Richard L. Miller, AIA President Earl Swensson Associates, Inc. Nashville		Sam Burnette, AIA Senior Design Architect Earl Swensson Associates, Inc. Nashville

Entering an artificially lit, imposing, windowless building filled with a maze of institutionally hard, cold, colorless tunnels devoid of dignity and privacy is intimidating to any patient seeking healthcare services and treatment. To a cancer patient, however, the intimidation is magnified. Such an impersonal, unpleasant atmosphere can trigger fright and panic and leave optimism at the door. It is comparable to jumping into a dark chasm and not knowing how or where you will land.

Perception, in other words, can have everything to do with the attitudes of patients and medical professionals. And attitude matters. For cancer patients, particularly, personal attitude—both their's and the caregiver's—contribute to outcome, as shown by numerous studies. Positive equals positive, and vice versa.

Logic, therefore, follows that a patient's surroundings in a cancer care facility can create a perception or mindset of either optimism or pessimism. This is where the holistic approach to architecture and interior design enters the picture. This approach continues to gain followers for its value in all types of healthcare environments. Incorporation of the basic, organic elements of nature—natural light, plants, water, color, and texture—into a healthcare setting adds sensory dimensions to create perceptions that are soothing.

These organic elements, beyond adding a calming tone, contribute to an overall pleasing ambience and inject the familiarity of human scale into what may otherwise be foreign territory to the patient and family.

"Clinical studies show that patients do better under certain circumstances when placed in a serene atmosphere," says Dr. Julian Josey, medical director of radiation oncology of Spartanburg Regional Healthcare System, which is anchored by the 588-bed Spartanburg Regional Medical Center in Spartanburg, S.C. SRMC Cancer Center is one of the National Cancer Institute's original Community Clinical Oncology Program (CCOP) sites, allowing it to conduct prevention trials and clinical studies and make the industry's latest drugs and treatment options available.

Design is now being looked at in literally a different light than 20 years ago. "Radiation therapy centers traditionally have been placed on ground levels so that they can be backed up to earth," says Dr. Josey. "As if the disease isn't terrifying enough, the cancer patients are then taken to a 'vault' for treatment. We want to alleviate these fears. When natural elements of sunshine and green grass are added to this experience, the patient gains tremendous benefits."

The thought behind the natural, holistic concept is to create a sense of wellness-to build hope rather than dwell on negative aspects of the disease.

Other important, not-to-be-ignored considerations for creation of a patient comfort level include simplistic wayfinding and obvious visual cues to the areas of importance, such as a multi-story lobby visually expressing points of service on upper floors. To dispel confusion and unnecessary steps or wandering, the entrance needs to establish an unmistakable sense of entry and of place.

To make the entry and departure experiences less taxing, the big picture should provide the convenience of immediately adjacent parking and covered entries for the drop-off and pick-up of patients during inclement weather.