Sydney’s new translational research centre by BVN Donovan Hill offers a benchmark for this emerging building typology where advanced research is combined with targeted health care.
While acknowledging that many of Australia’s scientific and medical researchers are among the world’s best, the 2013 Strategic Review of Health and Medical Research identified “the lack of a sufficiently strong connection between health and medical research and the delivery of healthcare services.”1 The review’s recommendations include the establishment and funding of integrated health care centres involving collaborations between hospital and community-care networks, universities and research organizations such as medical research institutes. The close interrelationship between research and clinical health care has been called translational research and enables a structured bench-to-bedside model to maximize the ready application of scientific discovery to medical care.
Although not yet of the breadth or scale envisaged by the review, there are several notable health science centres in Australia that exemplify the ability of translational health and medical research to inform and advance clinical practice and health care, though few integrate clinics with their research facilities.
In Sydney, the Garvan Institute of Medical Research and St Vincent’s Hospital have jointly founded The Kinghorn Cancer Centre, combining advanced research with targeted health care to enhance the effectiveness of cancer diagnosis, treatment and prevention. Opened in 2012, The Kinghorn Cancer Centre is co-located with the Garvan Institute and the Victor Chang Cardiac Research Institute at St Vincent’s Darlinghurst research precinct, further strengthening a powerful health and medical research cluster. The centre aims to develop new diagnostics and therapeutics informed by advances in microbiology, in partnership with the delivery of personalized medicine and holistic health care.
Despite the potential of such an integrated approach it is uncommon for clinics and specialist laboratories to be housed together, largely because of a possible risk of cross-contamination that may invalidate research findings or impair clinical care. The design of The Kinghorn Cancer Centre enables distinct realms of research and clinical care to coexist by clustering their respective activities and separating the clusters through vertical stacking. Sensitive research support services sit below ground, while clinical, consultation and treatment spaces are grouped on the first three levels of above-ground space to optimize access by patients. The specialized research facilities and supplementary administration spaces occupy the higher levels of the centre and, though operationally distinct, are linked back to the clinics through the spatial continuity of the atrium.
Responses to the complex technical and planning requirements of the centre are ordered by a layered zoning of functions, graded from the most secure to the south through to the most public to the north. The planning of each level is anchored by a bank of goods lifts, escape stairs and support services abutting the boundary with the Garvan Institute. Service risers in this zone feed into the physical containment laboratories on the research floors and the specialized clinical spaces on the health care floors, in turn buffered from the more public space of the atrium by write-up, administration and reception spaces.
With its principal address on Victoria Street, The Kinghorn Cancer Centre rises as a singular block above the close grain of its setting. From a distance, the clarity of the centre’s form projects a sense of authority and certainty of purpose. This is reinforced by the distinctive binary composition of the strongly defined concrete plane of the northern service core standing in exact alignment with an open aluminium mesh of solar screening, which combine to create a single, discrete entity.
The visual mass of the centre’s profile is amplified by the suspension of the mesh screen some two metres clear of the envelope that it shields and shades. This bounding zone accommodates a cantilevered broadening of the laboratory bays above and, at level four, a bridge link that threads through to the neighbouring Garvan Institute. The precise, machined neutrality of the gridded mesh of the screen resonates with the disciplined purpose of the activities it veils. Shifting patterns of translucency and transparency throughout the day and variations in illumination and silhouette at night animate this otherwise mute surface, offering a subtle kinetic presence for the centre in its broader setting.
Above the third level, the centre sits back from its northern boundary, enabling the Victor Chang Cardiac Research Institute to retain its prominence and views to the west and to the centre of the city. Scale, form, surface and colour along the length of the lower levels of the centre are modulated to convey the different functions within and to contribute to the mixed character of the immediate streetscape. The setback to the north steps down to form a two-storey link matching the height of the Green Park Hotel. This link provides retail space, opening onto Victoria Street and into The Kinghorn Centre’s foyer, with office space for the centre on its upper level. The presence of the cancer clinic and patient services is registered by a three-storey-high, slender steel frame reaching up to the mesh screen above and infilled along the ground level with translucent channel glazing, ensuring visual privacy for the clinic.
The contrasting mass of the portico block frames the principal entry, which opens into a dramatic atrium activated by serried flights of stairs climbing between levels and by the walkways and decks that span the void. With offices and meeting rooms projecting into its volume, the atrium holds reception areas and coffee and lunch points on various levels. This interweaving of form and space and of internal and external views, along with the extensive use of timber elements and finishes throughout, invites inclusion and dissipates any preconception that clinical and research environments are necessity sterile, or institutional, in character.
The atrium embodies The Kinghorn Cancer Centre’s ambition to achieve the most effective level of health care through an interrelation of research and personalized medical treatment. The many pathways in, around and through the space are intended to foster chance exchanges and so trigger new ideas that may lead to further advances in research and care. More fundamentally, the intersection of the many uses of this space will enrich communication, enhance understanding and serve to establish and reinforce a shared culture among the users of the centre – researchers, clinicians and patients alike.
The visual complexity of the atrium is calmed and grounded by a remarkable artwork that reaches through the full height of the space. Painted in situ by British land artist Richard Long and titled White Water Falls, it evokes fundamental patterns of life and the forces of the natural world. The allusion to nature is extended by efforts to introduce views to planting wherever possible on such a constrained site. Patients will enjoy a greening of the outlook from the clinic and consulting spaces as vines take over a trellis grid behind the steel frame to Victoria Street and, as planting matures, along the rear laneway linking to the Garvan Institute. At the north-western corner of the third level, the Reflection Garden provides an accessible area of planting and open terrace reached from the atrium and from the adjacent seminar rooms.
Those afflicted by cancer face up to the uncertainty and anxieties caused by this virulent disease, its treatment and prognosis. The purpose, methods and outcomes of research are unfamiliar and unclear to many. The design of The Kinghorn Cancer Centre provides a place where research is seen to count and where the needs and anxieties of patients are addressed through expertly delivered, research-based, personalized medical care. By giving primacy to the needs of the patient, an active and supportive place for all has been created without undue contrivance or embellishment beyond the thoughtful orchestration of circulation and an interconnection of the realms of medical research and holistic health care. The efficacy of the design of The Kinghorn Cancer Centre in terms of the translation of research into the advancement of medical practice will be evaluated over time but in its inception it already provides a benchmark for future integrated health care centres that answer the recommendations of the government’s strategic review.
1. Australian Government Department of Health and Ageing, Strategic Review of Health and Medical Research – Better Health Through Research, February 2013.