Healthcare Design - April 2023 - 38

In F o cus
2/5
includes several substantial additions since the
1970s, such as a 10-story patient tower completed
in 1981. As a result of generations of construction,
the cancer center site is restricted on
three sides by existing buildings, on the fourth
side by busy North Avenue, and from above by
flight paths to the nearby helipad located atop a
garage. With two basement levels aligning with
the subgrade floors of the existing hospital, the
new facility also sits below the foundations of
some of the surrounding buildings.
Upon excavation of new foundations for the
new cancer facility, shoring and bracing solutions
were implemented to support the neighboring
structures, which included the original hospital,
a 1986 clinical building, and the garage with helipad.
However, construction phasing plans required
flexibility to accommodate circumstances
that arose during construction, such as unforeseeable
subgrade conditions and temporary brief
construction pauses to accommodate the nearby
emergency department helipad.
ABOVE: The new cancer
institute sits prominently
on North Avenue,
serving as a front
door to the Allegheny
General Hospital campus
in the urban North
Side neighborhood
of Pittsburgh. BELOW:
The bright, airy atrium
lobby showcases the
historic institution in a
contemporary space.
Redesigns occasionally affected program in addition to structure. In
these cases, it was necessary to evaluate the balance of engineering feasibility,
construction cost, and program impact. For example, one solution
to the space planning challenges associated with the tight site was to create
an entrance experience through the adjacent existing garage. Additionally,
each floor plan iteration was analyzed as part of a larger whole to achieve
seamless integration with the overall campus.
Because it's not always possible to understand the full picture of site conditions
before breaking ground, consistent collaboration between the architect,
engineers, and hospital was vital to maintaining momentum on the
project. The project team was also in contact with the city to manage access
to the site from North Avenue, a primary conduit across multiple adjacent
neighborhoods, gaining permission to block off a lane throughout the construction
period.
CONNECTING TO EXISTING SERVICES
Placing the cancer institute beside the original hospital building allowed
the existing radiation oncology department to connect and expand into the
new facility, creating space for new equipment including a gamma pod and
an MRI-guided linear accelerator. However, with the existing department
housed on the second basement level below grade, seamless expansion
required the cancer institute to match a depth of 14 feet below the lowest
grade, or 27 feet below the first floor of the hospital.
The benefit and convenience of merging new space with old was determined
to be worth the added expense and complexity of digging down further.
It enabled the radiation oncology department to seamlessly expand
without disruption to the existing services and created a natural link between
the 1936 structure and the new facility. This connectivity continues
at the street level, where the addition's new lobby atrium acts as a junction
for those entering the institute from the hospital and those entering from
the street.
PLANNING FOR EQUIPMENT INSTALLATION
Along with construction of a new cancer care facility comes installation
of the latest technology to best treat patients. For this project, the challenge
of accommodating equipment came in two forms: designing the
vaults and physically moving the equipment into place. Here, not only is
the radiation oncology department below grade, but connectivity to the
existing hospital dictated a set floor-to-floor height that's less than the
38
APRIL 2023
HCDMAGAZINE.COM
ADAM WARNER, IKM ARCHITECTURE (EXTERIOR); ED MASSERY (ATRIUM LOBBY)
http://www.HCDMAGAZINE.COM
Healthcare Design - April 2023

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