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FEBRUA RY 2016 | 59 PHOTOGRAPHY BY RICHARD JOHNSON/COURTESY PARKIN ARCHITECTS LIMITED Oakville Trafalgar Memorial Hospital Oakville Trafalgar Memorial Hospital by YVAN MARSTON T he first thing patients will notice about the Oakville Trafalgar Memorial Hospital's emergency department is the size of its waiting room. "It's tiny," says Bill Bailey with a sweep of the hand indicating an artfully partitioned seating area with chairs for little more than 20. At first blush it's surprising for a hospital built to serve a community of 180,000, but there's a method to it. "It's designed to process patients to triage rooms more efficiently," explains Bailey, the hospital's VP of redevelopment. The series of five triage/registration rooms are aligned and serviced by a back corridor. Patients remain in the triage room while staff travel through this back space to come to them, he says. Once triaged and registered, they are moved to an internal waiting room or one of the department's 64 examination rooms, each equipped with switchable glass that allows privacy and enables better infection control than curtains or blinds. Designing a new hospital from the ground up offers a number of opportunities to rethink how these spaces function. As this design-build- finance-maintain (DBFM) project came to life in time for a December opening, staff implemented much of the learning they had been doing over the past three years to adapt to a facility triple the size of the Oakville hospital they left behind. Set on a 50-acre site some 10- kilometres west of the legacy Oakville Trafalgar Memorial Hospital, the new facility features the capacity for 457 inpatient beds (up from the 340 hosted in the old site), enhanced patient privacy and infection control measures – including 80 per cent single-patient rooms – and patient-centred details like oversized windows, patient-controlled lighting and temperature, and pull- out couches in some patient rooms for family members to stay overnight. From a clinical perspective, the hospital's programs have also expanded to include a cancer clinic, stress echocardiography tests for heart disease, an endoscopy ultrasound for imaging digestive tracts and surrounding tissue and organs. With its expanded service mandate, the initial thought was to build a campus-like environment. But a campus this early in its development could prove too spread out to be practical, explains John Christie, a partner at Parkin Architects, the firm in charge of designing the project and developing the building's clinical programing. Instead, the winning bid, from a consortium consisting of Fengate, Carillion and EllisDon, and Parkin Architects in joint venture with Adamson Associates Architects as the site planning and exterior envelope designers, opted for a complex made up of three buildings and a parking garage. To the north sits the five-storey continuing care and rehabilitation building. Clad in a terracotta- coloured precast concrete panel system that evokes a residential palette, this structure also houses a number of outpatient programs such as nephrology and includes a mechanical penthouse. Standing prominently to the south of the rehab building is a 10-storey inpatient tower that houses patient rooms, operating suites as well as pre- and post-operative support functions. Behind this tower, a four- storey diagnostic imaging building forms the west side's podium. This is where services such as emergency care, ambulatory care, maternal and child services as well as adult mental health are housed. And there's a fourth element: a two-storey lobby that connects the space between the rehab building and the main patient tower. "While the facility has been constructed to meet and exceed the needs of patients today, the hospital has been designed to evolve and scale to accommodate technical innovation and expansion in the future," says Edmund Mahabir, executive VP, PPP Infrastructure Development and Construction at Carillion. "Having the opportunity to contribute and collaborate at all stages of the process and influence the finished building enables our team to manage a well- designed and well-structured social infrastructure project that will offer a lasting effect and benefit to the communities it serves for the long term." The main lobby is defined by its calming palette of colours and the warm tones of its materials, explains Domenic Virdo, a partner at Adamson Associates Architects and the project's design manager. Upon entering from the east, the expansive, light-filled space draws warmth from the curved cherry wood- coloured laminate wall that forms the exterior of the auditorium. Directly across from it stands a full-height hearth made of Ontario split-faced stone and features a long gas fireplace insert. Complementing these elements is the terrazzo floor. Animated with subtle waves of blue and white, it draws its inspiration from the nearby Sixteen Mile Creek. "The notion was to inject a series of natural materials into the design here and throughout the hospital as a way of de-institutionalizing these spaces," says Virdo. Natural light figures prominently in the design. It's used both as a means of orientation and for its proven therapeutic properties, explains Christie. Even the 32,000-square-foot podium's back-of-house spaces benefit from strategically located light wells, ensuring that patients and staff access light as they experience the space. There's an attention to user experience here that goes beyond the hospital lobby, says Christie. "What you'll notice is a lot of colour, a lot of LED fixtures. We used the money and resources we had to make sure that the whole hospital offers an experience – not just on the public side but in the back of house space where we could create a positive work environment to attract and retain staff," he says. From a structural point of view, hospitals present their own set of challenges because they are considered post disaster buildings, explains Jennifer Watson, the project engineer for structural consultants Read Jones Christoffersen. Designing for post disaster involves many more requirements, she explains, for example structural walls, such as those surrounding a stairwell have to continue all the way to the foundation to make them far more robust. LOCATION 3001 Hospital Gate, Oakville, Ontario AGENCY RESPONSIBLE Infrastructure Ontario CLIENT Halton Healthcare PLANNING & DESIGN CONSULTANT Stantec ARCHITECTS Parkin Architects Limited / Adamson Associates Architects DESIGN BUILD FINANCE MAINTAIN CONTRACTOR EllisDon Corporation / Carillion Canada Inc. STRUCTURAL CONSULTANTS Stephenson Engineering / Read Jones Christoffersen MECHANICAL CONSULTANTS HH Angus & Associates Ltd. / Crossey Engineering Ltd. ELECTRICAL CONSULTANT Mulvey & Banani International Inc. TOTAL SIZE 1.6-million square feet TOTAL COST $2.7 billion ($1 billion for construction; $1.7 billion for 30 year facility maintenance and lifecycle)

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