Healthcare Design - April 2023 - 39

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typical height of equipment vaults. Under normal circumstances, a linear
accelerator room might take up a one-and-a-half-story height in order
to fit enough concrete to contain the radiation from the equipment.
For AHN's project, the reality of squeezing the vaults into a tighter space
prompted the project team to consider alternatives to concrete, instead using
thin lead bricks. The solution was an added cost but reduced the thickness
of the radiation shielding between floors, enabling it to fit the tight
parameters of the urban site.
Taking advantage of the proximity to North Avenue, an areaway was
built into the facility that's accessible from the street to allow equipment
to be lowered into the subgrade level by crane. From there, equipment is
shifted along to the proper vault, whether in the new facility or through the
connection to the existing department. The project team worked to prepare
the construction and MEP infrastructure for the installation of new
equipment, ensuring that the space was ready for the highly specialized
delivery. Additionally, a removable roof on the areaway facilitates the replacement
of magnets in the future.
ADDRESSING PATIENT FLOW
Recognizing the variation in treatment at the facility, from the sickest
patients who may be pushed on a stretcher to comparatively healthy
patients who are able to direct themselves through the department,
Allegheny General Hospital wanted to separate inpatients and outpatients
to the greatest degree possible. Despite the complexity of merging
new and existing spaces at the basement level, the location of the cancer
institute allows the two patient populations to have separate circulation
paths. Specifically, inpatients enter from the existing hospital on one
side of the department, while outpatients come in from the street on the
opposite side. These two groups with differing needs can access the same
facility through separate corridors located on opposite sides of the basement
level.
Meanwhile, the ground-level atrium forms an iconic main lobby space in
the new building where patients and visitors can orient themselves relative
to the rest of the hospital. As people flow in from the street or hospital,
they converge in the atrium, which acts as the front door to the institute
and the campus beyond while also providing space for visitors to wait for
appointments, access informational resources, and gather socially.
MAXIMIZING NATURAL LIGHT, VIEWS
Another project goal was to provide as much access to natural light as possible
to facilitate healing. Due to limitations of the urban setting and proximity
to existing buildings, daylighting solutions had to be strategically
implemented to maximize effectiveness. Every effort was made to include
natural light in patient areas, such as a large infusion center where exterior
windows are distributed throughout the space to make views to the
park across North Avenue a focal point. The infusion area itself is set up as
shared lounge space instead of being divided among private infusion bays.
Some patients may be required to sit in their chair for many hours, while
others may have the ability to move around during the course of infusion
treatments, so the lounge provides options for seating with access to daylight.
The views of nature and city life offer a richer alternative to the TV,
phone, or surrounding patients.
These views are also present in patient and family waiting areas on all
floors, helping to orient visitors. Additionally, primary patient corridors
end in natural light, and a light well was created in the below-grade family
waiting area to carry daylight down to the radiation oncology department.
BLENDING OLD AND NEW
As much as the cancer institute is intended to
represent forward-thinking care, its design
also honors the historic nature of Allegheny
General Hospital. The new structure neighbors
the iconic South Tower of the existing
building, whose 22 stories of white brick rise
above the North Side landscape and are visible
from across the Allegheny River in downtown
Pittsburgh. This landmark has been a fixture
of the community for a century and is beloved
by residents of the surrounding neighborhood.
The design team recognized the significance of
the building and catered the new lobby atrium
to highlight the existing building's masonry articulation
and sculptural terracotta.
The design places tree-like columns in the
center of the atrium to avoid interfering with
the structure of the historic wall and to minimize
construction directly against it. Positioning
the columns away from the façade also
allows it to have an unobstructed presence in
the new facility. This preservation brings new
life to the intricate façade and provides the opportunity
for visitors to appreciate the filigree
up close.
MORE
ONLINE
For more images
of the completed
project, visit
hcdmagazine.com/
projects-ahn-cancerinstitute.
MEANINGFUL
CONNECTIONS
The complexities of building on urban sites may
be daunting, but they can be managed effectively
through strategic solutions and consistent collaboration
between the hospital and project
team. It's important to understand the existing
conditions and the obstacles that come with
them, but also to recognize when an obstacle
has the potential to become an opportunity. For
example, the historic façade of the South Tower
could have been easily covered up to simplify the
design of the new project. But by constructing
an atrium at this juncture of the old hospital and
the new facility, it instead highlights the institution's
legacy and provides a meaningful gathering
space for the community.
The best urban facilities fit seamlessly into
the context of the community and the landscape
of nearby architecture. While construction of
these facilities may pose additional challenges,
they ultimately create higher visibility as significant
care institutions integrated within the
surrounding neighborhood. 
John Keelan, AIA, ACHA, is a principal at IKM
Architecture (Pittsburgh). He can be reached at
JKEELAN@IKMINC.COM. Roger Hartung, AIA,
NCARB, is a principal at IKM Architecture. He can
be reached at RHARTUNG@IKMINC.COM .
APRIL 2023
39
http://www.hcdmagazine.com/projects-ahn-cancer-institute
Healthcare Design - April 2023

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