Winship Cancer Institute at Emory Midtown is adopting a new model of care

Winship Cancer Institute at Emory Midtown is adopting a new model of care

Leaders at Emory Healthcare Institute and Winship Cancer Institute at Emory University (Atlanta) made it clear from the beginning that they had big ambitions for their new building. Give us something “never seen or imagined before,” they told the design team.

The new facility, which occupies 450,000 square feet in Atlanta’s downtown neighborhood, was designed by Skidmore, Owings & Merrill (SOM; New York) in collaboration with May Architecture (Atlanta) — with input from more than 200 doctors, nurses, janitors and families. Patients, counselors, and more, says SOM Director Anthony Trew.

“Anyone who could be involved in this project was asked to come and participate, ‘How are you doing things now?’ ”How would you like to do things differently?” he says.

Then they dug deep. “Clinical teams are so adept at overcoming obstacles on a daily basis that when presented with the opportunity to find a perfect solution, there is a natural tendency to default to what has worked for them,” says Jill May, principal of May Architecture. “It took a minute, but eventually everyone started shifting from ‘This works’ to ‘This is what we think would be the best solution without restrictions.’”

The 17-story facility opened in May 2023, eventually embracing a model organized around five “communities of care,” each focused on different types of cancer: breast and gynecologic oncology; Head and neck tumors. Sarcomas and endocrine cancers. Cancers of the genitourinary system and digestive system. Lung cancer, lymphoma, and multiple myeloma.

Each care community consists of two floors: the lower floor for outpatient services and the upper floor for inpatient care. In these societies, the patient is at the heart of the event in every sense of the word.

“Patients stay in a private outpatient ward, and as much of their care as possible — including doctor appointments, lab tests, infusion treatments, and support services — is delivered on the ward,” explains Dr. Suresh Ramalingam, executive director of Winship Cancer Institute. At Emory University. “We wanted to create the best possible patient experience and an environment that promotes healing.”

Planning approach for the new cancer center

The process of translating the vision of patient-centered cancer care into a physical building was greatly aided by cardboard models of each floor, which were built one by one in a nearby warehouse during the planning stages.

“It wasn’t just part of the floor, it was the entire floor,” May says. “This allowed the team to spend time in the space confirming flow, relationships, room sizes, etc. The care teams ran scenarios and exercises that delved into the details of equipment layouts, millwork, and more.”

The decision to stratify the population according to cancer types benefits both patients and staff, and it starts with the recognition that “cancer” is a big tent: “Nobody diagnoses you with cancer.” “You’re getting a certain type of diagnosis, which looks different for every patient,” Treu says.

For patients, Communities of Care, linked by two-story community lobbies, provide an opportunity to interact (as much or as little as they want) with others who can relate specifically to their diagnosis.

For physicians, it is a setting that increases consultation and coordinated care. “Cancer care often requires multiple types of treatments with specialists from different medical specialties,” says Ramalingam. “The idea was to design the space to best enable this collaboration.”

Patient-centered design

On the outpatient floor of each care community, the patient has a general room where he or she will be cared for by several doctors during the visit as needed.

In addition to the core specialties of radiation oncology, radiology, surgery, pathology, hematology, medical oncology, and pharmacy, the room may also support consultations with everyone from dietitians and patient care coordinators to audiologists, genetic counselors and financial navigators.

Designing a room that can handle all this activity took some careful consideration. “It seems simple on the surface, but the devil is in the details,” May says. “For example, in a traditional model with an infusion center, the compounding pharmacy is adjacent to the infusion center and chemotherapy drugs are delivered directly to the patient. But in a decentralized one-stop room approach, how do you get drugs from the central pharmacy to 11 other floors?”

Solution: Having a dedicated small floor with the ability to control access to the affiliated pharmacy reception rooms on each floor.

The common room groups are based on shared spaces called “living rooms,” where patients and their families can interact if the mood strikes, even during infusion therapy.

“We’ve learned that an infusion patient may want privacy one moment, but the next moment, that same patient may want to be social,” May says. “This provides the patient with a choice.”

The main corridor of outpatient units follows the perimeter of each floor along the exterior windows, with groups of patient rooms and beds on the interior. This setup resulted in a light-filled ward with daylight for all patients and clear circulatory guidance.

Glass windows and clear glass doors in public rooms bring daylight into those spaces as well, without compromising privacy.

Staff considerations

The design of each community of care allows for an enhanced experience for both patients and providers. “One of the net results of shifting the corridors to the perimeter was that we were also able to create an uninterrupted provisioning area in the middle of the cancer center. It creates a connected, collaborative space that is exclusive to providers, while at the same time providing a more comfortable and dignified experience for patients,” Treu says.

An uninterrupted caregiver area provides discreet access to patient spaces along the length of the building. These areas have doors leading to living rooms and associated treatment spaces, allowing providers to enter and exit within these areas unobtrusively.

“It takes the patient aspect out and makes it feel less clinical and allows the provider area to be more secure and private for the staff,” Treu says. “Patients are protected from a lot of the logistics of supplies and samples being transported back and forth. Staff can access most areas in the cancer center without crossing into patients’ circulation. The same central spine thinking was applied to inpatient floors as well.

Balancing warm aesthetics with a modern material palette

Aesthetically, the design team aimed to balance comfort and familiarity (taking into account the amount of time patients spend there on repeat visits) with the reassurance that the care provided is high-tech and state-of-the-art.

Warm elements that evoke hospitality, including white oak finishes, a subdued color palette, and an emphasis on natural light, are combined with “bright, clean, modern, subtle materials with polished metals and glass,” says Treu.

The design team expands the community concept beyond the center’s walls with a double-height, glass-fronted atrium at street level, where amenities such as a patient store, wellness center, retail pharmacy and café are grouped together.

“The cancer center is part of this community, and it’s not a place of illness. It’s a place of treatment and health,” Treu says. “We wanted people to be able to see the building. “There’s nothing to hide.”

Ramalingam of the Winship Cancer Institute agrees. “We hope that our presence there will be a source of hope,” he says.

Kristin De Zeit is a contributing editor for Healthcare Design magazine and can be reached at kristinzeit@gmail.com.

Details of the Winship Cancer Institute project at Emory Midtown

Project: Winship Cancer Institute at Emory Midtown

Location: Atlanta

Project completion date: May 2023

Client: Emory Healthcare

Client Program Manager: CBRE Healthcare

Total building area: 450,000 square feet

Total construction cost: approx. 400 million dollars

Cost/square foot. Feet: approx. $890

Architect: Skidmore, Owings & Merrill (SOM)

Clinical Architect: Mayo Architecture

Construction Manager: Batson Cook Construction Company

Structural Engineering: Skidmore, Owings & Merrill (SOM)

Civil Engineering and Landscape Design: Kimley Horn Associates

Signage/Wayfinding: Herter Design Group

Programming: MPR International

MEP and Lighting: Newcomb and Boyd

Medical Equipment Planning: Entropa (FKA Ross & Baruzzini)

Kitchen Planning: Rippe Associates; Minneapolis

Instrumentation: Phillips Langley & Company

VT and Materials Management: Lerch Bates

Acceleration: Acceleration in the south

Acoustics and Vibration: Cerami & Co

Interface system: Permasteelisa

Glass: AGC Interpan

Doors: AD Systems, Stanley Access, CRLaurence

Car garage doors: overhead door

Roofing: Carlisle

Waterproofing: Polygard, Expex, BASF, Hydrotec, Henry

Fire protection: Hilti

Insulation: Owens Corning, rock wool

Interior finishes: Flooring: Nora, Terrazzo, Marble, Smartwood, Stonehard

Inner glass partition: Transwall system

Operable Section: Modern Fold

Shade: Mermet, Cascade Coil

Bishop: USG, Armstrong

Carpet: facade

Hair: Wolf Gordon

Tiles: Porcelanosa, Daltile, Marazzi, Crossville, Casalgrande Padana, WOW Design

Decorative glass: McGrory glass

Protective wall coverings: Acrovyn, Marlite, In-Pro

Toilet partition: iron wood

Smokescreen: McCune

Wallcoverings: Carnegie, Muharram, AccuTrack Systems

Laminates: Formica, Wilsonart

Landscape Products: Hanover Buffer, Wausau, Ohio Barriers, Landscape Forms, Bellgard, Victor Stanley, Escovit.

Art/Photos: Featured art resources

AV Equipment/Electronics/Software: Doors/Locks/Miscellaneous Hardware: Assa Abloy, Rajack

Handrails/wall guards: InPro, Acrovyn

Surfaces (solid surface materials): Corian, Caesarstone

Project details are provided by the design team and have not been previously vetted Healthcare design.

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