Abstract

The Advanced Treatment Center project at Fox Chase Cancer Center is a strategic response to the escalating demand for innovation in outpatient infusion therapies. The primary objective is to strategically repurpose, maximise, and revitalise the existing hospital campus, envisioning its transformation into an advanced treatment centre with a modern, patient-centric design, well aligned with the world-class clinical treatments provided. This vision also seeks to breathe new life into the institution’s brand.

The project was devised to address challenges arising from increasing demand for outpatient infusion services. Its vision includes enhancements in infusion services, the introduction of a purpose-built theranostics centre, and the establishment of a dedicated day hospital tailored for bone marrow transplant (BMT) patients.

The project’s multifaceted goals encompass a proactive response to innovations in cancer treatment, optimising outside views for infusion chairs to create a therapeutic environment, maintaining operational continuity without reducing cases, and implementing phasing of a series of smaller, manageable endeavours, while ensuring uninterrupted patient care throughout construction. Recognising the importance of patient experience, the project aims to update the arrival and registration processes while optimising space usage of hospital-based clinical programmes.

The phased construction plan is designed to ensure continuous operation of critical services. Emphasis on cost-effective adaptive re-use demonstrates that thoughtful programming, planning, and building analysis can yield a beautiful, dynamic space that responds to treatment innovations, improves clinical care delivery, and enhances positive patient experiences and healing. In close collaboration with Fox Chase’s leadership, NORR Architects employed advanced 3D visualisation tools and storytelling techniques to communicate the goals of the project and garner support.

The overarching strategy of the advanced treatment centre project goes beyond meeting clinical needs; it endeavours to create a buzz around transformative efforts, encouraging philanthropy and engaging the loyal patient community. This strategic engagement aims to secure the necessary support for the project’s ambitious goals and reinforces Fox Chase Cancer Center’s position as a leader in cancer care. This holistic transformation not only revamps the physical infrastructure but also positions Fox Chase Cancer Center as a modern, patient-centric facility dedicated to continual innovation in cancer care.

Full article

Fox Chase Cancer Center, a component of the Temple University Health System (TUHS), has a rich history dating back to 1904 when it was founded as the American Oncologic Hospital (AOH) in West Philadelphia. It has since emerged as a major player in the fight against cancer. Over the decades, Fox Chase solidified its reputation as a world-class institution, earning comprehensive designation from the National Cancer Institute in 1974 and playing a pivotal role in several groundbreaking scientific discoveries, including the Philadelphia Chromosome and the development of the Hepatitis B vaccine, as well as involvement in numerous clinical trials that have become the accepted standard of care for many cancer therapies.

Situated in the tranquil confines of Burholme Park, Fox Chase’s main campus boasts a diverse array of facilities, ranging from the historic Reimann Research Building to the state-of-the-art Young Clinical Pavilion. With its network extending across eight additional locations, Fox Chase is deeply embedded in the fabric of the Philadelphia community, providing accessible and exemplary cancer care for all.

The cancer centre, however, is not immune to the same healthcare environment challenges facing many other healthcare organisations in the US. It’s also impacted by the role that  Temple University Health System plays in the support of the increasingly underserved population of inner-city Philadelphia. Indeed, the TUHS flagship hospital provides more charity care than any similar sized hospital in the United States. The healthcare economy is under immense pressure to grow revenue, reduce costs, and increase overall productivity, while simultaneously supporting the growing population of uninsured or underinsured patients in their catchment areas. In this landscape, cancer care stands as a focal point, with demands for innovative treatments and patient-centric care on the rise. Against this backdrop, Fox Chase seeks to maintain its position as a leader in cancer care, adapting to the changing healthcare landscape while upholding its commitment to excellence and innovation.

NORR Architects has collaborated with Fox Chase and TUHS on a variety of projects across the Fox Chase campus and network. These included renovations to the Urology Institute and Boo’s Boutique, as well as the development of Interior Design Finish and Wayfinding Standards. As this ongoing collaboration flourished, Fox Chase recognised the value of NORR’s expertise and engaged the design practice in what initially appeared to be a simple study to expand its infusion treatment programme into the soon-to-be-vacated pharmacy. However, this endeavour evolved into the ambitious Advanced Treatment Center project.

The Advanced Treatment Center Study represented a strategic initiative aimed at ensuring that Fox Chase remains at the leading edge of cancer care. It began through a close collaboration with Fox Chase’s leadership team to provide a comprehensive assessment of the existing conditions, meticulously examining the layout, functionality and limitations of the current facilities. Through this process, the project team identified key areas for improvement and opportunities for innovation.

As part of the Advanced Treatment Center project, the Fox Chase Cancer Center recognised the pressing need to address the limitations of its existing outpatient infusion facility. Engaging NORR Architects, TUHS commissioned a comprehensive concept study to analyse how to expand infusion chair capacity by at least 25 per cent, incorporate a new theranostics centre, develop a day hospital to support the growing cellular therapy programme, and renovate the entire floor to conform to the finish standards that the architects helped the health provider develop ­– all while maintaining ongoing operations. Significant building expansion was never an option. The original charge was simply to re-use the existing footprint in a more creative and cost-effective way.

Theranostics, also known as radioligand therapy (RLT), uses infused radioisotopes attached to ligands, which bond to cancer cells and destroy them. The administration of these short half-life products requires a very controlled environment to ensure the safety of staff and caregivers. These products also have applications in the molecular imaging space to enhance diagnostic accuracy using PET/CT. Today, therapeutic uses are primarily focused on the treatment of metastatic prostate cancer but new applications in different disease sites are being explored in clinical trials. 

Day hospitals in cancer centres are specially designed environments that support patients receiving cellular therapies ranging from autologous transplants to CAR-T. The focus is on the care and comfort of the patient, so they can avoid a lengthy hospital admission. This controlled environment needs to meet a range of conditions, supporting treatments that could be 8-10 hours in length but allow the patient to sleep in their own bed.

In collaboration with department heads from infusion, outpatient clinic, clinical research unit, and bone marrow transplant, NORR Architects assessed programme space needs and requirements. Attention was paid to regulatory considerations, ensuring compliance with licensing and regulatory standards.

The scope of work ultimately outlined by NORR Architects encompassed not only massive renovations of physical spaces but also the strategic phasing of the project to align with funding availability, with a focus on sustaining operations of these key clinical areas. A key aspect of this phased approach involved an enabling phase, which entailed relocating the existing pre-anaesthesia testing (PAT) clinic to free up space for subsequent construction activities. In addition, the relocation of the pharmacy was already underway as a separate project. This soon to be vacated area was the free space in the densely occupied existing plan, crucial to the implementation of the new plan, with completion expected before construction was due to commence to allow for the fit-out of vacated space.

One of the primary objectives of the concept study was to reimagine the entry experience for patients and visitors. The existing entrance, characterised by a compressed and dated appearance, was deemed inadequate for the institution’s evolving needs. NORR proposed a redesign that involved relocating registration and admissions areas, along with renovating the entry lobby to create a spacious and inviting waiting area. This transformation aimed to provide a more welcoming environment and offered opportunities for new branding elements, reinforcing Fox Chase’s identity as a leader in cancer care. The addition of a new entrance vestibule and raised ceiling was identified to alleviate the compressed feeling experienced upon entering the facility while also serving as a vertical expansion, which would enhance the overall aesthetic and functionality of the space.

Despite the challenges posed by funding constraints, NORR Architects and Fox Chase’s leadership team were committed to realising the Advanced Treatment Center project. Recognising the importance of community support, NORR made use of its design tools to create compelling visuals that illustrated the impact of essential renovations to the facility. These ‘eye candy’ concept design visuals were used by Fox Chase’s philanthropy team in creating a video to garner support and raise funds for the project at their annual gala and activities beyond. In addition, the initial phase will be funded entirely through philanthropic efforts.

As the study is now progressing into a funded project, feedback from stakeholders will continue to inform and refine the design concepts. Benchmarking, iterative design reviews, mock-up evaluations, and user input will validate proposed solutions and identify areas for improvement. Through this iterative process, the project team will remain responsive to evolving needs and priorities, ensuring that the final design meets high standards of innovation, while meeting the clinical and technical needs required by the clinical programme.  Patient input will be incorporated at every step to ensure that the space is redeveloped to deliver a patient- and caregiver-friendly environment, in keeping with the Fox Chase philosophy of placing the needs of the patient first.

The transformation of the Advanced Treatment Center stands as a testament to the pivotal role of strategic engagement, collaborative innovation, and unwavering commitment to patient-centric design in changing healthcare. Through a rigorous process of assessment, meticulous planning, and flawless execution, NORR and Fox Chase are not only navigating the intricacies and hurdles of today’s healthcare setting and regulatory requirements but also placing paramount importance on meeting the diverse needs and enhancing the experiences of its patients, caregivers and staff. By exploring the application of theoretical models and design concepts, Fox Chase not only adapts to the ever-changing demands of healthcare but is also committing to enhancing patient outcomes and satisfaction through thoughtfully planned, high-value initiatives that will optimise every resource available.

More than mere physical renovations, this project epitomises an enduring commitment to transformative innovation and delivering high standards of care in cancer treatment. While positioning itself at the forefront of clinical design innovation, Fox Chase acknowledges that adaptability and affordability must remain cornerstones of the facility’s development. The groundbreaking therapies envisaged for support within the Advanced Treatment Center were mere theoretical concepts just 15 years ago, yet they now stand as symbols of scientific progress, illuminating the path towards major advancement in cancer care.

Dedicated to providing quality, cutting-edge care in the community, the Advanced Treatment Center is poised not only to serve as a beacon of hope and progress in the relentless fight against cancer but also to reinvigorate Fox Chase’s reputation as a trusted leader in innovative healthcare solutions.

About the authors

Haley Driscoll, IIDA, CHID is principal at NORR; and Joel Helmke, MSHP, FACHE is chief operating officer at Temple University Health System, Fox Chase Cancer Center.