The drive-up entry to Winship at Emory Midtown
The drive-up entry to Winship at Emory Midtown
“Build something never seen or imagined”
The challenge from the Robert W. Woodruff Foundation in providing Emory University with its largest-ever single donation of $200 million for a new oncology center was as clear as it was daunting: “Build something never seen or imagined.”
The new full-service cancer facility would be intended to give physical presence to the vision of the foundation’s namesake. As P. Russell Hardin, president of the Woodruff Foundation, explained at the November 15, 2019, groundbreaking for Winship Cancer Institute at Emory Midtown, “Mr. Woodruff fundamentally loved his hometown of Atlanta, and wanted Atlantans and Georgians to have access to the best care in the world without traveling afar.”
With the funds available for a dearly held dream to become a reality, the next challenge was to define what, exactly, “the best care in the world” looks like in practice and in a physical space.
The “visioning” began by sorting out what Winship Cancer Institute of Emory University means when we describe the institute’s care model as “The Winship Way.”
Suresh S. Ramalingam, MD, FACP, FASCO, Winship’s executive director and the Roberto C. Goizueta Distinguished Chair for Cancer Research at Emory University School of Medicine, explains, “The Winship Way is integration of research into patient care to offer advanced therapies and technologies, teams of specialized experts collaborating to consult on treatment plans and coordinate care, and providing comprehensive care that encompasses the entire spectrum of a patient’s cancer experience, from risk reduction, early detection and diagnosis to treatment, rehabilitation and survivorship.”
“The Winship Way is integration of research into patient care to offer advanced therapies and technologies, teams of specialized experts collaborating to consult on treatment plans and coordinate care, and providing comprehensive care that encompasses the entire spectrum of a patient’s cancer experience, from risk reduction, early detection and diagnosis to treatment, rehabilitation and survivorship.”
Translating this care model into a physical space would require a process. “The process where people spent hours and hours, days, together talking about the care model,” says Ramalingam. First, he says they discussed what does an exceptional care model look like. Then they asked what is it going to take to deliver that care? And finally, they would consider what infrastructure would be needed to deliver that care. “Once you address that methodically,” Ramalingam says, “then you are better positioned to develop the infrastructure that incorporates the views of stakeholders on a continual basis.”
Sagar Lonial, MD, FACP, Winship’s chief medical officer, professor and chair of the Department of Hematology and Medical Oncology at Emory University School of Medicine, was a central advisor in the visioning process. “Once we had clearly visualized what The Winship Way was about,” says Lonial, “we started to try and design the floors and the space to really support that care model, with less motion for the patient and more focus on them in the middle of the circle, if you will.”
Lonial says the first 10 or 11 iterations of what the space could look like were similar to typical hospitals, “nothing really unique.” Then groups of about 180 stakeholders from across Winship and Emory Healthcare—including patient advisors, nurses, physicians, pharmacists and other frontline users—were brought together to conceptualize the new space and were challenged to think more about innovation. “And that’s what led us to what the current building design is,” says Lonial.
“If we put what’s best for the patient as the guiding, central North, then the rest of it falls into place. And ultimately it will be better for care. It will be better for research. And I think it will be a better patient experience."
“Parts of the components of the care model that we’re talking about may exist in bits and pieces already,” says Ramalingam, “but they don’t all come together in the same facility. At Winship Cancer Institute at Emory Midtown, with exceptional teams, we will be able to better integrate research into the care of patients with cancer. We will drive generation of new knowledge. We will elevate our care innovation to new heights, and we will meet the needs of the communities we serve through the expanded capabilities of this new center. And our vision is to bring this care model to all Winship care sites to best serve our patients and their families everywhere.”
Keeping patients at the center
Lonial says the “true North” for the project has been “what’s best for the patient.” He explains, “If we put what’s best for the patient as the guiding, central North, then the rest of it falls into place. And ultimately it will be better for care. It will be better for research. And I think it will be a better patient experience.”
For Nicole Bansavage, RN, MSN, OCN, Winship’s interim vice president of nursing and oncology specialty director for the Winship at Emory University Hospital Midtown campus, giving patients a good experience means giving them easy access to clinical trials and bringing care to them instead of requiring them to move around to multiple places and buildings for each thing they require. “It’s very typical across the country that outpatient and inpatient care are not even in the same building, so there can be a disconnect between the two,” Bansavage says. “It’s our intention to bridge that gap between inpatient and outpatient cancer care.”
Bridging that gap is precisely why one of the most unique features of Winship at Emory Midtown will be the building’s division into “care communities,” each one dedicated to a particular type of cancer. Researchers leading clinical trials related to a certain type of cancer will work in the same space as doctors, nurses and other frontline staff caring for patients with that cancer. “When you typically think about cancer care,” says Lonial, “you think about the inpatient component and the outpatient components as separate. What this center tries to do is to unify them in a way that allows each care community to ultimately feel like a patient’s home-away-from-home. Meaning that they know the staff, they know the space. Everybody who is on those two floors is really focused on dealing with their specific kind of cancer, not just cancer in general.”
Another unique feature will be bringing virtually all the services the patients need—from diagnostics and doctors’ appointments to infusions and support services—to them in one place, rather than their needing to go to multiple places. “The idea of one room for everything really stemmed from patients describing lining up at each different place they had to go,” says Lonial, “and then having to check in, answer the same questions over and over again and go through the same drill no matter who they were talking to. This is a way to streamline that valuable patient time by creating one place where everybody comes to them, as opposed to their going to everybody else.”
Offering this kind of “one-stop shopping” is a major benefit for patients. David Hauenstein, co-chair of Winship’s Patient and Family Advisors and a steering committee member for the new Winship oncology center, says it’s “horribly disconcerting” for people undergoing cancer treatment to be required to navigate multiple check-ins and wait areas throughout a cancer care center. Recalling his late wife Julie’s experience during her own cancer treatment, he says, “You cannot overstate how important it is to just get them in, get them to sit down somewhere comfortable, do everything you need to do and then go home for the day.”
Hauenstein also sees a huge benefit, for patients and Winship researchers, in the way researchers and patients will be able to interact regularly in the care community spaces. “This new care model, and the building, is built around getting the researchers closer to the patients so they can be there, they can talk to patients, they can talk about new investigations that are going on. They can answer questions and enroll patients.” He adds that research is a distinctive feature of Winship versus community cancer treatment centers.
“At Winship, we strive to turn science into hope for our patients,” says Winship's deputy director Adam Marcus, PhD, Winship 5K Research Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. “This new building facilitates this mission by connecting our innovative science with this new care model to improve patient care.”
Mark El-Deiry, MD, FOCS, Winship’s program lead for the Head and Neck Tumor Multi-Disciplinary Program and associate professor in the Department of Otolaryngology at Emory University School of Medicine, was centrally involved in the visioning process. In part this was because he already had deep experience with putting The Winship Way into the practice and design of the Head and Neck Clinic he directs. El-Deiry advised on a wide variety of features, including how inpatient showers were designed and how to design the operating rooms and OR process.
“The care community concept is really where the joy and work for a practitioner intersects with the patient-centric experience.”
El-Deiry says that everyone involved in the planning process asked, first and foremost, what could be done to make it easy for patients. He says the open floor plan, brightly lit rooms and comforting colors and wood textures are used deliberately “so when you walk in the room you’re not hit in the face with the fact that it’s an oncology treatment space.” Machines and monitors are hidden behind panels and doors. Processes and procedures are designed principally for patients’ comfort and convenience. El-Deiry says, “Those are things that really informed the vision of what the building could be.” He adds, “The care community concept is really where the joy and work for a practitioner intersects with the patient-centric experience.”
Bradley C. Carthon, MD, PhD, echoes El-Deiry's comments. Carthon is Winship's section chief of hematology and oncology at Emory University Hospital Midtown and interim director of the Division of Medical Oncology in the Department of Hematology and Medical Oncology at Emory University School of Medicine. “The new Winship at Emory Midtown center will allow us to focus on care of the patient in a way that hopefully best enhances their comfort and outcomes,” says Carthon. “This patient-centric approach truly allows for quick access to infusion, ancillary services and multidisciplinary collaboration. We are so excited to begin this endeavor for all of our patients.”
From drawing board to construction
Anthony Treu, principal and health care practice leader for Skidmore, Owings, & Merrill in New York City, the renowned architectural firm Emory chose to design Winship Cancer Institute at Emory Midtown, recalls, “The original task was to design a care facility that had never been seen or imagined. For us, that was an opportunity that could not be squandered. We were going to find a way to help advance cancer care through design.”
“The original task was to design a care facility that had never been seen or imagined. For us, that was an opportunity that could not be squandered. We were going to find a way to help advance cancer care through design.”
Treu pointed out how unusual it was for a client to commit to such an ambitious goal. “A lot of institutions simply repeat what they or others have done in the past,” says Treu. “But Emory recognized the need to say, ‘We need to make health care better. We need to advance cancer care, and we cannot let this opportunity pass us by.’” He adds, “Many talk about doing it, but Emory has actually achieved it.”
Treu recalls the fun and engaging parts of the early design process, which brought together Emory and others from the project design team, including local design firm May Architecture and Batson-Cook Construction. “We would sit down in front of a table and have everybody collectively design the building themselves,” he says. “We even mocked up the entire building with cardboard in a warehouse, in what became ‘Cardboard City.’”
The result of the collaboration ultimately saved time and costs. “When we put things down on paper and shared it with the group,” says Treu, “it demonstrated how quickly we had reached consensus. This kind of design process creates an enduring product that minimizes the need for later changes.”
“To be able to build an oncology center for a National Cancer Institute-designated Comprehensive Cancer Center in the middle of a major metropolitan area, for a client like Emory, and to be able to be involved from the beginning—it’s really hard to top.”
Lee Williams, Jr., project director for CBRE Healthcare—the world’s largest commercial real estate company, which Emory engaged to deliver Winship Cancer Institute at Emory Midtown—describes the new facility as nothing short of “revolutionary.” He also speaks of the planning process leading up to the design and construction of the new building as rather revolutionary in its own way.
It was a “very ground-up process,” Williams says, and more organic—quite unlike what he called the common “guess-and-check” method in which the architect will say, “Hey, do you like this one or do you like that one?” The extra engagement from the Cardboard City exercise is paying dividends as construction is wrapping up. Williams says, “Typically, at that stage of the project you would expect users of the space to say, ‘I don’t like that wall’ or ‘Why is my nurses station over there?’ or something like that. Knock on wood, we have not had to move one wall. That never happens. To see those folks walking through their space as it’s beginning to come together and go, ‘This is exactly how I imagined it,’ is really cool.”
Williams, who describes himself as “a nuts-and-bolts construction guy” calls Winship at Emory Midtown “a once-in-a-career project.” He explains, “To be able to build an oncology center for a National Cancer Institute-designated Comprehensive Cancer Center in the middle of a major metropolitan area, for a client like Emory, and to be able to be involved from the beginning—it’s really hard to top.”
Treu puts it another way, “This is maybe a once-in-a-generation building,” he says. “I think this is going to fundamentally change the way people think about new building design for cancer care.”
Another amazing aspect of the dream coming true in Midtown Atlanta: The disruptions of the COVID-19 pandemic and global supply chains didn’t slow it down. “The project is on schedule and on budget,” says Williams, “something that I’m very, very proud of with everything the team has gone through.”
Innovations and innovative new uses throughout
The 17-story, 450,000-square-foot cancer care center is truly full-service and includes medical oncology, radiation oncology, surgery, infusions, diagnostics, imaging services, clinical trials, cardio-oncology, oncology rehabilitation, psychiatric oncology, integrative oncology, palliative and survivorship care—and many other support and wellness services. It features 80 inpatient beds in private rooms, up to 24 private care suites per outpatient floor, a fully dedicated central lab and pharmacy, a perioperative floor with six operating rooms, advanced radiology and radiation oncology equipment and an oncology intermediate care center.
The center also features an attached parking garage for patients and visitors with options to self-park and valet park, a patient and family resource center, full-service cafeteria, Starbucks café, rooftop garden, retail pharmacy, financial navigation offices and a boutique for patients—among other amenities.
Winship Cancer Institute at Emory Midtown employs technologies and designed processes and spaces to improve workflow efficiencies and wayfinding. It uses real-time location system technology to help minimize patient wait time, and uses a wayfinding system that is connected to an app to help patients easily navigate the building.
One of the unique innovations aimed at saving nurses and other care providers time is actually an old invention put to efficient use in Winship at Emory Midtown. Ryan Haumschild, PharmD, MS, MBA, director of pharmacy services for Winship and Emory Healthcare, says his part of the visioning process was to conceive of a state-of-the-art pharmacy for the new cancer care center. The pharmacy will be able to supply needed cancer medications—including radio-pharmaceuticals, investigational agents and drugs that require unique sterile manipulation and compounding.
One of the challenges for the new pharmacy was how to transfer medications, which are sometimes short-stability and often high-cost drugs that require careful handling, to all 17 of the building’s floors. “You can’t use a pneumatic tube system that typically other pharmacies would utilize,” says Haumschild. “You have to utilize functionality that gently lifts medications up without compromising the integrity of the product, almost like its own elevator.”
Enter the dumbwaiter.
First used in the 1800s to transfer food or laundry from one floor of a house to another, the small freight elevators will be used to move pharmaceuticals between floors of the facility. Each floor will have pharmacy technicians in medication rooms where the dumbwaiter will stop. “The technicians will pull the drug off and then hand-deliver it to the nurse or the patient,” Haumschild explains. “That way the drug gets delivered to each floor without the nurse having to go down to a centralized pharmacy, letting them spend more time with their patients.”
“In the end, the best facilities aren’t that meaningful if you don’t have the right people taking care of the patients. A facility, a physical structure, helps support what we want to do—but we can’t do it without great people.”
The dumbwaiter is only one technical feature of the building aimed at making the most of everyone’s time. Which is precisely why Stacy L. Palmer, MBA, Winship’s vice president of cancer clinical administration and strategy, describes Winship at Emory Midtown as a “facilitator.” She explains, “In the end, the best facilities aren’t that meaningful if you don’t have the right people taking care of the patients. A facility, a physical structure, helps support what we want to do—but we can’t do it without great people.” She adds that it’s not only about what the building looks like, but “how we function together in the building to bring that vision forward.”
Marlena Murphy, a breast cancer survivor and advisor in the planning process, says the dumbwaiter is just one of the new facility’s time-savers. “One of the things that takes the longest is waiting on medication to be prepared,” says Murphy. She echoes Haumschild’s comments about the dumbwaiters, pointing out that they will be convenient for the nurses and save time for patients. She says that another time-saving “comfort and convenience” will be the attached parking garage. Murphy says, “The last thing a patient experiencing a cancer diagnosis wants to deal with is finding a parking space.”
There are other technological features of the new facility to make treatment more manageable for patients. Karen D. Godette, MD, medical director of radiation oncology at Winship at Emory Midtown and associate professor in the Department of Radiation Oncology at Emory University School of Medicine, points to the care center’s new high-dose rate (HDR) operative suite—which allows targeted radiation in a tube or catheter to be delivered internally to the cancer, while sparing side effects to surrounding organs such as the bladder, rectum and bowel. “Once treatment is delivered,” says Godette, “no radiation remains in the body.” She adds that another new machine, the Halcyon linear accelerator, “allows us to treat more patients.” Godette explains that the Halcyon is excellent for head and neck malignancies and prostate cancer. “Treatment is delivered faster,” she says, “with more efficient workflow and high-quality image guidance.”
Helping a dream come true
Of course buildings and equipment need upkeep, employees need to be paid, and there is always the challenge of making sure the dream continues to come true for future patients. “We do require ongoing philanthropy,” says Palmer. “It’s not just for the building, but for what happens in the building and how the building can facilitate that and integrate our clinical and research and teaching missions.” She adds that philanthropy also “helps us figure out how we educate the community, how we educate underserved populations and how we participate as part of our community in reducing disparities.”
Emory University’s Advancement and Alumni Engagement team says that people are inspired by the care model and the cause it serves; they’re interested in a purpose. In the case of Winship at Emory Midtown, donors who have supported it say that they’re supporting an idea and movement in care. That was certainly the case with the generous gift from the Woodruff Foundation that set the dream in motion. Philanthropy allowed Winship to imagine big.
“We fully anticipate people from beyond Atlanta, beyond Georgia, will come to take advantage of the excellent science that’s happening here and the caliber of physicians here.”
Sheryl Bluestein, vice president of operations for Winship Cancer Institute and Emory University Hospital Midtown, was involved from the very beginning of the planning efforts. “It was a dream back in 2010,” she says, “when we developed a business plan for a comprehensive center for cancer care on the Emory University Hospital Midtown campus. What was missing was the funding to make it a reality.” When Bluestein got a call telling her about the Woodruff Foundation grant, she says, “It was just that feeling of ‘Oh, my gosh, we can do this now. It’s no longer just a dream.” Looking ahead as the building neared completion and readied for its May 2023 opening, Bluestein said, “Now that we’re talking about ribbon cuttings and moving into the building, it’s been more than 12 years in the making. But it was the Woodruff Foundation gift that allowed us to really make it happen.”
Bluestein expects to see even more people with cancer traveling to Atlanta for Winship’s quality care. “I think we’ll see that even more, given that the center is full-service with inpatient care and outpatient cancer care available in one single facility and designed with our patients at the center of specialized care teams. We fully anticipate people from beyond Atlanta, beyond Georgia, will come to take advantage of the excellent science that’s happening here and the caliber of physicians here.”
Ramalingam says of Winship at Emory Midtown, “I think it will be a new landmark for cancer care.” Becoming a partner in supporting that landmark for cancer care offers a chance for those looking to invest in helping to change cancer as we know it. “By looking at this facility, and the care that’s going to occur there, people can give shape to their own vision of what exceptional care looks like—and partner with us in bringing to life that exceptional cancer care, and be part of this team.”
El-Deiry puts it this way. “I think that if things go as I hope with this concept, process and space, Emory will become the shining beacon on a hill for cancer care and will be well-positioned to have representatives from other academic centers come visit us and learn from us.” He adds, “This is a really unique opportunity for Emory as an institution to lead on the national stage. It is an exciting time to be here.”◼︎◼︎◼︎
Writer John-Manuel Andriote; Designer Marco Alarcón
Helping to support patients’
inner strength, and carrying
on her mom’s legacy
Johanna Ellis Reisinger is one of the many individuals whose gifts have helped to make the dream of Winship Cancer Institute at Emory Midtown a reality.
Johanna gave a gift to Winship at Emory Midtown to name the Radiance Boutique in memory of her mother, Cathy, who was a Winship patient.
Johanna says her mom was given six months to live but made it to two and a half years. “I believe that’s because of the treatment we got at Winship,” says Johanna. She also believes it was because of Cathy’s enormous inner strength.
“And not everybody has that,” says Johanna. “So if the boutique can help people feel strong within themselves to keep on fighting, that’s something we are incredibly blessed to be a part of. And I know that my mom would be really happy about it.”
Aerial view of Winship at Emory Midtown on the campus of Emory University Hospital Midtown.
Aerial view of Winship at Emory Midtown on the campus of Emory University Hospital Midtown.