Making Places, Healing Spaces
Bloorview Kids Rehab
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| Project completion date |
June 2006 |
| Cost |
C$80m |
| Client |
Bloorview Kids Rehab |
| Architect |
Montgomery Sisam Architects / Stantec Architecture |
| Structural engineer |
Yolles Partnership |
| MEE |
H H Angus & Associates |
| Quantity surveyor |
Curran McCabe Ravindran Ross |
| Main contractor |
EllisDon Corporation |
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Sean Stanwick describes how Canada’s regional responses to healthcare design are rooted in the life-affirming connection between humanity and nature.
The Canadian healthcare system has enjoyed a longstanding reputation for being one of the best in the world. Part of this recognition is based on the fact that pre-eminent Canadian hospitals intentionally draw on regional or natural themes to create meaningful and relevant designs. As a result, several examples have risen to international attention by addressing both the innate human desire to connect with natural surroundings and the necessity to deliver technologically advanced medical infrastructure.
Making places
Canadian architects have a tradition of treading lightly on the land they occupy and also seeking to honour the origins and influences of the building site. Such efforts often include references to local geography, environmental sensitivities or unique cultural values. "Since the 1940s, a uniquely Canadian architecture has developed," writes Lisa Rochon in Up North: Where Canada's Architecture Meets the Land. "Rooted in the principles of human scale, material warmth, and deep connections to site" [ours is an architecture that] "resonates with the humanity of this country."1
By and large, Canadians understand that a hospital is a highly emotional place and recognise the negative implications of creating a generic, corporate-like office building with beds. Therefore, materials such as wood and stone are used generously to create places of quiet refuge and bring something familiar and comforting from everyday life. Light is embraced as an essential life-affirming force, often giving a spiritual dimension to the care experience. Natural features, such as running water, fish and live foliage also serve to complement the care environment. In one northern Ontario hospital, a 'seasonal river' terrazzo floor pattern composed of fish and other natural forms flows through the multi-storey wooden concourse.2
In short, the best Canadian hospitals rarely function as a drive-by experience, but instead they allow us to slow down, breathe and heal. There are several noteworthy examples that illustrate this shared desire to celebrate what is special about the land and local culture. A case in point is the new Peel Regional Cancer Centre at the Credit Valley Hospital (CVH) in Mississauga, designed by my own firm, Farrow Partnership Architects.
Senior partner Tye Farrow has followed the tradition of noted Toronto architect Eberhard Zeidler, who first championed the case for human-centered healing facilities at the Hospital for Sick Children in Toronto, by challenging accepted healthcare norms through the creation of a much-needed communal gathering place in a sprawling suburban community.
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Peel Regional Cancer Centre
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| Project completion |
May 2005 |
| Cost |
C$83m |
| Client |
Credit Valley Hospital |
| Architect |
Farrow Partnership Architects |
| Structural engineer |
Halsall & Associates |
| Services and environmental engineer |
Rybka Smith and Ginsler |
| Quantity surveyor and planning supervisor |
Altus Helyar Cost Consulting |
| Main contractor |
PCL Constructors |
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Initially, cancer patients at the hospital were asked about their priorities for the new facility. “Our spaces should give us hope," they responded. when asked what would give them hope, they replied: "Something that is alive."
Faced with a devastating illness, this response emphasises the importance of fostering strong civic and social connections. In the Toronto suburb of Mississauga, the quest to create a unique gathering point called for a solution far beyond such standard elements as a canopy and a coffee kiosk in the lobby. Dramatic use of wood in the entry atrium, flooded with natural light, serves to acknowledge the necessity for a memorable place to congregate and interact. Clearly visible from the street, the sheltering tree-shaped forms combine with natural materials to give a spiritual dimension to the experience.
"There is nothing timid about this design," says Farrow. "The goal was to provide a place that would contribute to the economic vitality of the city, but also incite a spiritual reaction from the users."
While the design team is a key contributor, it is by no means a singular effort. Confronted with pressure to conform to conventional design standards, president and CEO Wayne Fyffe also seized the unique opportunity to raise the bar for healthcare delivery internationally. “The bold design was embraced immediately as a logical extension of our vision and values," says Fyffe. "The board got it and key staff members instantly saw that this was the right thing to do. An anonymous, steel-columned box would contradict our values and turn our vision into empty words."
Clearly there is a powerful attraction to this design that draws patients, staff and visitors who gather to talk through emotional issues or to simply share their thoughts. Its function goes far beyond the standard requirement for circulation and waiting. Conveying in every respect the message that "you are in good hands", a reassuring sense of community and animationnow infuse the surbuban block. "It's uplifting." says Corinne Stafford, a visitor to the centre. "It's almost like not being in a hospital."
The commitment of the design and management team has not gone unnoticed by the international community as well. An expert panel chosen by the UK’s leading advocate for high quality design, the Commission for Architecture and the Built Environment (CABE) selected the project as its Best International Design at the ninth Building Better Healthcare Awards. The award recognises, "an outstanding project that contributes to new thinking and influences the UK's future experience of delivering healthcare in the 21st century."
Close to home
Passive, disconnected hospitals will have a limited future, while those that take an active role in the health of their constituents will maintain their relevance well into the future. Through what some critics have hailed as one of the finest examples of modern architecture in the city, the Bloorview Kids Rehab in north Toronto makes a strong statement about the value in creating inroads into the community.
Designed by Toronto architects Montgomery Sisam in a joint venture with Stantec Architecture, the new six floor, 358,000 square-foot 'home away from home' for children coping with disabling injuries and illnesses offers a welcoming alternative to the typical hospital.
Situated in the heart of a residential neighbourhood, at the edge of a wooded Toronto ravine, Bloorview executed the role of good neighbour perfectly. City planners, local residents, as well as neighbouring institutions were all consulted to help shape the building. The resulting site design incorporated greenspaces, strong linkages between the neighbourhood to the south and the ravine to the north, as well as a dedicated public pedestrian walkway across the top of the ravine.
The design intentionally respects the look and feel of the adjacent residences. On the outside of the wedge-shaped west wing, which rises from two storeys to six, the designers created an earth-tone brick base and used warm-grey zinc patterned to mimic the weathered wooden shingles prevalent in the neighbourhood.
Along its sloped edge, the metal roof cuts itself away to expose several outdoor terraces – a gesture, in part, to the adjacent residential condominiums. Anticipating light, wind and rain to penetrate through the filigree of wooden trellises and ivy, the terraces reinforce the concept of the hospital as a living, breathing building.
Bloorview also gives back to the community with new urban infrastructure. “We created a new street with a direct link to a widened walkway along the edge of the ravine,” says architect Terry Montgomery. “All of these moves create a multi-layered sense of place for both hospital and neighbourhood.”
Bloorview actually functions more like a community centre than a hospital, as a variety of therapeutic and social spaces are offered for daily use by local residents. For children, this connection with their family rhythms, rather than being insulated from the outside world, is a vital aspect in their healing process.
“In most hospitals, children experience such disconnection from the normal rhythms of life,” says lead interior designer Anne Carlyle. “Because this site bridges the cityscape and the natural environment of a ravine – with extraordinary views of both – we had the opportunity to reinforce that connection.”
The heart of the scheme is the double-height family resource centre, created as the place where the city and the ravine come together. Providing a comfortable setting for first-time voters to congregate and orient themselves, the centre is also a good vantage point for those already familiar with the layout to observe the daily comings and goings. Generous use of glass and natural materials such as warm cherry woods and limestone floors soften the feel and yield warmth underfoot.
The benefits of art are also well considered. Drawing on themes from nature, transformation and history, the installations are intentionally abstract and whimsical. In the main lobby, artist Jan MacKie created Whispered Invitation, a curtain of over 5,000 coloured glass beads. Triggered by the motion of children, wisps of cosmological light dance across the walls and emulate the great northern lights.
But the most emotional installation is also the least technical. Created by children, a tactile mosaic of hand-patterned ceramic tiles featuring elaborate birds or just simple dents and wiggles gives children an opportunity to make their own mark on their home away from home.
An urban village
The human connection between nature and building is an intuitive and deeply emotional one. Harvard biologist EO Wilson wrote in The Biophilia Hypothesis of our deeper attachment to nature that includes a broad range of intellectual, physical and emotional needs. Wilson infers that it is impossible to detach from nature without also compromising our spiritual existence.3
As a paradigm for healthcare, Vancouver architect and award-winning leader in green design Peter Busby agrees. His firm, Busby, Perkins + Will, and Farrow Partnership are currently laying the groundwork for a new green standard at the Providence Legacy Project in Vancouver, British Columbia.
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Providence Legacy Project
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| Project completion |
2014 |
| Contract form |
P3 |
| Cost |
C$1.5bn |
| Client |
Providence Health Care |
| Architect |
Farrow Partnership Architects; Busby Perkins; Wills Architects
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Providence Health Care (PHC) is the largest Roman Catholic, non-profit healthcare organisation in Canada. The Legacy Project will establish a new 418-bed hospital, research and teaching facility in the city's Downtown Eastside, a gritty neighbourhood experiencing gentrification. Though still on the drawing board, the first impression is of a verdant wellness campus, rather than a place for processing the sick.
Conceived as an interconnected urban village, the hospital will integrate mixed-use functions including healing programmes, residential, research, retail, and a village green. The same gesture for place-making seen at Farrow’s Credit Valley Hospital extends to Legacy in the form of the Patient Intake Centre (PIC), a central hub that functions as main circulation atrium and community gathering space. Flanked by retail and residential, the PIC and the pedestrian-only forecourt will be animated by fluid and casual movement between campus and city buildings.
Momentum for the ambitious project comes both from an accelerated trend towards ambulatory care and short-stay treatments, as well as a growing belief that green design and healthcare are not mutually exclusive states. This is particularly relevant in British Columbia, where personal health is so closely linked to the outdoors.
The project is aiming to be the greenest in Canada, achieving a minimum LEED-Canada gold certification. "We'll be pushing the envelope to make things better and be sustainable,” says Neil MacConnell, Providence vice-president responsible for Providence Legacy Projects. "We would expect our building to be at minimum gold and hopefully platinum."
Through careful consideration of passive design strategies, buildings have been oriented to correspond with the sun’s path, allowing maximum sunlight penetration deep into courtyards, green terraces, and light wells. Additionally, higher structures located on the north will give patients unobstructed views to the False Creek waterfront. Photovoltaic panels have also been incorporated for renewable energy production, while natural ventilation in all patient rooms will help balance mechanical and electrical loads.
When complete, Legacy will provide a new value proposition for the future of healthcare. "Hospitals are the unhealthiest buildings going," says Busby. "Providence wants a green building with fresh air and sunshine; these are extremely important for the health of both patients and employees.”
In 41° to 66°, Regional Responses to Sustainable Architecture in Canada, architects Marco Polo and John McMinn wrote: "The enduring presence of regionalism in Canadian architecture...addresses both environmental conditions and material traditions.”4
More akin to portraits of the landscape around them, Canada’s exemplary hospitals intentionally support conscious decisions regarding the oft-neglected contextual dimension - and in doing so, find the common ground between sustainability, functionality and civic pride.
Sean Stanwick is an associate of Farrow Partnership Architects
References
1. Rochon L. Up North: Where Canada’s Architecture Meets the Land. Toronto: Key Porter
Books; 2005.
2. Salter Farrow Pilon Architects (Farrow Partnership Architects, Salter Pilon Architects,
successors). Thunder Bay Regional Health Sciences Centre. Thunder Bay, Ontario; 2004.
3. Wilson EO. The Biophilia Hypothesis. Washington Sheerwater Books/Island Press; 1993.
4. McMinn J. Polo M. 41° to 66°, Regional Responses to Sustainable Architecture in Canada.
Cambridge Galleries. Cambridge, Ontario; 2006
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