Working in construction grants the ability to be a part of truly remarkable projects that provide life changing solutions for many of our clients. Providing top tier service requires out-of-the-box thinking to consider unique ways to deliver.

At the Adult Outpatient Pavilion for VCU Health, one such example is the placement of the Linear Accelerator in VCU Massey Cancer Center’s new treatment space. This machine is designed to customize high energy x-rays to conform to a tumor’s shape and kill cancer cells while sparing surrounding healthy tissue. We sought to transform the patient and technician experience.

Customarily, this piece of equipment resides in the basement level of hospitals. However, in this case, the staff wished to relocate their Linear Accelerator to a non-traditional elevated terrace level — giving their patients access to rooms with more natural light making a typically dreary experience more comfortable.

Residing in an environment with natural light produces more endorphins which aids the recovery process. Natural light helps with quality of life and supports mental health as well.

Working with the design team to build out cost models and logistics plans, there was a need to account for the increase of steel and concrete needed to support such a function on an elevated slab — one of only a few elevated Linear Accelerators in the world.

This adjustment required:

• 8’ thick slab (includes layer of lead block shielding) with stainless steel rebar
• 4000 psi concrete wall thickness between 36” & 42” plus high-density concrete block (250 pounds per square foot)
• 4’ thick 4000 psi concrete ceiling/lid, poured on top of ¾’ steel plates welded to the inside flanges of W21 x 93 steel beams, plus a “pyramid” of high-density concrete block on top of the lid

In addition to material, a thorough plan and checklist are needed. Some action items to consider include:

• Review and understanding of the mechanical, electrical, and plumbing requirements for the equipment
• Coordination of the Physicians Report with MEP design to eliminate all ferrous materials from the axis point of the imaging equipment
• Understand which interior walls may need to be upgraded to heavier gauge studs for lead lined drywall and lead lined hollow metal doors and window frames
• Consider upgrading existing low voltage cabling hooks for cable trays for both the vault and control rooms. Upgrading to cable trays will help free up the space for low voltage and power to avoid overhead congestion and static interference with the two systems

There are many factors to account for when taking on a project of this complexity. From pre-construction through completion, elevating the patient experience is the purpose of these projects and creative thinking that anticipates all outcomes is the pinnacle of success.