and a prevention and early detection center.
One example of patient-centric care is the patient and family library. The library houses medical books and journals and computer stations for access to up-to-date medical databases, as well as a media room and a place to demonstrate prosthetics with models. The library and the retail pharmacy are connected, so that patients and families can browse in the library while waiting for prescriptions.
“Our design encourages people to use the library, and we have found that the use of the space is significantly higher than at the previous UPCI facility,” says Schlauch. “The library offers a chance for patients to be in control and not totally rely on someone else.”
Merging Technology and Patient Care
Most of the first floor is used for diagnostic imaging. According to Schlauch, a unique characteristic is that the entire radiology department is dedicated to the Cancer Center as part of the concept of complete patient care and convenience: “Patients don't have to come and have a test and come back in a week. They can actually come into this department, take the elevator to the first floor, have a CT done, and then take the elevator to the second floor exam rooms and find the doctor reviewing their image.
“Technology had a big impact on the design of this unit, and we had to work closely with manufacturers’ reps and researchers,” Schlauch continues. “The entire department is based on use of filmless digital technology, which affected the wiring and the data points required.”
With more than 20 years of experience installing advanced technology in healthcare environments, Schlauch understands the special needs and pitfalls involved. One example was the relocation and isolation of the MRI unit. It was initially planned to be located directly over the entrance driveway, but it was determined that there would be interference from the metal of automobiles passing below.
“We ended up moving the MRI unit so that it is not directly above the driveway, but above the conference center,” explains Schlauch. “We still had to take into consideration the fact that the room was noisy, and we had to do special acoustic isolation and verify that the magnetic field strength wasn't going to affect the electronic video displays in the conference center.
“The design of the radiology department was technically challenging, but it was also motivated by patient comfort,” Schlauch continues. “For example, there are windows all around the outside corridor. Even though you don't need windows in a radiology department because of privacy and shielding issues, it's nice to have access to outside light so that people don't feel trapped.”
Examination and Treatment Areas
The main UPCI clinic takes up the entire second floor. This floor houses examination and consulting space on one side, chemotherapy treatment space on the other, and support space in the middle, accessible to both sides.
“We utilized a concept where the exam rooms are not assigned to specific doctors, but rather are configured as ‘pods’ shared by physicians,” notes Radelet. “Each pod consists of four exam rooms, a consulting room, a workroom for the physician, and an area for the nurses.
“We also designed the treatment spaces larger than normal. Treatment lounge chairs are in groups of four in a room large enough to comfortably accommodate three or four visitors.”
Innovative Stem Cell Program
The third floor houses the stem cell program, which involves blood drawing, processing, and reinfusion. “The procedure takes most of the day,” notes Schlauch. “As a result, we have a set of rooms that are designed especially for the program. The rooms have traditional beds instead of hospital beds, an entertainment center, and a lounge area for family and visitors.
“This is obviously a medical facility, and we need medical equipment and emergency power for infusion pumps, but the design philosophy was to reduce the institutional look of the building as much as possible. In some cases, medical oxygen, medical vacuum and associated regulators, and sphygmomanometers are concealed behind artwork. We specified overhead lights that look like normal lights, but you can flip a light and an exam light emerges from the back; the exam light isn't visible all the time.”
Satisfying Multiple Clients
“You would think that the complex technology would be the most challenging aspect of this project,” says Schlauch, “but in fact, the hardest part was establishing people's needs and the goals of the varying participants to make the project work for all of them. Participants included a board of directors; administrators from the UPMC administration, UPCI, and UPMC Shadyside Hospital; researchers; the clinical staff, private-practice physicians, and support staff; and users—all under one client umbrella. Each of these different groups had different criteria, needs, and expectations that had to be met to make the project work for them.”
“Our key role in this was listening to what the different groups had to say and distilling from that the really strong emphasis needed,” continues Radelet. “The common thread among them was the issue of patient convenience and comfort.”
“We were really concerned about designing a healing environment,” says Schlauch. “You can affect the well-being and stress of a patient through the design of a space. You need to balance that with the needs of the staff who take care of the patients. It is a balance that we've achieved at Cooper Pavilion.”
Patient Lisa Antoun readily agrees: “It is such a beautiful space. When I first entered, there was an immediate feeling that ‘this is a good place.’ The space communicates respect for the patient and says, ‘You deserve this. It's not just what you need to have medically, but we're thinking about how you feel while you're here.’” HD