Snehal Bhoola, MD
Typical examination room doors separate slightly from the doorframe as they open and allow passersby to see into the rooms. It’s hardly ideal for a half-dressed patient inside. That’s why the new Arizona Oncology building at Arizona State University Research Park, southeast of Phoenix, has door-length hinges that eliminate gaps and protect patients from exposure.
It’s a small detail, but it illustrates how much architects can tailor new buildings to oncology’s specific needs and why Arizona Oncology, as it tries to succeed in an unusually competitive market, built its newest facility from the ground up rather than renting generic offices.
The greater Phoenix area is home to at least a half dozen other private practices, several large hospital chains, and satellite branches of the Mayo Clinic and MD Anderson Cancer Center. Each of these competitors is constantly working to expand its treatment options, improve the patient experience, and increase market share.
The freedom to build and expand can work against the best interests of practices. “Unlike some other states, Arizona does not require medical practices to demonstrate need for new services,” said Snehal Bhoola, MD, a practice partner who specializes in gynecologic oncology. “Private practices and corporations can build new facilities, buy new equipment, and otherwise expand as they see fit. It does not create the most stable and secure of business climates for healthcare providers, but it’s probably a good thing overall because it keeps us striving to get better and innovate.
“There are, obviously, a huge number of factors that decide which practices will succeed. We believe that all-inclusive facilities are a major differentiating factor and that this new location will be a major competitive advantage for us in the region it serves,” he said.
The 22,000-square-foot building has 19 exam rooms, 35 infusion chairs, a compounding pharmacy that is compliant with pending US Pharmacopeia <800> standards, and a retail pharmacy. Its diagnostic-imaging nuclear medicine department houses a positron emission tomography—computed tomography scan. Its 2 concrete radiology treatment vaults contain an external-beam treatment linear accelerator and internal radiation therapy with high-dose radiation brachytherapy equipment. Its staff includes 3 medical oncologists, 2 gynecologic oncologists, and 1 radiation oncologist, as well as genetic counselors, dedicated research nurses, financial counselors, nurse navigators, pharmacists, and nurses specializing in every cancer treatment modality.
Among Arizona Oncology’s competitors, only Mayo and MD Anderson can boast of so many treatment options under a single roof, and Bhoola contends that good design makes the new facility better for most patients than anything those renowned organizations can offer.
For example, patients park in a small lot, a short distance from the entrance, rather than in a huge garage that would require a long walk. The facility itself, while large by the standards of private oncology, still does not approach the dimensions of most hospitals. The radiation vaults are a few steps from the infusion chairs instead of being down in a distant basement.
Avoiding those extra steps is important to patients who are often significantly weakened by cancer and chemotherapy. Workers appreciate the convenience as well. Time spent walking affects productivity, which is why the architects who designed Arizona Oncology’s new facility modified their plans again and again to minimize steps for patients and staff alike.
“Essentially, we calculated all the places that every person inside the building would typically need to go and compared the efficiency of various layouts, with the emphasis on saving steps for patients,” said lead architect David B. Howell, the principal at David B. Howell Architecture & Design, of Tucson, Arizona.
Typical medical office design has cancer patients moving back and forth from a single large waiting area to examination rooms, infusion chairs, and other treatment zones. In the new Arizona Oncology building, each division—medical, gynecologic and radiation—has its own corridor, and the treatment rooms are organized such that the rooms patients are most likely to visit are closest to the entrance. To spare patients from unnecessary walking, there are mini-waiting areas between each of the major service areas.
“The emphasis on efficiency carried over into the individual rooms as well,” Howell said. “Many large treatment centers put a single nursing station to one side of their main infusion rooms. The new center has several nursing stations, so each nurse is closer to patients. Shave a few seconds off each walk and multiply that by the hundreds of trips that a nurse makes in a typical day, and you’ve given nurses significantly more time to help patients.”