Case Study

University of Texas MD Anderson Cancer Center Alkek Tower Expansion A New Approach to Health Care in a Familiar Setting

Houston, Texas, USA

The Challenge

To add 12 stories to an existing high-rise hospital without distractions for patients, families and hospital staff, while accommodating different hospital programming needs than when HKS designed the original building in the 1990s.

The Design Solution

Even though HKS designed the original hospital with infrastructure for expansion, health care practices and technology had changed greatly in almost 20 years. For the expansion, we increased the building’s footprint by cantilevering over the corners of the existing building, allowing space for bigger patient rooms that are on average 40 square feet larger than those below. We then added cantilevering on both sides of the rear staff corridor to add four patient rooms for a total of 48 beds on each patient floor.

To address the challenge of having construction proceed atop an existing structure without creating distractions for patients their families and staff, a mechanical floor was created between the existing and new building to facilitate building systems operations and create a buffer between the upper and lower floors.

The Design Impact

Finding a lighter exterior façade material that was an exact match to the existing exterior façade posed an interesting design dilemma. Glass Fiber Reinforced Concrete (GFRC) was the answer. GFRC, a precast system, creates a 1- to 1 ½-inch thick façade – versus the traditionally 7- to 9-inch precast concrete system – allowing less weight to be attached to the vertical structure. This enabled the team to add two more floors to the building.

Project Features

  • 500,000 square feet (46,451 sm) of new space
  • 192 beds, with shell space for 192 additional beds
  • Improved staff and patient circulation
  • Improved wayfinding
  • 8,000-square-foot (743 sm) enclosed observation deck


  • 2017 The Center for Health Design, Silver Recognition Evidence Based Design Touchstone Award
  • 2016 Architects Newspaper, Best of Design Awards)
  • 2014 American Society of Health Care Engineering/American Hospital Association/AIA Academy of Architecture for Health, Vista Award Winner
  • 2011 ENR Texas and Louisiana, Best Overall Project
  • 2011 ENR Texas and Louisiana, Best Health Care Project