Adding a new wing to the fully developed site would require surgical precision.
The original Chinook Regional Hospital, which was constructed close to 30 years ago, cuts a hard-angled U-shape around a courtyard and faces out onto a mechanical plant and parkade. That left only a sliver of land available for expansion.
The long and narrow footprint of the now completed addition squared off the courtyard. This approach came with challenges as the healthcare facility remained in operation through construction as well as opportunities to draw in natural daylight.
Completed late last year, the five-storey hospital wing formally opened its doors to the growing Lethbridge, Alberta community it serves this summer. The five-year, $127-million project revitalized a traditionally styled healthcare facility with an unconventional modern addition. It is intended to improve access to medical services in the short term and accommodate future demand in the long term.
“The hospital upgrades and new addition were designed specifically to meet the medical service needs of Lethbridge and area families today and far into the future,” Brian Mason, Alberta’s minister of infrastructure, said in a news release celebrating the hospital wing’s grand opening.
The original building has all the hallmarks of its era, said architect Kirsten Reite, principal-in-charge, formerly with Perkins+Will, currently with KRA. The six-storey building’s exterior features a brick façade perforated with punched-out windows and topped with mansard-like roofing.
“Respecting the monolithic nature of the building, we did want to reflect some of that and how we did that was we carried on some of the datum lines of the windows and other doors and other architectural features horizontally, as well as tie into the masonry element,” said Reite.
The slate grey bricks at the base of the addition echo, rather than replicate, the burnt-red bricks of the original building.
The upper storeys of the addition transition into insulated glass panels that give it durability in Lethbridge’s climate, said Julie Verville, project manager, formerly with Perkins+Will, currently with KRA.
Over the span of the project, Perkins+Will worked with Group2 Architecture, who understood the local climate. The southern Alberta city swings from hot summers to cold winters and is situated in the ‘chinook belt,’ which gets blasted with the Rocky Mountain’s warm winds.
“Throughout the building, we had a high-efficiency envelope, lots of insulation and didn’t do a curtain wall all around the building,” said Verville. “[We] went with more punched windows to add more insulated wall than just glazing, but without affecting the amount of daylight that we were bringing inside the space.”
While the addition’s skinny footprint naturally soaked in the sun’s rays, the goal of daylighting was supported by a number of elements. Glass floor cutouts and light scoops located on a rooftop respite area carry those rays into the core of the building to common areas such as waiting rooms.
In a departure from the beige palette common to healthcare facilities, the interiors are finished in warm woods and vibrant colours. These primary and secondary hues — which reflected the culture of the young hospital, noted Reite — are captured in illuminated artwork panels that distinguish between different departments to provide visual wayfinding.
Also aiding in wayfinding is the simple layout, which is planned around a central corridor which acts as a spine. The layout remains fairly uniform from floor to floor to provide the flexibility to make adjustments to the programming of spaces, Reite explained.
Lean design principles placed the nursing stations closer to patients for optimized work flow. The stations are outfitted with modular furniture for ease of reconfiguration and reinforced with solid surface material to withstand impacts from carts and stretchers.
The hospital’s Day Procedures department was renovated alongside the addition. Lean design principles factored into its planning, too. An assessment of actual needs freed up 30 per cent of the space for uses including a rapid assessment waiting room.
“We build these hospitals that are too big, and they don’t need to be this big, because it’s always a reaction to the ‘What if’s,” remarked Reite. “And so in this instance, we said, ‘Okay, let’s go through some scenarios and see how many rooms you actually need, not just guess.”
Complicating construction was the fact that the addition was giving the hospital a new main entrance, Verville observed. While the work was under way, however, staff, visitors and patients had to pass through the active site to enter the building.
“The challenge was to keep safe, secure access to the hospital during the construction,” said Verville. “But with the team we had in place, and constant communication, it was possible and no incidents happened.”
In a related challenge, the team also needed to map out a permanent path to get patients arriving by air ambulance from the helipad atop the parkade into the healthcare facility, noted Stacy Christensen, project architect, Group2 Architecture.
“It took quite a bit of gymnastics to get that to work, to get a person who had been brought in by ambulance down the parkade elevator, through the basement, back up the elevator in the hospital and into Emergency, in a seamless flow without crossing public paths,” Christensen explained.
The redevelopment of Chinook Regional Hospital has the distinction of being the first project in Canada to have registered for LEED for Healthcare with plans to pursue Silver level certification. Compared to a benchmark building, the design of the facility is aiming to reduce energy use by 26 per cent, lighting power density by 30 per cent and potable water use by 42 per cent, Verville reported.
The daylighting, high efficiency building envelope, mechanical and electrical equipment are expected to help the project achieve its targeted LEED certification. So is the effort to use healthy and locally sourced materials, which included specifying bio-based resin flooring instead of the typical PVC-based flooring.
All told, the addition expanded the hospital’s Cardio-Respiratory, Outpatient Services and Spiritual Care departments along with other support areas. The Neonatal Intensive Care Unit saw its number of beds more than double, increasing its count from eight to 20. The addition also introduced a multi-faith Ceremonial Room with the ventilation required to perform the traditional First Nations practice of smudging.
The project, more than five years in the making, delivered two floors of shelled space in the new hospital for future development. The design also accounts for the possibility of adding a tower to the site for uses such as ambulatory care or medical offices that would connect to the facilities.
“The City of Lethbridge is growing,” Lethbridge Mayor Chris Spearman said in a news release celebrating the hospital wing’s grand opening. “As we inch closer to a population of 100,000, it is vital to have the healthcare facilities that can support this growth.”
Michelle Ervin is the editor of Canadian Facility Management & Design.