The Breast Center serves as an important part of Anne Arundel Medical Center’s cancer program and is located immediately adjacent to the two-story lobby of AAMC’s 165,000 gsf ambulatory care facility, the Lesly & Pat Sajak Pavilion. The Breast Center is immediately adjacent to one of AAMC’s diagnostic imaging centers. Although these distinct entities can operate independently, CRGA designed the departments with deliberate adjacencies to maximize the potential for shared program functions, shared imaging equipment, and staffing efficiencies.
A key design focus was to create an environment that supports the delivery of care in a private, confidential, and dignified manner. The layout of the space and the selection of finishes and furnishings focused on the need to create a very “soft,” non-clinical environment. Attention to detail began with the design of the reception and waiting area. Seating arrangements are surrounded by plantings, offering patients a variety of options, since a patient arriving for a routine screening may not desire the same privacy as a patient who is in the middle of a treatment program. A library with publications and Internet access is immediately adjacent to the waiting area for use by patients. Private registration/counseling spaces provide privacy for patients and family. Exam rooms were carefully located to allow family members or close friends access to these spaces without intruding upon other patients.
Once in the exam room, a patient can access mammography, stereotactic and ultrasound treatment rooms from a second door into a private corridor. Patient changing/waiting areas are located immediately adjacent to these treatment rooms and provide maximum privacy. No gowned patient has to access a corridor to get to a treatment room. Multiple mammography units, including the first digital unit in a community hospital in Maryland, are located to segregate routine screenings from patient treatment areas.
The clinic is divided into two pods, one for imaging and one for clinical examinations prior to and following surgery. Both pods are located immediately adjacent to each other to facilitate interaction between the surgeons and the radiologists located within each area. Both pods have separate reception and waiting areas, and patient flow within both pods was carefully considered to promote staffing efficiency and support patient privacy and dignity.
Once patients have received a positive diagnosis through the imaging process, they are referred to surgeons within the clinical pod. Within this pod, ten exam rooms are arranged around a central staff work core, which provides space for reading films, dictation, etc. Patients enter the exam rooms from an outer corridor and are not exposed to the activities within the core. Private registration and check-out areas maintain patient confidentiality and following examinations, patients are taken to private treatment rooms to discuss their course of treatment. An administration area, located immediately adjacent to the clinical pod but not within the patient's sight, provides offices and conferencing space for surgeons, fellows and other staff.
AAMC’s Breast Center is a very successful example of the concepts of “Healing Environment” design applied to an ambulatory care facility.