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Bridgepoint Active Healthcare among the 8 winners announced for Architectural Record’s 2016 Good Design is Good Business Award

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“No one likes going to the hospital,” says architect Bruce Kuwabara of KPMB Architects. That was the central insight that Kuwabara and a team of collaborating architects—including Toronto-based KPMB, Stantec, Diamond Schmitt, and HDR—used in designing a new hospital for the city’s Bridge­point Active Healthcare. This would be a new typology that would better serve patients’ happiness and well-being.

The 680,000-square-foot campus, commissioned by the University of Toronto–affiliated health network Bridgepoint and the province of Ontario’s Ministry of Health and Long-Term Care, breaks the mold by opening itself to the city and to nature.

The site borders the 104-acre Riverdale Park just east of Toronto’s core; it is located on a hill with views west over the Don River valley and the downtown skyline. Bridgepoint, a rehabilitation and continuing-care institution, had occupied a 1960s building that was functionally obsolete. Hospital CEO Marian Walsh advocated for its new facility to be “a village of care,” with improved quality of life for patients and stronger links to the community. The project also includes an adaptive reuse of the 19th-century Don Jail, which sits to the east, for administrative and educational purposes.

Michael Moxam, practice leader at Stantec in Toronto, says that the hospital “typically deals with very long stays, up to six months.” In light of that, “the vision is creating a healthcare environment that goes way beyond the building.”

The hospital is a long rectangular block that runs north–south, parallel to the nearby valley. Its facades are primarily clad with dark-gray zinc panels and studded with tall bay windows, one for each patient room. A series of moves and details break down the massing: the largely glazed main floor, a horizontal bar at the central fifth level for mechanicals, and bands of local Algonquin limestone cladding.

KPMB and Stantec, working with a site plan from consultants Urban Strategies, translated the hospital’s ethos of openness into urbanism. “We spent a lot of time thinking about the lower levels being not a hospital, but a community building,” says Kuwabara. “The key was to integrate the building with the landscape, the streets, and community.”

The 404-bed, 10-story building, while massive, succeeds at that goal. Because car and ambulance traffic is relatively limited, access roads are modestly scaled; the hospital reaches out to the surrounding Riverdale neighborhood through a series of plazas and green spaces. A one-story “porch” pushes north from the main building. It contains a therapy pool with glazed walls overlooking the valley and park, and it is capped with a public open-air terrace that includes a labyrinth conducive to meditation. Above, a fifth-floor balcony and rooftop garden provide outdoor space for patients.

Inside the patient rooms, walls are 40 percent glazed, with horizontal windows that allow patients to see outside even while lying in bed. And each room includes a vertical bay window offering high and lateral views of the sky, valley, and city. “Through a tremendous degree of transparency and porosity, the natural world is always apparent,” says Diamond Schmitt principal Gregory Colucci, a design team member. “Patients are never in a place where they don’t have a reference to the outside world.”

The building evolved through a complex design-build procurement procedure. KPMB, Stantec, and preservation specialists ERA worked with the hospital, provincial government, and community groups to establish the project’s goals and a design. Then a consortium led by developers Plenary Group won the contract to design, build, finance, and maintain the facility for 20 years. Diamond Schmitt Architects and the Toronto office of HDR elaborated on the design, oversaw construction, and served as architects of record.

This unwieldy process—which Moxam describes as “an epic relay race”—produced a consensus among the four architecture firms involved in the main building. The Stantec and HDR teams, which have substantial health-care experience, focused on the design of patient care areas, while KPMB and Diamond Schmitt oversaw the site plan, massing, building envelope, and other aspects. KPMB’s Kuwabara credits Diamond Schmitt with “substantial alterations and improvements” to the original scheme.

This many-hands approach has translated into clinical and financial payoffs: since moving into the new building in 2013, Bridgepoint has seen its average stay for rehab patients drop by 20 percent, at a cost savings of about $1,100 per day. The LEED Silver–certified building delivers a 30 percent energy reduction beyond the Model National Energy Code for Buildings and a 32 percent improvement over LEED baseline water use. And the hospital reports a strong qualitative response. In post-occupancy surveys cited by Bridgepoint, a full 100 percent of responding patients said they would recommend the hospital to other patients.

Collaborating again with ERA as well as an additional heritage consultant, Ventin Group, Diamond Schmitt oversaw a sensitive restoration of the Italianate stone structure, designed by local architect William Thomas and opened in 1864, and connected it to the new hospital through a one-story bridge. The symbolism is powerful. The jail, with later additions, held prisoners until 2013; now those later wings have been removed to make way for the hospital’s green spaces and plazas. As Moxam says, “It is an environment for healing people, and it has healed the city as well.”