Family¡¯s cancer journey helps designer turn fragile moments into better projects
October 18, 2022
Using her personal experiences with cancer allows a designer to focus on patients, their support system, and safety
There is something compelling about designing healthcare spaces that can¡¯t quite be found with other types of projects. I will never tire of shaping the environment that people inhabit during their most vulnerable moments in life. Whether it¡¯s the patient waiting to receive a diagnosis, family or friends sitting close by holding their hand, or the care team member who is delivering the news¡ªeach of these forms of bravery is something we can meet with comfort through the power of design.
As we move through October, it¡¯s always encouraging to see the outpouring of support for breast cancer awareness. Fundraisers, walks, and the pink ribbon continue to fuel us in the race to find a cure.
Years before I became a healthcare designer, I was the daughter of a breast cancer survivor. My mother, mother-in-law, and aunts have all battled breast cancer with tenacity and strength. I have been the family member trying to process and understand what it meant while healthcare providers expressed with empathy that they did the best that they could.?
A rooftop garden overlooking the surrounding landscape is adjacent to the UPMC Pinnacle Ambulatory Care Building¡¯s infusion center. It is divided by a privacy screen offering patients a place to soak in the sun¡¯s warmth and visitors a place to decompress.
As I¡¯ve grown as a design professional, my priority has been to digest these fragile moments and use my personal experiences to guide healthcare design responses.
One size does not fit all
No two patients heal the same. My mother is a social butterfly, but that doesn¡¯t mean that the patient sitting next to her is too. It also doesn¡¯t mean that because my mother is typically outgoing that she won¡¯t want to seek solitude on days when treatment is hard.
When diagnosed with cancer, your health, among many other aspects of your life, can feel out of your hands. Designing healthcare spaces that allow patients to have choices in their surrounding environment can restore a sense of control and lower stress during their healing process while increasing their comfort.?
What if each time a patient walked into their infusion center, they could choose a different type of room to spend their day in?
At Thomas Jefferson University Hospital (TJUH) Specialty Care Pavilion, 12 private rooms are available for patients needing a higher level of care or privacy. The remaining 46 positions are open-infusion bays, half of which include flexible family seating and integrated technology that face towards neighboring patient¡¯s bays to promote conversation and a more social community. The other half are more inward facing for the patients that would like to focus on the company supporting them. Built-in family seating and entertainment technology are both located opposite the neighboring bays, which naturally positions the patient inward.?
Imaging treatment rooms include customizable light colors for patients to personalize the mood of the room to reduce stress before their upcoming examination.
Within the infusion bays, more layers of personalization can be added to create an experience tailored to each patient. At the University of Pittsburgh Medical Center (UPMC) Memorial Ambulatory Care Building, each diagnostic imaging treatment room has color-changing lights. That flexibility allows the patient to curate the mood of the room to reflect how they are feeling or set intentions for how they want to feel. This ability to adjust lighting can instill a sense of comfort and dampen stress.
It is a natural response to focus first on sight but taking the customization of other senses into account during design can further enhance the healing journey. Imagine this. Sound systems play a patient¡¯s personal playlist during treatment to create a sense of calm. Integrated systems control the room¡¯s scent to an aroma containing nervine properties of the patient's choice. Varying materials on seating elements provide comfort and feel like home.
Although these may feel like small decisions, control of the little things is a step in the direction of comfort and healing. Time and thought should be taken to consider how we can make treatment spaces flexible to respond to the varying needs of each patient.
My priority has been to digest these fragile moments and use my personal experiences to guide healthcare design responses.
Patient support system as an integral design feature
As cancer patients undergo treatment, they become more familiar with the place and the care team as time goes on. Their infusion center becomes like a second home. But for the visiting family of that patient, it can be intimidating to step inside such a space. Illness is inherently frightening. It¡¯s uncomfortable to see others in pain, there are no two ways about it. By designing with the perspective of a patient¡¯s family or support system in mind, it can lighten the stress for all in the difficult situation.
This integration can take many forms¡ªa dedicated seating area in the patient¡¯s room, lockers to store necessities, social lounges to rejuvenate, and even contemplative spaces to just take a breath. Giving supportive family and friends a place to step away can help prolong their stay, and visitor presence during this time in the patient¡¯s life is essential to maintaining a sense of normalcy and morale. It¡¯s this knowledge and firsthand experience that has helped me as a designer.
Healthcare environments can be filled with uncomfortable stimuli that increases visitors¡¯ stress. By introducing design elements such as a tranquil, contemplative waiting space it encourages visitors to find their own level of comfort and feel a sense of inclusion in the healing process.
My first healthcare design project was a Neurocritical Care ICU for Robert Wood Johnson University Hospital. As an ICU, typically the patients had experienced severe trauma and were often unconscious. So, our team explored the needs of the family and how that could impact the patients¡¯ healing. The programmed waiting space included an in-unit quiet waiting area, along with a traditional off-unit waiting area. Centered around an oculus-shaped skylight, the quiet waiting area provided a space for contemplation and for loved ones to catch their breath while remaining only a short distance away.
I took what I learned from the Neurocritical Care ICU and what I experienced as a cancer patient¡¯s family member and applied it to the cancer treatment spaces I later worked on. At the UPMC Memorial Ambulatory Care Building a rooftop garden overlooks the surrounding landscape adjacent to the infusion center. The garden is split in half with a privacy screen to offer both the patients a place to soak in the sun¡¯s warmth and visitors a place to decompress. At the TJUH Specialty Care Pavilion's Infusion Center, a common area with refreshments and lounge was centrally located inside the unit for family members to step away and recharge. The lounge is the first thing you see upon entering the unit, reinforcing the importance of community.
Prioritizing patient safety
A few months into working on the TJUH Specialty Care Pavilion, cancer was once again at the forefront of my world. As I was actively working on planning the infusion center, as well as its supporting pharmacy and imaging suite, my mother-in-law was diagnosed with cancer. She shortly thereafter passed away while receiving an infusion. Due to the COVID-19 pandemic, I never got a chance to see her treatment facility. I often wonder about the design and if it could have been planned better to increase response times and reactions to crises. Continuing to work on TJUH Specialty Care Pavilion¡¯s Infusion Center after this was extremely delicate for me. I was more sensitive to the patient population than ever and felt a personal responsibility to create a space that would prioritize patient safety.?
Decentralized nurse stations are located among every four infusion bays to increase visual and audible monitoring of patients.
Our design for the infusion center includes several decentralized nurse stations that accommodate two care team members spaced evenly at every four patient bays. While this concept was a departure from their previous operations and consumed a lot of programmed area, it was easy to support knowing that it increased patient monitoring and access. A centralized station is still located at the entrance to the unit, but the 12 smaller stations allow for better distribution and more immediate care. Each decentralized touchdown is open to the next, which improves visual and audible connections across the unit in the event of an emergency.
Through my personal experience I was able to fully appreciate the urgency that is often required in these spaces in a way that I would not have before and in a way that I wish no one else experience. Not only are we tasked with creating spaces that feel calm and promote positivity for everyone involved but we are depended upon for making them safe and functional at the same time. This balance is something I hope others can learn from and carry forward with them.
Using life experiences to design better
While I wish experiencing cancer firsthand was never part of my family¡¯s life, I am grateful to be able to take my personal experiences and leverage them to better serve future patients and their families.