World-Class Cancer Care, Hometown Location
CHALLENGE
A rural Appalachian community has some of the highest rates of cancer mortality in America. A deep dive into some of the root causes yielded an easily fixable solution: many patient in the region prematurely halted their cancer care due to the burden associated with seeking on-going care. Patients in need is cancer infusion services had to drive a minimum of 90 minutes on two-lane roads over multiple mountains. For some particularly ill patients, the travel was just too physically difficult. For other patients, access barriers, like limited transportation options and even money, caused many patients to give up on their care much too soon. Patients with curable forms of cancer were dying prematurely. In partnership with a regional academic medical center, the local critical access hospital decided it was time to take action. Together, the two organizations would build a cancer infusion center in a community where one had never been before.
Baseline strategy validation
Operational analysis
Clinical functionality assessment
Patient consumer demographic analysis
Patient consumer experiential analysis
Provider consumer experiential analysis
Asset inventory
Facility condition assessment
Co-creation sessions to explore tomorrow’s cancer care
Co-creation sessions to explore the cancer patient and provider consumer experience
Site tours
Customized demand projections
Site of service planning
Key room forecast
Space programming
Phasing strategies
Clinical design peer review
APPROACH
The client had limited experience with designing and constructing a cancer infusion center other than the information it had gathered from interactions with their cancer care partner and visits to other cancer centers.
The project began by validating the organization’s strategy, translating the strategy into customized volume projections and space needs. Recognizing that the needs and health equity challenges facing the community are markedly different than those in more densely populated areas, a deep dive into the local community was undertaken. One-on-one conversations, consumer segmentation, shadowing and direct observation were combined with immersion strategies to learn as much as possible about the unique characteristics and culture of the region.
During the planning process, it became obvious that multiple phased campus moves would be required to facilitate opening the infusion center. Namely, administrative spaces would nee to be relocated and the pharmacy expanded to support USP-800 functions. With speed to market a priority, this required careful phasing and parallel design and construction processes.
RESULTS
The cancer infusion center has opened with great anticipation and fanfare with 10 infusion bays provide a combination of private and more social environments, giving patients more control over their infusion experience. Lounge chairs and bedded options also exist to accommodate ambulatory patients as well as those not feeling as well. Pandemic-inspired social distancing prompted the decision to create separate entrance to the cancer infusion center to protect those from weakened immune systems from potentially contagious individuals.
Expansion of the pharmacy required relocation of the department to another area in the building. The location of existing 4-bed ICU was selected as the most logical space for the expanded pharmacy. To accommodate this relocation, the ICU was moved to a newly renovated pod on the medical / surgical unit. This relocation facilitated the design and construction of state-of-the-art ICU rooms. With the ICU embedded on the medical / surgical unit, labor costs can be reduced during times when the ICU census is low.
90 min
reduction in travel times in the region for cancer care
$500K
projected annual labor cost reduction from relocation of ICU to support expanded pharmacy