A Design That Gets Teens Talking: FWAYAOC

Being a teen—making the transition from childhood into adulthood—a time in life characterized by emotional and physical change and uncertainty. For teens and young adults with cancer, it is even more so.

Located in Fort Worth, Texas, within Baylor Scott & White All Saints Medical Center, the Fort Worth Adolescent and Young Adult Oncology Coalition unit (FWAYAOC) is among the first community-supported AYA oncology inpatient units in the United States, and sets a new benchmark for AYA facilities around the world. Designed by HKS, FWAYAOC offers young adults diagnosed with cancer, ages 18 to 29, comprehensive, life-enhancing support, age-relevant resources and specialized care designed to improve their lives before, during and after cancer.

We sat down with architect Evelyn Reyers and interior designer Corrine Kipp, key members of the FWAYA design team, to learn more about how the project came to be, and why it’s so meaningful to the people who use it—and to our own team, too.

ER: The good news is that kids with cancer today—those who have grown up with pediatric oncologists—are surviving longer. Teen patients are graduating high school, going to college, getting their first jobs. When it comes to cancer treatment, the question is: where do these patients belong? They don’t belong in the pediatric unit, and the adult unit isn’t the right place for them, either. They need their own dedicated space for treatment as they transition from being home with their parents to being out on their own, while also tackling this disease.

CK: When FWAYAOC first opened, Dr. Karen Albritton, FWAYA’s Medical Director, began hearing from her medical staff and support people that treating this demographic was difficult because their needs are so different. The thing is:  the needs weren’t new. They had always been there, but they simply hadn’t been as visible because there wasn’t a place where AYA’s were the sole focus for cancer treatment. Now that we have a unit with dedicated staff, we are learning much more about the unique needs of AYA patients.

ER: AYA’s in cancer treatment are missing their classes and missing their friends. They’re faced with academic and social challenges. They are trying to keep up with classes, trying to get good grades, and looking at colleges or considering how they will land their first real job.

Teens and young adults are also experiencing a period of intense social development and growth. They have to spend time with their friends, with their peers, in order to fully develop. For that reason, we knew that our design had to draw patients out of their rooms and entice them to spend time together. They need to socialize with each other, for many reasons.

Another thing to keep in mind is that people can be scared to visit hospitals. We thought about things like: will teens’ friends have to walk through a corridor lined with hospital rooms to get to the unit? We knew that could deter some visitors, so we designed other options to make sure that in every way, we made it easier for teens to connect with people outside the hospital.

CK: Our design for FWAYA focuses on fostering social interaction, supporting visits from friends and family, and helping patients maintain social and academic development while undergoing cancer treatment. To do this, we envisioned a welcoming, comfortable place for visitors to spend time with patients. And it had to have a youthful vibe unique to teens and young adults—not the feel of a pediatric unit, or the quiet of an adult unit.

To draw patients out of their rooms, key design elements were pivotal. For example, the central table had to be a place that welcomed people to play puzzles, cards, or games together. The message board is another important place. You can see patients leaving each other messages there, to encourage one another. It’s incredibly uplifting.

One of the most meaningful concepts in the design was that of a cairn. A cairn is a stack of rocks built on trails by climbers who wish to leave evidence of their journey, and provide future travelers with a path marker. For me, this concept was the main driver behind our work. It informed everything—from the ceiling elements, to the artwork and even the patterns in the upholstery.

ER: This is one of the first AYA units in the United States, and until FWAYA was built, the UK was really leading in the field. The Teenage Trust in the UK is the predecessor for all AYA units in the UK, and they were heavily involved in our project in Fort Worth. Just as their work helped us, we think that now people from around the world will come to Fort Worth to see what we have done here. Because we’ve built upon the expertise of our predecessors to advance the design of AYA units, this project will have a global impact on how future AYA units are designed.

ER: This project presented us with a rare opportunity for health designers: to involve the patients themselves. Because patients are members of the FWAYA community, they were involved in design sessions from the onset until the end, even at the point where our team was selecting the furniture. Their participation was truly critical to the overall success of our design.

CK: As a designer, it’s important to tell the story of the patient. We were especially successful in doing this for the FWAYA. A year after construction, the staff and patients continue to tell the story of the cairn and how it relates to AYAs. Staff even give each patient their own cairn trinket when they leave. Knowing how deeply a design concept can resonate with patients, doctors and staff encourages me to continue to find ways to tell the patient’s story through design.