Photo courtesy of Brian Strickland

As medical care has progressed through the 20th and 21st centuries, so too have the facilities that house the practitioners, labs, and equipment. Moreover, as the delivery of care became more specialized, hospitals and clinics began to need similarly specialized spaces. Imagine, then, how difficult it was for doctors at the North Carolina Cancer Hospital to deliver adequate and proper care working out a former Tuberculosis hospital built in the early 1950s. With a clear need for a new hospital—and specifically one to complement the world-class research done at the neighboring UNC Lineberger Comprehensive Cancer Center—Zimmer Gunsul Frasca Architects (ZGF) were awarded the challenge of creating a cutting-edge, clinical cancer facility.

The ZGF-designed, 315,000-square-foot NC Cancer Hospital is the only public cancer hospital in the state of North Carolina. Because of this designation and responsibility, administrators were able to secure $180 million from the state for the design and construction of the facility. “The state essentially underwrote the cost of the building,” says Dr. Richard Goldberg, professor and division chief of hematology and oncology, physician-in-chief, NC Cancer Hospital. “They allocated $180 million for both the cancer hospital and an adjacent physicians’ office building. Soon after the money had been allocated Katrina hit, and the cost of steel and concrete went up dramatically, so in the end, the price tag was about $210 million of which $30 million came from hospital reserves.”

The most important aspect of this facility remains: Bring the clinical facility up to par with its neighboring research building and the work being performed. Goldberg goes on to say, “UNC was better known as a research facility than a clinical facility for many years. What this cancer hospital allows us, is to have as nice a facility for clinical care as we’ve had for research for many years. For many patients as well as the physicians that were practicing here, the facility that we were in was a ‘grit your teeth and stand it’-facility. Now it’s an aesthetically and functionally lovely building that means that our clinical care is in a state-of-the-art facility that makes it easier to bear with the indignities of the disease.”

Photo courtesy of Brian Strickland

And ZGF understood this dichotomy going into the design of the new NC Cancer Hospital. “They had been working in poor physical conditions for a number of programs,” says Allyn Stellmacher, design partner, ZGF Architects. “They have the Lineberger Comprehensive Cancer Center there, which is their primary research driver. Lineberger has been able to draw and attract a tremendous amount of young and talented physicians in a diverse practice relative to cancer care and delivery. There was a lot of initiative relative to the state and legislator to upgrade the quality of care that could be delivered to the citizens of the state and to put this new building into place and give it a shape and form on the campus.”

Because of the cancer hospital’s strong emphasis on research, designers understood that this new facility could not solely be used for clinical care. There had to be an overlap between the research and care delivery aspects of the hospital, something that went a long way into determining how to design the facility, and the various specialties in the building.

“Most of [the new hospital] is geared toward treatment,” says Stellmacher. “That being said, a lot of the individuals working as physicians are doing research at the same time. To draw these top practitioners and attract them to practice in this area, you find that the top practitioners are both doing research, as well as doing care at the same time. It is that kind of mission that you find in these top-notch researchers. They don’t just live at the bench.”

Photo courtesy of ZGF Architects, LLP

As such, the way the building was arranged was of great importance to ZGF in designing the building. Because of the facility’s adjacency to the existing emergency department and support spaces, as well as the requirements for the various disciplines to be housed, ZGF had to stack the building, designating a different function for each floor.

“What’s interesting about this building is that almost every floor of the building is different in its function and its requirements,” he says. “Typically when you do a hospital, you might have two or three floors at the base support or surgery or diagnostics, and then extruded beds that come out of the top of that. In this case, we do have one floor of beds on the top of the building. But other than that, we have different functions for each floor.

“Each of the floors had very different demands, so you couldn’t just stack one on top of the other. It made a really interesting combination of programs to put together, but it’s really about the diversity of having all of those practitioners together. In the cancer discipline, more so than others, we find that the space we define for clients is really space that services large groups of practitioners that are integrated and working together.”

This is not to imply that the design team wasn’t sensitive to the staff, patients, and visitors who would be spending significant time of their life in the facility. Aside from the goal of creating a healing and de-institutionalized feel for the patients, ZGF actively involved the physicians that were going to be using the space. “We spent lots of time meeting with people from the ZGF interiors team,” says Goldberg. “The physicians were very involved in the design process. I was surprised with the level of involvement. They would come for a week every month during the design process. It was all of the different stakeholders: nurses to physicians to try and work on the design. There was also the involvement of patients to advise us as well.”

Photo courtesy of Brian Strickland

Stellmacher believes that they reached all of these goals effectively. “We worked very hard to accommodate all of the physical requirements and requirements for the future, as well as the operational requirements, but at the end of the day, what we want to provide are examination rooms, patient rooms, infusion spaces, clinical spaces, and waiting spaces that are all comfortable and provide some sense of comfort and care,” he says.