Kingston’s newly opened Providence Care Hospital (PCH) provides physical medicine, rehabilitation, geriatrics, complex continuing care, palliative care, specialized mental health care, and forensics, for patients in southeastern Ontario. The building location close to Lake Ontario, and the site’s surrounding natural beauty, inspired many aspects of the facility’s exterior and interior design.
Working collaboratively with the client and key stakeholders, the common objective was to create a facility that supported patients through every step of the healing journey. Equally important, was to create an environment in which staff enjoyed working. Cameron Shantz, lead architect on the project, explains, “By integrating the building into the landscape, the design provides an excellent experience to the patients and staff.”
He continues, “The needs and requirements of continuing care facilities like PCH differ from those of an acute care facility, in both design and function. As architects, our primary concern is to ensure that all design elements positively influence patients in their healing process.”
Shantz provides additional insight into a few of the elements that have been incorporated into the design.
Sightlines to Nature
“Providence Care Hospital orients patient bedrooms and social spaces towards the lake, thereby creating optimal views of the surrounding natural landscape, often across large rooftop courtyards incorporated into each inpatient unit. The scale of the building was reduced by articulating the massing of the inpatient units, which also provided great opportunities for views to the outdoors.
“Two primary building materials were used to create the aesthetic for PCH. First, limestone masonry was used to pay homage to the heritage buildings immediately east of the site. Second, traditional brick masonry was incorporated to create a more human, warm and home-like setting.
“Inclusion of natural elements continues throughout the interior of the buildings. Three main materials—glass, wood and stone—are used to reinforce the connection to the Hospital’s surroundings. The central concept for the design is the “Water’s Edge” theme, which builds on the facility’s connection and orientation to Lake Ontario. These natural elements and unique orientation are important way-finding tools to guide patients and visitors through the facility, by distinguishing specific inpatient pods based on their relationship to the surrounding site. The inpatient units are identified relative to their proximities to these site features:
- to the west is Lake Ontario Park, known as Parkside, symbolized by wood;
- to the south is Lakeview, represented by glass; and
- to the east is Heritage, represented by stone tile.
Light and Transparency
“To support patient healing, incorporating light and the natural beauty of the site into the building was essential.” Naturally lit, double- and triple-height spaces and exterior courtyards were incorporated into the framework of the building from the beginning, to ensure an abundance of natural light penetrates the building. Patients, staff and visitors are always exposed to views of the outdoors and the presence of daylight as they walk through the facility.”
Shantz explains, “For staff, sunlight and outdoor views produce warmer environments that are less sterile, less institutional. In these subtle ways, their quality of life is improved, which affects how they care for their patients, and ultimately reduces their stress levels.”
The transparency necessary to allow natural light to enter the facility serves a significant purpose. It creates a visual connection between different spaces and levels within the buildings. Shantz describes the effect it has on patients saying, “They understand that they are not on their own; it gives them the understanding that there is a context and connection with other people around the building.” Areas of transparency promote accessibility and diminish the stigma associated with mental health facilities.
Mock Up Process and Design Development
In an institution that is designed around patient and staff experience, a collaborative design process is critical to a successful outcome. During the design phase of PCH, clinically focused user group sessions were undertaken to encourage input from key stakeholders. These user groups were held in a collaborative “round-table setting” and included clinical staff, support staff, hospital administration, and patient representatives. The objective was to ensure a comprehensive perspective on the detailed requirements for each department.
Once the specific priorities were established for key rooms, a detailed mock-up process helped all stakeholders, who may not be familiar with design, better understand, even experience, how the space would feel and function:
- Working with the clinical groups, full-size paper mock-ups were taped to the floor to give everyone a better understanding of the size of the space. Furniture, a stretcher, and temporary partitions were brought in to create perspective more realistic context. The mechanical contractor even came in to place toilets in the mocked-up space to help the team visualize what the final layout would look like.
- Based on findings from the first step, the rooms were re-designed. A “rough” mock-up was created which included the physical build out of the rooms with studs, drywall, and fittings. At this stage the rooms were reviewed and rebuilt until the design was agreed upon them.
- At the third stage, finishes from floor to ceiling were installed. The clinical group reviewed the space again and additional adjustments were made.
- The final mock-up step involves the creation of a finished room. Everything is installed, including all accessories, millwork, windows, and a working patient lift.
This collaborative mock-up review process was crucial in ensuring a final design that met the needs of all stakeholders. At each stage of the process, important user feedback was received and incorporated.
Testing the Design
Providence Care Hospital will undergo a Post-Occupancy Evaluation (POE) in the upcoming months. This is an important process, which compares key criteria between the hospital’s old and new facilities.
For example, one area of comparison will be to evaluate the reduction in staff injuries. In the original facility, there were only two or three patient ceiling lifts per floor, the lack of which contributed to staff back injuries when they attempted to lift patients into beds. In the new Hospital, there is a patient lift in every room. The POE will conduct the analysis to determine whether there has been a reduction in staff injuries and determine whether this reduction can be attributed to the inclusion of patient ceiling lifts in all rooms.
Other areas that will be reviewed in the POE will include design aspects such as connection to nature, ease of wayfinding, and travel distances for patients and staff.