I visited Pinehurst last week but not for golf. I do not play. I went to tour the new cancer center at FirstHealth of the Carolinas’ Moore Regional Hospital. The $68 million outpatient facility opens for patients March 27, 120,000 square feet and four stories dedicated to the idea that cancer is survivable. In fact, according to the National Cancer Institute, there are more than 18 million cancer survivors in the U.S.
Many of us grew up with a notion that cancer wasn’t survivable and was to be whispered about. But medicine has come a long way. The tour, for me, was as much about how treatment has advanced as about a building.
Major regional institution
FirstHealth competes in a state with a number of large, university-affiliated hospital systems like Atrium Health, Duke Health, ECU Health, and UNC Health. UNC, in particular, has the 315,000-square-foot N.C. Basnight Cancer Hospital, open since 2009 and funded at $180 million through the efforts of the late Senate leader.
It is a big challenge for rural health systems to stay independent. FirstHealth has been doing that in the Sandhills since it was founded in 1929 as Moore County Hospital. Over time, the county hospital grew into a regional one, and then became the flagship of FirstHealth of the Carolinas, offering all major medical and surgical specialties. Today, FirstHealth serves 15 counties and is one of the area’s largest companies, with around 5,600 employees, nearly 4,100 of them in Moore County. It has hospital campuses in Hoke, Lee, Montgomery and Richmond counties. Revenues this year are projected to reach nearly $1 billion.
This was my first trip to Pinehurst, yes, after nearly 27 years in North Carolina, and after I navigated the iconic but challenging traffic circle, I did some sightseeing by car around the historic Pinehurst Resort to see what James Walker Tufts started in 1895.
It wasn’t difficult to find Moore Regional. Its footprint is vast between N.C. 211 and U.S. 15-501, a couple of blocks from the circle. Golf-driven tourism is a major employer in Pinehurst, 20% of the jobs, but healthcare is the big industry, at nearly 60%, and it is easy to see why, driving through the hospital complex, building after building. Healthcare has become a magnet for retirees, which is why many want to move to places around university towns like Chapel Hill, with their large hospitals. That is one reason why FirstHealth, with a broad range of specialties and services, is so vital in attracting folks to the Sandhills region, and so the new cancer center is a big deal.
Mickey Foster, FirstHealth’s CEO, talked about the new medical oncologist trained at Johns Hopkins that the hospital is bringing in.
“This thing’s already having an impact on recruiting physicians to this community,” he said.
Under one roof
Right now, Moore Regional’s cancer facilities are spread out on the campus.
“If you were a lung cancer patient today,” said Foster, “and you were having chemotherapy and radiation oncology, you would have to go to two different buildings,” and then see a pulmonologist in a third building, the Reid Heart Center.
“The vision of this cancer center is we’re bringing everything outpatient oncology under one roof.” Construction has taken nearly two years. Brasfield & Gorrie, one of the top construction companies in the Southeast, is the general contractor.
The folks Foster briefed on the tour I was on last week were with Moore 100, a business organization established by the county’s economic development arm, Moore County Partners in Progress. We were divided into groups, and I was fortunate to draw as my tour guide Cindy Hetzler, the FirstHealth project manager for the center. She was able to discuss not only the building’s nuances, but also the process of designing such a complex structure.
Building a cancer center means meeting the needs of stakeholders. Things have to be in the right place and done the right way. What will the patient experience be? What will go on the walls? What kinds of doors will go on this floor and that? Where will the nurses sit? Where will caregivers wait? Everyone who has worked for or been a patient at a health care facility could probably think of tweaks or amenities that would make a difference, if someone asked. FirstHealth asked.
Early in the design process, they used a former carpet factory in nearby Aberdeen to build mockups of every floor, room and hallway.
FirstHealth had done a version of this on earlier projects, said Hetzler, but not on the scale of the cancer center. The idea for a more ambitious simulation came from Tom Reoch, Hetzler’s boss, who had done full mockups at Cone Health up in Greensboro, where Foster was a top executive before coming to FirstHealth. Reoch joined FirstHealth at the end of 2019, as the cancer center project was finishing up its planning process with the village. Staff members formed groups to design their spaces, and then once designs were locked in, they rotated for six weeks down to Aberdeen to see how their ideas worked.
“We rented the warehouse down at the old Gulistan factory and went to town,” said Hetzler, “20,000 square feet worth of building that we built up. We would tear down departments and build up other departments. So it was really helpful, because you’re doing it with cardboard, so there’s only the expense of the cardboard.” Which is way cheaper than moving walls later if a design flaw emerges.
“They want their oxygen here, they want their power there, they want their data here. They need shelving over here. We haven’t had to tear down one wall in this building,” said Hetzler. “We got it right.”
Recently, on another tour for staff, Hetzler was coming off the elevator near the new gynecologic oncology space, and she could hear an employee “squealing with delight.”
“She was bouncing around so happy because it’s nothing like what they’ve got over there right now.”
Patient focus
The patient focus of the design process can be seen throughout. “Someone said, ‘Hey, how do you make it not like being in a treatment room,’” said Hetzler. The answer can be seen in the infusion therapy area, a mix of private, semi-private and open bays. In the 36 chairs will be patients who want privacy, but there are open areas for patients who want to be with others. The room opens to a “healing garden,” and patients with a mobile IV pole can walk out among the flowers.
“It doesn’t look like a whole lot right now as far as the plantings go,” said Hetzler, “but we are getting some blooms that are coming up. Come another three or four weeks, this place is going to be so much color that it’s going to be amazing.”
There are subtle features. The conference room TVs are equipped with cameras. There are conferences every week for certain types of cancers where all the folks treating a patient make sure they’re on the same page. If a provider can’t attend in person, they can video conference in.
Oxygen is piped into the exam rooms, so when patients using portable tanks come in, they don’t have to deplete their own supply. There are flat screen TVs in the rooms so patients can see their scans rather than just hear them described.
A chute system can carry medicine orders to the in-house pharmacy and then back to a nursing station, which saves a lot of running around.
On the fourth floor is a wellness center with a wide array of exercise machines and equipment, bringing fitness in-house. Radiation and chemo take a toll, and an exercise regimen builds back patient stamina. A therapist trained in oncology massage is on staff.
Foster, in his remarks, talked about the fourth floor especially. “We wanted to create a destination where people could get away from their treatment. You’re going to see a fitness center, massage therapy, meditation, wellness space. There’s community classroom space in there for support groups.”
“I’ve built a few cancer centers and overseen a few cancer centers in the state of North Carolina. I’ve never seen one that had a fourth floor like this.”
