Today, more people can live through cancer than ever before thanks to medical and technological advances. But cancer diagnoses remain completely life altering for patients and their families, and the built environment can exacerbate the difficulties of living with disease, or it can alleviate them.

As architects and design researchers, we understand it is our responsibility to ensure patients can do more than survive cancer. We strive to create heartfelt places where they can be comfortable and calm during some of their most vulnerable days — inpatient and outpatient environments where they can have hope for a brighter future.

So how do we leverage design to make life easier for cancer patients? Through research, collaboration and a commitment to centering the patient experience through design, we seek to create better outcomes and support holistic well-being with these approaches: 

1 – Evaluate What Exists and Determine Would Could Be

The design of oncology environments can influence how safe, comfortable and trusting patients feel throughout their cancer care journey. With the fast pace of today’s technology and treatment interventions, clinical spaces must be designed to be ready to handle new methods of care for decades to come, as well as the changing needs and desires of patients. Our teams conduct robust analyses of existing environments and engage with health system stakeholders, staff, patients and families to determine what works, what doesn’t, and establish guiding principles for cancer care projects. Focusing on patient experience in design has become paramount for clinical effectiveness and outcomes. Through our research and design processes, we help create places that enable health systems to enhance patients’ comfort, and ease across the care continuum. 

The Mount Sinai Hospital Tisch Cancer Hospital will transform cancer care in New York City with broader access to breakthrough therapies, diagnostics, and clinical trials while providing advanced, personalized treatment and holistic care. At the beginning of our visioning and design process, the HKS team evaluated existing facilities as part of a comprehensive research and design approach to transform a 1952 building into a 210,000 square foot best-in-class new cancer hospital environment that is ready to take on these new ways of delivering cancer care quickly and efficiently. Patient rooms in the existing facility had inboard toilet rooms with a wall that blocked views from the patient room to the nurse’s station. As the project included an entire gut renovation, our team was able to offer the solution of nested toilet rooms that allow for full height glass doors so patients and providers can see into and out of the room and can control for privacy and comfort with integral blinds.

In our years of experience, we’ve seen clients and communities increasingly desire evidence-based approaches to design, as they align with evidence-based medical innovations. At UW Health Eastpark Medical Center in Madison, Wisconsin —a seven-story ambulatory center with multispecialty clinics and oncology services that opened this fall — our team was challenged to provide a full range of research plans to link design to outcomes from the early proposal stages. The team’s Evidence-Based Design Touchstone Award-winning design came as a result of layering sophisticated planning and research tools to provide options for unit layout, amenities, and clinical flexibility so UW Health could make value-based decisions to enhance patient care. To help achieve a coordinated care journey for every patient, the building is organized around a repeatable and scalable clinical module, which supports future uses as clinical programs evolve. Our partnership with UW Health exemplifies that health systems have adopted a mindset of continuous improvement in creating their facilities and are looking to designers to help them transform care and patient experiences for the better.

2 – Enable Personalization, Flexibility and Choice

Clinical environments can feel far from personal and far from the comforts of home for cancer patients. And as cancer treatment approaches advance to support personalized medicine —strategies tailored to a person’s specific genetics and conditions — clinical environments must adapt. We identified the notion that personalized medicine can lead to personalized place in our 2018 research about cancer care facilities of the future. During the last several years, we’ve been exploring this idea further, driven by the understanding that creating truly personalized places means providing comfort in all settings within a cancer clinic or hospital. 

Personalization, flexibility and choice are intertwined design strategies that can be applied in cancer care environments at all scales from individual patient rooms to full units to the entire building or campus. We design specialty spaces where patients can choose surroundings that suit their physical, mental and emotional condition. Some examples include wig fitting areas where they can develop a sense of acceptance and normalcy, enclosed jewel box cafeterias where they don’t have to smell food unless they go inside, and communal spaces where they can choose to engage with others about their recovery journeys.

At UW Health Eastpark Medical Center, one of our challenges was to make sure each of the various clinics had flexibility, so that as the health system’s needs changed, they could be combined or right-sized over time. In outpatient treatment spaces, we incorporated evidence-based design strategies and solutions inspired by conversations with a Patient Family Advisory Group. 

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Noting that each patient may arrive for infusion treatment feeling different emotions or be in various states of physical wellness, the design team planned for choice throughout the unit. Infusion spaces include private rooms and semi-private bays, as well as a communal space where patients who are interested in socializing with others can pass the time together during treatment. The communal space can also flex into semi-private areas, ensuring that on any given treatment day, patients’ sensory and emotional needs can be met.

Similarly, The Mount Sinai Hospital Tisch Cancer Hospital’s private patient rooms are designed for operational flexibility and acuity level. As the project was designed during the height of COVID-19 pandemic, a desire for adaptability drove the decision to create acuity adaptable patient rooms. They can flex and transform into ICU rooms equipped with the appropriate gases, pressurizations and sightlines to accommodate patients of any acuity. In addition to easing care delivery for providers, this flexibility allows patients to stay in one place and not have to transfer to a different unit or floor, so they have some stability as they undergo treatment.

The private rooms also include fully integrated technology that maximizes patients’ control of their environment and experience. With a tablet, patients can control window blinds and lights, look at treatment schedules, order food, and even video chat with loved ones. 

3 – Supercharge Well-being with Biophilia and Amenities

It’s widely known that research shows patient healing and well-being are improved in spaces with access to elements of nature. Biophilic design strategies are essentially non-negotiable in cancer care environments today, but they can be challenging to incorporate. Contamination due to soil and polluted air can be harmful to vulnerable populations, but as designers, we strive to create environments that provide biophilic benefits that are safe for all patients. 

In addition to the floor-to-ceiling windows in every patient room at The Mount Sinai Hospital Tisch Cancer Hospital, the design also includes a two-story interior sky garden with a synthetic green wall. The sky garden cantilevers out from the building so patients, families and staff can relax in a biophilic environment, light filled environment that feels as close as possible to being outdoors.

The hospital also includes a first floor a medi-spa holistic care environment, a massage, acupuncture and reiki room, a hair salon, and an education and patient, family and staff support room, and a café with healthy food options. The design approach caters to the diverse needs of patients and families who want to take advantage of different services and opportunities for respite. Ultimately, it is intended to give back to patients and staff, so they know they’re being taken care of in a space that was designed for them. 

UW Health Eastpark Medical Center likewise incorporates holistic wellness and biophilia. The building is organized in a C-shape around a large central courtyard, which allows natural light to flow through nearly every space and aids wayfinding and orientation. The design integrates architectural and landscape design, enabling seamless transitions between interior and exterior environments. Scenic public corridors and walking trails throughout the campus promote mobility, and the courtyard includes a variety of zones for different modes of activity from quiet reflection to dining and exercise. 

The hospital also features a robust nature-inspired art program that provides positive distractions and a sense of calm. And an integrated services section features massage, acupuncture and other wellness programming for patients where patients can further their healing in a beautiful, restorative environment. The project’s commitment to holistic wellness corresponds with high-performance design elements like carbon neutral proton therapy center, proving that human and environmental well-being can be designed to go together.

4 – Create Space for Hope and Celebration

For many, the day-to-day experience of living with cancer can be marked by hurdles. But it can also be marked by positive milestones like successfully completing one round treatment, healing after surgery, and with hope, entering remission. Celebrating these moments should not be overlooked, and as designers, we have a role to play in helping patients be able to focus on the wins they fight so hard to get.

Many different spaces can be used for celebration throughout the patient journey including family respite rooms, wellness centers or outdoor spaces like the courtyard at UW Health Eastpark. But we also increasingly seek to create places intentionally designed for celebration. One design strategy our teams have integrated in our hospitals, including new The Mount Sinai Hospital Tisch Cancer Hospital, is “destination dining” where patients and their families can enjoy celebratory meals and receptions alongside staff upon the completion of their treatment. 

Creating meaningful space for positivity is a powerful step forward that is helping us shift the narrative about what a cancer care environment can be. Cancer care environments can be regenerative for patients, and the best thing we can do as architects and designers is to help people have a vision and hope for their future. Some might say that a building can’t do that, but we believe it can.