Architecture Canada n°7 2nd semestre 2009
Architecture Canada n°7 2nd semestre 2009
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  • Parution : n°7 de 2nd semestre 2009

  • Périodicité : semestriel

  • Editeur : Naylor Canada

  • Format : (213 x 276) mm

  • Nombre de pages : 48

  • Taille du fichier PDF : 3,4 Mo

  • Dans ce numéro : des architectes donnent de la vie au design des soins de santé.

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www.raic.org/2009 Health-care Design according to Jerald Peters, MRAIC, a principal with the architectural firm. There is a central corridor that features on one side an operating theatre, emergency room and several other rooms for medical procedures. On the other side are 12 multipurpose examination rooms with two-way mirrors that are equipped with blood pressure cuffs, otoscopes, thermometers, medical gas columns, heart-rate monitors and intravenous carts hanging from the wall. Only those people there for training or retraining, or medical students taking their practical exams, use the main corridor. The technical staff and actors use a back corridor that encircles the central area in an arena-like confi guration. « People playing standardized patients have lounge space in the backstage corridor areas where they are given instructions and then enter a clinic room in character, » says Peters, who explains that the idea of having separate sections was inspired by a similar set-up at the Mayo Clinic in Rochester, Minnesota. One of the greatest challenges over the two years it took to design the facility was getting the « theatrics » right. Video and audio recording had to be installed, along with the computerized simulation dummies known as SimMans. Students practise medical diagnosis and treatment on fi ve of these anatomically correct, robotic patients that simulate two adults, a birthing mother, an infant and a child. They can breathe, they have pulses and refl exes – and some even talk. And, they are outfi tted with technology that simulates the integration of touch with visual and audio responses to mimic the look and feel of actual medical procedures and surgery. Med students receive hands-on training and are tested on what they learn. Instructors and technicians, hidden from view in the backstage area, can manipulate situations. Four of the rooms are equipped with robotic headboards and elevated observation areas that allow professors to stage various scenarios or traumas, such as power failure in the middle of a procedure, or a Code Blue, to imagine a patient requiring resuscitation following cardiac arrest. It’s complicated stuff, so the U of M hired EMS, an Atlanta-based medical education software company, to ensure that the software Credit Valley Hospital’s intricate main-level lobby. and recording components of the simulation procedures system were properly connected and functioning. « One of the other challenges was that we had to design something that could accommodate the needs of each of the different disciplines using the facility, » says Peters. Fortunately, the Brodie Centre had the right space for the project. The lower level had concrete in place for a swimming pool planned, but never completed, for medstudents. That area was filled in and created a crawlspace through which Friesen Tokar was able to run cables and medical gases below the training facility’s fl oor. 18 ■ THE ROYAL ARCHITECTURAL INSTITUTE OF CANADA/L’INSTITUT ROYAL D’ARCHITECTURE DU CANADA Completed in 2007 at a construction cost of $1.9 million, the clinical learning simulation facility has been so successful at the Health Sciences complex that the U of M is now looking at replicating Friesen Tokar’s concept at satellite hospitals in Winnipeg for emergencyroom training. It’s also an example of how new approaches in architectural design are helping to improve the quality of health care delivery across Canada. Whereas the U of M simulation centre design focuses on the practitioner, the architectural vision for two hospitals to the east focuses on the patients.
FARROW PARTNERSHIP ARCHITECTS INC./PHOTO : TOM ARBAN Nature a feature of Mississauga hospital A cancer centre facility and ambulatory care addition at Credit Valley Hospital in Mississauga, which opened in 2007, is intended to provide plenty of access to natural light and nature. « Those natural features have measurable benefi ts in terms of productivity, emotional well-being and stress reduction, and images drawn from nature also have a strong therapeutic effect, » explains Tye Farrow, FRAIC, senior partner with Toronto-based Farrow Partnership Architects Inc. When beginning any project, his firmruns « common ground » sessions as part of a design-charette process to identify both the « tangibles » and the equally important « intangibles. » Says Farrow : « Despite a lot of good intentions, many hospitals don’t demonstrate much empathy for the emotional states patients are in. Designs are overshadowed by attention to technical specifi cations, which are one element of the design process. But what’s clear is that a lot of studies indicate people have an innate desire for a close connection at the physical, emotional and intellectual levels with the natural world. So the challenge is to create environments that tie into that and bring hospitals to life, which is essential for realizing an aggressive and economically vibrant vision of a hospital. » In fact, Credit Valley’s stated mission is to be « the fi nest hospital in Canada in the hearts and minds of people we serve. » Patients and visitors entering Credit Valley’s main-level lobby and radiation treatment waiting area are greeted by a four-storey wooden structure in the formof four large trees that bend and curve, and whose big branches appear to be holdingup the roof pierced by a variety of skylights. Almost cinematic in its presentation, its material serves as a reminder of life and, by its appearance, elicits a sense of wonder and, perhaps, a sense of hope at a time when people entering the hospital are in despair. Depending on your viewpoint, it can seem like you’re standing in the middle of a forest, or that you’re under water and the branches are reeds touching the sky-lit surface. The result is arguably North America’s most intricate wood construction, according to Farrow. Made of wood harvested from British Columbia, fabricated in Alberta, and designed and built in Ontario, the structure also created challenges for Farrow’s team. Wood did not meet the Ontario Building Code (OBC) performance standards for non-combustible construction, due primarily to the inability of conventional sprinkler systems to adequately reach surfaces shielded by the proposed design of curving beams. So, Farrow Partnership introduced a Hi-Fog water-mist, fire-suppression system to comply with the code requirements and serve as an environmentally friendly alternative to ozone-depleting chemical agents. But in doing so, the firmbecame a pioneer of sorts. The expanded application of the Hi-Fog system at Credit Valley led to the development of advanced types of nozzle hardware that willassist others who seek approval to use sustainable timber or wood products « Those natural features have measurable benefits in terms of productivity, emotional well-being and stress reduction, and images drawn from nature also have a strong therapeutic effect. » in an interior environment. By working with staff at the Ontario Fire Marshal’s office, Farrow Partnership illustrated that wood can be an acceptable design and performance alternative to steel for structural support, and achievecompliance ratings – but only after the National Research Council in Ottawa successfully tested a full-scale mock-up of the sprinkler system using a large piece of wood. The wooden architectural centrepiece now serves as Credit Valley’s brand image, appearing on the hospital’s recruitment advertising and on its website (www.cvh.on.ca). And, the project received three architectural awards in 2007 from the Stockholm-based Health-care Design International Academy for Design and Health, including its first-ever prize for an architect won by 45-year-old Farrow, who has been involved in the design of other hospitals, including the Thunder Bay Regional Health Sciences Centre, which, as one writer recently noted, promote wellness through inspiring designs. The London-based Commission for Architecture and the Built Environment as wellas the Ontario Association of Architects have also recognized Credit Valley with awards for excellence in health-care design. However, the hospital design’s crowning achievement has been the warmembrace it has received from patients, staff and visitors to Credit Valley’s Carlo Fidani Peel Regional Cancer Centre and Vijay Jeet and Neena Kanwar Ambulatory Care Centre. « The common theme from people who haveemailed us comments is that it isn’t a hospital and that they’ve never encountered souplifting an experience on a spiritual dimension, » says Farrow, who notes that it’s « extraordinary » for an architect to get such feedback, let alone so glowing. In fact, even Michelle DiEmanuele told him that prior to accepting the position as Credit Valley’s president and CEO, she walked around the facility anonymously and was impressed by how it didn’t « feel » or « smell » like a hospital. The lobby has also become a popular meeting place. Three days a week, a volunteer plays piano for an hour in the early afternoon while people eat their lunch, soaking in the sounds and sights from the light filtered through the branch-like patterns of the wooden sculpture. Farrow is gratified by the positive outcomes, but isn’t completely surprised by them. Prior to designing the new Credit Valley facilities, he visited over 30 cancer centres throughout North America and Europe and discovered that patients want to be surrounded by or reminded of nature and life. Not just through fl oral patterns on ceilings and fl oors, as some hospitals do, but at a deeper level with emotional, intangible biophilial representations embedded in the very fabric of the building, says Farrow, who holds a Master of Architecture in Urban Design degree from Harvard University. THE ROYAL ARCHITECTURAL INSTITUTE OF CANADA/L’INSTITUT ROYAL D’ARCHITECTURE DU CANADA ■ 19 www.raic.org/2009



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