Issue link: http://digital.canadawide.com/i/755184
DECEMBER 2016 | 73 Providence Care Hospital RENDERING COURTESY PARKIN ARCHITECTS LIMITED Providence Care Hospital by YVAN MARSTON B ringing natural light into health care spaces is accepted practice. And having a site with unobstructed views of a park-like setting and a Great Lake beyond is fortunate. But putting them to work in a complex facility that serves two distinctly different patient populations is a matter of design. Despite his deep involvement with the creation of Providence Care Hospital's new space in Kingston, Ontario, Cameron Shantz still felt surprised when he last toured the site one bright September day. "It's amazing that in a 625,000-square- foot building you're never really out of reach of either natural light or a great view," says Shantz, a director at Parkin Architects Limited, the firm in charge of designing the project and developing the building's clinical planning. Users' right to light and patient access to views served as two guiding principles in the redevelopment of the new hospital, a DBFM project awarded to a consortium consisting of EllisDon and their architects Parkin Architects in joint venture with Adamson Associates Architects, who were responsible for the site planning and exterior envelope design. The Providence Care Hospital project's real challenge, however, was to design a space for two very different patient populations: rehabilitation/ complex continuing care clients and mental health clients – both of which have been housed in buildings that have aged beyond their useful lives. The rehab patients currently reside in the St. Mary's of the Lake Hospital, a 1940s era facility where many of the rooms cannot accommodate wheelchairs and where the physiotherapy gym is too small to serve its patients' needs. The other hospital, Providence Care's Mental Health Services building, still functions using ward-style living conditions with eight patients to a room and shared washrooms. It is a facility conspicuously out-of-date with today's approach to mental health and recovery that factors privacy and social interaction spaces into healing. "The Providence Care redevelopment is meeting the changing needs of the region," says Infrastructure Ontario's Arin Arat, senior project manager, project delivery. "Providence Care joins 35 hospital projects entering substantial completion that we are overseeing, with another 13 in construction and seven more in the transaction phase. With each project the health care needs of the province are being addressed and changing access to state-of the-art hospitals, that's very exciting and we're very proud to deliver this project for Kingston to meet the unique needs that Providence Care offers," he explains. A single facility for Providence's delivery of health care service makes sense on a practical level, but Parkin's Shantz says combining these two populations also infused the project with another level of importance: it could contribute to de-stigmatizing mental health in the community. "We were trying to get away from the idea of having one wing for mental health and another for rehab and complex care," he says. The solution? Integrate the populations into similar but separate spaces. As such, all the ground floor spaces of every patient wing are dedicated to mental health services and the top two floors house rehab and complex continuing care patients. There are three T-shaped patient areas that reach out from the main structure. They form the nine in-patient units. Each unit is divided into three 10-bed clusters (all are private rooms with three-piece washrooms), and each unit has its own space for dining, recreation and therapy activities. Three 10-bed clusters make up a unit and there are 270 beds in total. Wards are configured to reduce walking for staff wherever possible, and are similar, so that there's no marked difference between a rehab hallway and a mental health hallway, except that the latter was constructed to be more robust, in terms of safety and security. Walls in a mental health unit are made of impact-resistant gypsum board and, while the windows and glazing might have the same dimensions and appearance as the ones in rehab, they're made of safety glass. Also, as is common in mental health facilities, the fixtures and fittings are of an anti-ligature design. Mental health patients access secure outdoor courtyards at grade while rehab and complex care patients benefit from terraces on the upper levels. Security door systems that are pass card protected enable varying levels of privileges to mental health patients. And these distinct patient populations integrate in the hospital's main public spaces. The lobby's two-storey glazing faces northwest, allowing light to stream into this main circulation space. The cafeteria, which opens from the lobby, provides a line of sight through to the park outside, and beyond it Lake Ontario. The use of highly glazed public sequences along areas like the concourse and the cafeteria create opportunities for visual connectivity between the public and private realms, says Domenic Virdo, a partner with Adamson Associates Architects. "It also offers connections to nature and serves to embody and communicate the concepts of recovery and transition," he says. What's more, these areas of transparency are also meant to promote accessibility and diminish the stigma associated with mental health facilities. The development of the facade, he explains, and in particular the use of massing and the arrangement and composition of the material palette, is a response to the hospital's vision; one rooted in the idea of creating a more human-scaled, homelike, non-institutional and patient-centred environment. For example, the in-patient units are inspired by the notion of creating a residential townhouse- like arrangement. Through the use of multiple materials and changes to surface planes, the units achieve a reduction in building scale as well as a degree of individualization. Cladding materials were carefully and thoughtfully considered. The use of brick, typically a residential building material, connects to the hospital's concept of creating an environment that is reminiscent of home. Then there's the use of stone, in both coarse and dressed finishes. This connects to the historic importance of limestone as a fundamental local building material. And it also acknowledges the materiality of the heritage buildings to the east of the site. Beyond its ability to connect to the natural landscape and the heritage around it, the hospital's systems have been designed to incorporate a range of sustainable design strategies, with the goal of achieving LEED Silver certification. This posed its own set of challenges, says Crossey Engineering's Patrick Waller. For example, despite stringent energy efficiency requirements, Providence Care Hospital, like most health care facilities, also had high ventilation requirements. His firm, the DBFM mechanical engineering consultants on the project, met this challenge by adding energy recovery wheels to most of the air handling units so that in the winter the building could take heat and moisture from the exhaust stream, recover it and put it back into the outside air coming in. That helps to reduce natural gas use in the winter and lower electricity use in the summer, he explains. "We also put in a heat recovery/ chiller system. That allows us to move heat from where it is not wanted to where it is wanted, year round," he says, explaining that hospitals require heating and cooling throughout the year because they have minimum ventilation rates. With more frequent air exchanges comes a need to cool or heat air to a comfortable temperature, regardless of the temperature outside. The use of energy-efficient systems to reduce pollution, carbon emissions and contaminants goes beyond the facility's responsibility to support the city of Kingston in achieving zero smog days. Rather, it's one more indication of the respect the facility has for the landscape in which it finds itself. A LOCATION 752 King Street W, Kingston, Ontario AGENCY RESPONSIBLE Infrastructure Ontario CLIENT Providence Care ARCHITECTS Parkin Architects Limited / Adamson Associates Architects DBFM CONTRACTOR EllisDon Construction Services Inc. STRUCTURAL CONSULTANT Stephenson Engineering MECHANICAL CONSULTANT Crossey Engineering Ltd. ELECTRICAL CONSULTANT Mulvey & Banani International Inc. LANDSCAPE ARCHITECT CSW Landscape Architects Ltd. TOTAL SIZE 625,000 square feet TOTAL COST $810 million