Radiation therapy is physically and psychologically grueling. And because of the technology required, it often takes place in sterile, dim, underground spaces. But for its Radiation Oncology Center in Anaheim, California, the medical provider Kaiser Permanente ditched the institutional feel and tried to infuse spa-like touches where it could. This wasn't just about making patients feel comfortable. This was about helping improve medical outcomes.
To create the building, Kaiser Permanente enlisted Yazdani Studio, the experimental arm of global architecture firm CannonDesign. The studio's founder, Mehrdad Yazdani, worked closely with Carlos Amato, the Los Angeles health leader for CannonDesign and an architect with more than 25 years of experience designing for the health care industry.
Yazdani, who's known for injecting his projects with an artistic sensibility, first began to think about what the building should communicate to its users and how it should fit in with its surroundings. The 16,000-square-foot building is one part of a master plan for Kaiser Permanente's forthcoming medical school and campus that Yazdani Studio is also designing.
"I started thinking completely independent of functionality—what should this building be?" Yazdani says. "I began to draw and almost paint on my computer this notion of a beacon of hope, something that was light, somewhat ethereal, and something that was distinguished but at the same time gave the patient and their family a level of comfort."
To achieve this, Yazdani Studio made virtually every space within the center a room with a landscape view. "The plan is the result of keeping the cancer patient and their emotions and experiences front and center and then designing around that reality," Amato says. "Harnessing natural light, views to nature, and a soothing interior helps creating a calming and nature-oriented experience rarely seen in these types of buildings."
Cancer treatment centers generate radiation through powerful linear accelerators, which are typically located underground to help contain the radiation. With this building, Kaiser Permanente wanted to bring the experience above ground.
"The main problem with traditional radiation oncology centers is that technology and building challenges overshadow all other priorities," Amato says. "Kaiser Permanente allowed us to explore alternative ideas that led to a solution that was not exclusively driven by construction."
Early in the process of designing the center, Yazdani interviewed patients and providers about what their idea experience in a cancer treatment center would have. Often, it turned to light and air.
"Traditional radiation centers were built in basements, thus creating a very dark and unpleasant environment," says Giang Hong, supervisor of clinical radiation therapy at Kaiser Permanente's Anaheim outpost. "Our center is above ground with many elements that allow views to the outside environment and natural light, which promotes a happier place to be treated and to work."
In order to build the structure above ground, the architects still needed to find ways to contain the radiation. They oriented the three treatment rooms in the building's core and constructed thick concrete walls around them. Yazdani refers to this area of the building as "the vault." Medical offices, support spaces, CT imaging rooms, and exam rooms are located along the building's periphery.
Although the vault is in the building's center, far from the perimeter, Yazdani Studio carved out enough space to wedge in a vertical "zen" garden that patients can see through a floor-to-ceiling wall of glass. "In order to reduce the anxiety and stress of patients, we wanted to bring daylight into the vault," Yazdani says.
The building faces a busy boulevard in Anaheim and rises near the entrance to Kaiser Permanente's campus. Because of the building's visibility, the architects had to think about ways to make the structure stand out in the right ways while protecting the privacy of patients.
"It’s a very public site for a very private experience," Yazdani says. "And it’s a building that’s small, but wants to be distinguished."
Because there's no "back" to the building, Yazdani designed it to have a circular footprint. To shield radiation coming from the vault, the building's walls are extra tall, but to make the scale less foreboding to patients, the walls gently slope to a shorter height near the entrance. The curved walls are also positioned like a broken spiral offering space for landscape designs and creating multiple entry points to the building.
The majority of the facade is glass. Because of that, Yazdani Studio had to find a way to provide the right level of privacy for each interior space depending on how it's used. The solution? Fritted glass—glass with a silkscreened pattern. By varying the pattern's density, the architects could offer privacy, a visual flourish, and still let daylight in—all in one gesture. Doctor's offices are more transparent and exam rooms are more opaque.
Light and landscape are only one part of the spa-like experience. The reception area is clad with warm woods. The architects recessed the lighting in alcoves so that the walls and ceiling appear to glow (much better than harsh fluorescent bulbs). Comfortable modern furniture offers a place to wait, and it's arranged to face a garden. Once patients are admitted, they're escorted to a private area where they change into a robe to await treatment, much like you would at a spa.
While this experience was designed and choreographed to reduce anxiety in patients, it also helps the doctors, nurses, and staff.
"It was clear from the start that operational performance would be increased by providing clinicians with a space that inspired them," Amato says.
By borrowing architectural tricks from service-oriented luxury environments like spas, which design their spaces to make customers feel like their $500 facials are worth the expense, Kaiser Permanente is attempting to transform the perception of a dreaded and demanding medical procedure. Of course, it will never be exactly like a spa, nor should it—but psychology is a powerful thing. Offering a more comfortable experience may help lure talented providers looking for a nicer work environment. And it stands to reason that the better your staff, the better your medical outcomes.
"With health care facilities, design is almost always compromised for other priorities, but with the Kaiser Permanente Radiation Oncology Center, it’s not," Amato says. "The building plan and design is simple—and that’s on purpose. That simple planning celebrates nature and light."
All Photos: courtesy Yazdani Studio