-By Danine Alati, Photography by Barry Halkin

Healthcare settings in general incite trepidation in even the healthiest of patients. And a cancer center elevates the stress level exponentially, as dealing with the disease from its diagnosis through treatment and recovery is a trying and emotional process. When designing the AtlantiCare Cancer Care Institute in Egg Harbor Township, N.J., EwingCole made a commitment to creating a "healthy" building that would benefit the patients and create a tranquil, comforting environment. Beyond taking special care when selecting colors, textures, and materials, EwingCole considered the specific functional requirements of those undergoing chemotherapy or radiation, and how to deliver this care in the most appropriate environment. The design team also seized the opportunity of working on a site in the New Jersey Pine Barrens, and allowed the natural surroundings to inform the interior design.

Fady Barmada, AIA, healthcare architect at EwingCole, explains, "We wanted to take full advantage of the Pine Barrens backdrop and bring nature into the design so that the building does not impose on its surroundings." Copious use of glass creates an element of transparency to offer views, blurring the interior and exterior and permitting sunlight to penetrate. Brick, stone, and Trespa (a building material resembling wood) on the exterior of the 40,000-sq. ft. structure are brought to the interior with a palette of bright, neutral, natural materials.

"There have been many documented, controlled studies that prove that this connection with natural surroundings promotes healing, and based on this notion, we thematically brought the surrounding wetlands into the building," says Andy Jarvis, AIA, principal for EwingCole's healthcare design practice. "There is extreme stress and anxiety associated with a cancer center, so we sought to create an environment of care that is functional, comforting, tranquil, and offers emotional support and a sense of optimism. There are therapeutic objectives to the building design."

Lauren M. Ochs, executive director, oncology services, AtlantiCare Regional Medical Center, The Cancer Care Institute, explains what the client requested from EwingCole. "We wanted the creation of an evidence-based, unique building that will be a healing environment with efficient patient flow, as well as a healthy environment for patients, visitors, and staff," she says. "We incorporated healing arts into the building, as 1 percent of our construction budget was allocated to the acquisition of original art of all mediums, created by N.J.-based artists."

As part of creating a healthy building, environmentally sustainable strategies ultimately earned the project a LEED Gold rating. Achieving LEED certification was not an initial goal of the project, "but it quickly became apparent how important it is," says Ochs. "We wanted to contribute to 'the greening of AtlantiCare,' and create a true healing/healthy environment for our patients. It was particularly prudent to pursue LEED certification for our cancer center, as when thinking about chemotherapy and radiation therapy, one does not associate these treatment modalities with a healthy environment."

The entry atrium with abundant glazing promotes daylighting, and the skylight of the lobby nourishes the growth of trees indoors, bringing the outside in. The designers also employed energy-efficient measures including insulation and a high-efficiency cooling and pumping system; use of low-VOC, low-off-gassing, and recycled materials; and reuse of as much material from existing walls, floors, and roof as possible. The green roofing system set outside the window of the chemotherapy bays facilitates the sustainable initiative and also gives patients a literal tie to their natural environment.

With a main goal of creating a psychologically uplifting environment, the designers kept the end users' state of mind at top of their minds throughout the design process. The floor plan is delineated so that the entrance for chemotherapy is different than that for radiation treatment. Radiation therapy and imaging patients are on the first floor, while medical oncology patients are on the second floor, along with shelled space for future expansion and physician time-share space.

"Circulation is set so that there is no backtracking, and it's a straight path from entry to reception to treatment and out, maintaining a connection to nature the whole time," Jarvis explains.

Since chemotherapy patients are hooked up to machines for hours with room-temperature treatment running through their bodies, it was crucial for the designers to create spaces that keep patients warm yet keep staff comfortable. A clever solution is radiant heat panels in the ceiling that target the patient in the treatment chair in such a specific way that it does not make the environment too hot for staff. Chemo bays reflect a beach motif, with dune grass pressed between the panels that separate each patient station. While radiation therapy takes a shorter amount of time and is not associated with pain, the technical machinery can cause some anxiety. To alleviate this tension, a skylight floods the areas immediately outside the radiation rooms with natural light.

Recognizing that "healthy buildings aide in the delivery of healthcare," Barmada explains that the designers viewed the challenges of creating this green cancer center as "an opportunity to help patients all the way through the process: dealing with anticipatory fears and responding with non-institutional, non-clinical, non-frightening interiors that make patients feel as at ease as possible." As a testament to EwingCole's painstaking design efforts, Ochs says, "Patient feedback has been excellent, as flow is very streamlined, and circulation is easy. They love it! And staff really appreciate the improvement in their work environment."


who
Project: AtlantiCare Cancer Care Institute. Client: AtlantiCare. Owner’s representative: Granary Associates. Architect: EwingCole; Andrew Jarvis, project principal; Fady Barmada, project designer; Glenna Dugan, project architect; Christina Kang, architectural team. Interior designer: EwingCole; Tara McGrath, Colleen Boland, interior designers. Structural engineer: EwingCole; Aitor Sanchez, Jonathan Memmel, structural designers. Mechanical engineer: EwingCole; David Gordon, project engineer. Electrical engineer: EwingCole; J. Vince Garcia, engineering leader. Plumbing engineer: EwingCole; Daniel Batt, project engineer. Construction manager: P.Agnes. Lighting designer: EwingCole; J. Vince Garcia. Furniture dealer: Cofco. Photographer: Barry Halkin.

what
Wallcoverings: JM Lynne, Wolf-Gordon. Paint: MAB Paint. Laminate: WilsonArt, Formica, Panolam. Dry wall: USG. Masonry: National Pool and Tile Group. Flooring: Armstrong World Industries, Forbo, Roppe, Amtico, Toli, Ergon Engineered Stone, Urbana, Casa Dolce Casa, Gerflor. Carpet/carpet tile: Shaw. Carpet fiber: Antron Legacy Nylon. Carpet backing: ecoworx tile. Ceiling: Armstrong World Industries, Decoustics, Modular Arts, Newmat. Lighting: Columbia, RSA Lighting, Prescolite, Philips, Delta Light, Lite Control, Color Kinetics. Doors: Eggers. Door hardware: Tru-Fit, Hagar, Best, Rockwood. Glass: 3Form. Window frames: RACO. Window treatments: Draper. Railings: Crescent Ironworks. Exam  room seating, conference tables: Davis. Exam room casegoods: Paone. Exam tables: Midmark. Patient overbed tables: Stryker. Exam room lighting: Pinnacle, Zumtobel. Lounge seating: Bernhardt. Conference seating: Keilhauer. Upholstery: Knoll Textiles, ArcCom. Coffee and side tables: Gunlocke, Hudson Furniture. Files and shelving: Allsteel. Woodworking and cabinetmaking: Paone. Elevators: Otis. HVAC: McQuay. Building management system: Siemens. Plumbing fixtures: Sloan, Kohler, American Standard.

where
Location: Egg Harbor Township, NJ. Total floor area: 39,600 sq. ft. No. of floors: 2. Average floor size: 19,800 sq. ft.