Cleveland Clinic USA - at the forefront of cancer centre design and patient experience

 

Around the world, cancer care is changing. A number of different approaches to cancer centre design are emerging, influenced by different treatment models, along with the physical possibilities or limitations of specific sites. One cancer centre that is gaining international recognition for its patient-centred model is the Taussig Cancer Center, a US$276m, seven-storey, 37,000 square metre outpatient facility at the Cleveland Clinic in Ohio.

The Center demonstrates the pivotal role of architecture in balancing the client’s vision with practical considerations of work flows, circulation, inter-disciplinary collaboration, translational research, and patient wellbeing.

A simpler patient journey

The core vision for the Taussig Cancer Center is for treatment to be delivered by tumour type, with inter-disciplinary care provided in a specific and dedicated location. As Dr Nathan Pennell, director of thoracic malignancies at the Taussig Cancer Center, puts it: ‘The patients are in one place that’s tailored to their needs and everyone comes to them.’

Thanks to the location and orientation of the plot, the building was designed in an elegant and simple layout, dividing the rectangular floor-plate into north and south zones, with each floor housing clinics and infusion treatment spaces according to tumour type and laid out to the same planning principles.

The North zone is the location for the chemotherapy infusion suites, which provides a relaxing treatment environment with views of green space and natural light penetration. Meanwhile, the South zone features the clinics, where patients have consultations with their clinical team. Sandwiched between the two zones, and running the entire length of the floor, are back of house staff and clinical support areas. Staff move seamlessly and unobtrusively between clinics and infusion treatment areas, maximising opportunities for multidisciplinary care.

The patient lifts, reception, and waiting areas are located centrally in the plan with open views to both north and south, allowing for intuitive wayfinding along light-filled corridors.

A low stress experience

The layout delivers a simple and intuitive patient journey, a principle that is increasingly influencing the design of cancer centres to reduce levels of stress and anxiety. Patients are naturally guided to the same location on every visit (unless they are attending for radiotherapy treatment or imaging, which are located on the lower ground floor).

Intuitive wayfinding has also been designed into the interior finishes at the Taussig Cancer Center, with wood accents complementing the extensive use of glazing in the façades to develop the connection between indoor and outdoor space and enhance the feeling of openness. Meanwhile, carefully curated artworks support wayfinding throughout the building, providing a sense of location against the blank canvass of the clean, white interior while providing a focus for relaxation.

The value of art in a hospital setting is well-documented and this has been fully explored at the Taussig Cancer Center, with abstract artworks that aim to both distract patients from the clinical environment and enable them to feel more familiar and confident in their surroundings. This is a technique that could be applied in any cancer centre setting.

A model design

The principle of reducing patient anxiety by ensuring their surroundings are familiar and their experience is consistent at every touch point has been designed into the Taussig Cancer Center’s 126 consultation rooms and 98 treatment rooms. These areas were developed on a standardised model with a consistent layout and specification for each, following an extensive stakeholder collaboration with clinical, managerial, and maintenance staff, as well as patient groups.

As part of this process, initial designs were mocked up into rooms so that the stakeholder engagement process could include discussion of the spatial layout and the detailed design, including furniture and building services.

Identical rooms provide clear benefits for both patients and staff, with clinical teams able to find everything they need instantly, reducing wasted time, disorientation, and the potential for human error. Meanwhile, patients benefit from a sense of the familiar, aligned to the overall strategy of centering the patient journey around a single location, regardless of which consultation room or treatment area they use on successive visits.

Again, this is a design principle that could be replicated in any cancer care environment, based on the needs of the specific environment. With a blueprint for the ideal consultation and treatment rooms in place, the model can be replicated for additional sites or any future remodelling/extension projects.

Leveraging technology

Cleveland Clinic has pioneered the use of the latest technologies to ease the patient journey, and the Taussig 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 the hospital and other clinicians can see where the patient is, who they are with, and how long they are spending in the system. 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 thanks to the combination of this technology and the optimised, patient-centred layout of the facilities. Any cancer centre environment could benefit from this use of technology, enabling patients to relax and use the range of facilities on site, rather than just sitting in a waiting area for their appointment.

Holistic care

A key element of designing a more relaxing patient experience into a cancer centre is providing facilities beyond the treatment areas and waiting rooms. At the Taussig Cancer Center, patients and family have access to many public areas, including 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 also has a café, 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.

A new model

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. It provides core design principles for a tumour-type based model of care that could be replicated on any scale within the context of varying clinical requirements and site-specific challenges.

This article was originally published in Healthcare Markets Magazine, published by LaingBuisson.

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