ARCHITECTURE AND DESIGN


Patients and family have access to many public areas on the main entry level and first floor, including a café with views of the green. Finishes have been selected ‘to combine practicality with the aesthetic parameters’.


strategy of centring the patient journey around a single location, regardless of which consultation room or treatment area they use on successive visits.


Collaborative treatment and care The $276 million, seven-storey, 37,000 m2 outpatient facility incorporates 126 exam/consultation rooms, 98 infusion treatment rooms, six linear accelerators, a Gamma Knife suite, a pharmacy, and haematology lab services. The linear accelerators and associated radiotherapy care are located at the lower ground/ basement level, along with the brain institute and aseptic pharmacy services. The upper floors – five and six – provide office, conference room, and break areas for doctors and all administrative services. Cleveland Clinic is a pioneer in incorporating the latest technologies to ease the patient’s journey, and the Cancer Center uses a patient GPS system to track patients from check-in to check-out using radio frequency identification. The tracking devices look like ID badges, and are scanned into a computer system when the patient checks in. This allows clinical staff to look at real-time, colour-coded computer screens to see where patients are, and how they are progressing through their visit. The staff are coded according to their speciality, so staff can see where the patient is, who they are with, and how long they are spending ‘in the system’.


Identifying bottlenecks


Data is used to identify bottlenecks and improve the patient experience. To date, The Taussig Cancer Institute has reduced the overall wait for chemotherapy patients to just 20 minutes.


Patients and family have access to many public areas on the main entry level and first floor, including a café with views of the green where ‘high tea’ is served every week for patients. In addition, there is an accessories boutique, operated by a licensed beautician, where patients can select a complimentary wig that they can take home with them the same day, or utilise the make-up service. The boutique also offers a range of prosthetics, hats, scarves, and accessories for both men and


women. The ground floor has dedicated areas for spiritual and complementary therapies, including yoga, music, and art therapy, and a meditation centre. The 4th Angel Mentoring Program also operates from this location, enabling patients to drop in for support and advice from mentors who are living with cancer or have survived their cancer journey.


Core ancillary services


In addition to these softer services, the ground floor houses the core ancillary services that are key to every cancer patient’s journey – including the haematology laboratory service, which has 14 semi-private cubicle spaces, and a retail dispensing pharmacy. The large numbers of clinics (126) and infusion bays (98) have been broken down to recognisable modules following the tumour model approach. This provides a human-scale experience both for patients and staff. The second floor provides the internal connection to the skyway, patient services, a dedicated 10-bay clinical trials area monitored by specially trained nurses and research assistants, and the Haematology, Bone Marrow, and Apheresis Clinics. Lung, Head, and Neck, Gastrointestinal, and Brain tumour clinics, are located on the third floor, while Genitourinary, Skin, Gynaecological, and Breast, including a breast imaging suite, are located on the fourth floor.


Each of the tumour clinics comprises a clinic and an infusion treatment module supported by multidisciplinary work spaces and clinical support rooms. They also feature ‘touchdown’ spaces for social workers, pharmacists, and other health- related disciplines that may be involved in the care, treatment, or additional needs of an individual patient.


‘Team work’ rooms


Each clinic module includes 10 identical examination/consultation rooms grouped around the fully glazed ‘team work’ room, where oncologists, surgeons, radiologists, palliative care providers, oncology nurses, and advanced practice providers, can review therapeutic decisions and treatment plans and provide decisions while the patient is still in the building. Adjacent to this is the nurse charting base overseeing the exam rooms and the scheduling suite, where patients go to review their next appointments following the multidisciplinary case review. Similarly, each infusion suite comprises 16 treatment stations – 10 private rooms with shared en-suites and six semi- enclosed bays. They all have access to floor-to-ceiling windows overlooking the campus green, and are designed to meet the patient’s need for privacy and space for accompanying family members, as the treatment can often take several hours. In addition to comfortable adjustable recliner chairs, they each contain eye-level TV screens and integrated, in-built cabinetry, which contains clinical supplies.


A new model


The linear accelerators and associated radiotherapy care are located at the lower ground/basement level.


Both aesthetically and organisationally, the Taussig Cancer Center at Cleveland Clinic in Ohio pushes the boundaries of cancer centre design, and creates a model where the layout of the building is central to the concept of collaborative care and a simpler, more familiar patient journey. The project benefitted from involving the design team from site selection to determining the finishes and furnishings, enabling the Stantec and William Rawn teams to put stakeholder consultation and the client’s desired outcomes at the heart of the design process.


hej October 2018 Health Estate Journal 53


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