From the September 2017 issue of HealthCare Business News magazine

Design and construction teams working on a proton therapy project are faced with an interesting contradiction relative to the more typical process. Critical infrastructure and proton equipment are literally speaking, “cast in stone” from the outset of construction, with no tolerance for deviation. Yet, because of ever-changing technological advances, equipment planned for during design may need modification by the time construction begins. This unique aspect of proton therapy mandates ultimate flexibility during planning and construction for what amounts to absolute inflexible equipment installation tolerances.

Another challenge faced during construction of these types of facilities is general phasing and sequencing. Much of the critical proton therapy infrastructure must be installed prior to more typical building elements. Successfully being able to accomplish this requires collaborative engagement of every participant much earlier than typical. To further complicate matters, participation must include scientists, equipment vendors, physicists and facility operators whose expertise is critical early during design in order for the team to be successful at the end of construction.


One analogy is that typical projects are built from the outside working in while proton therapy projects require the opposite as construction progresses from the inside working out.

Building information modeling (BIM) is an invaluable tool when planning and constructing a proton therapy project. The more typical industry-drawn line separating the design team from the construction team is virtually erased on proton therapy projects. Architects and their consulting engineers work digitally side by side with construction managers and their subcontractors in order to define and achieve the exacting requirements of this project type. Again, the best predictor of success for the project is the collective past experience of the assembled team on similar projects.

Because of the sensitivity of the proton equipment, every item incorporated into the construction must be coordinated relative to adjacency, interface and even chemical makeup. Building system tie-ins are especially critical in this regard. A storm water pipe, an electrical conduit or an embed being a fraction of an inch out of alignment may cause proton equipment failure.

Professional expertise interface
Maintaining allowable construction tolerances on proton therapy projects is critically important for successful operation of the facility. The root of that success is planted during preconstruction by a complex team of cross-discipline professionals, each with their unique perspective and expertise. Creating clear communication protocols within an atmosphere of trusted collaboration is a priority early on that must be leveraged to allow optimal solutions to be individually voiced and then collectively evaluated and approved.

September 2017 Magazine

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