At The Crossroads

Project Peterborough Regional Health Centre, Peterborough, Ontario

Architect Stantec Architecture Ltd.

Text Ian Chodikoff

Photos Richard Johnson

The provision of adequate health care remains a high priority for Canadians. But despite the billions of dollars being spent on new hospital facilities, the expedient process of building hospitals is resulting in mediocre architecture that responds only to bureaucratic design guidelines established by provincial governments. This process rarely addresses the less tangible but no less important characteristics of “pride of place” and “community.” Fortunately, there are a few notable exceptions, such as the recently completed Peterborough Regional Health Centre, a project led by Michael Moxam of Stantec’s Toronto office. Awarded to Moxam’s firm in 2000, the $205million, 715,000squarefoot health facility was completed in August 2008. Built adjacent to the existing hospital, the 494bed acutecare facility is nearly three times the size of the original facility. Moxam, who has also designed healthcare facilities in Chatham, Toronto and Ottawa, is becoming increasingly well known as an expert in designing forwardthinking healthcare communities. His firm, along with Kuwabara Payne McKenna Blumberg Architects, recently won a 2008 Canadian Architect Award of Excellence for their thorough design strategy for Bridgepoint Health, a complex healthcare facility and urban regeneration project just east of Toronto’s Don River.

Located about 90 minutes northeast of Toronto, the city of Peterborough (pop. 75,000) is situated in the picturesque Kawartha Region, an area characterized by sublime views overlooking rolling hills, lakes and marshland. Peterborough, like many other communities within the Kawarthas, evolved from the establishment of rural crossroads or “corners” used by the agricultural or dairy farmers in the region. Driving through the area today, one can still discover communities with names such as Fowlers Corners, Precious Corners or Mathers Corners. In addition to its agricultural roots, Peterborough has a strong connection to both the Ottonabee River and the TrentSevern Waterway. Consequently, numerous bridges have been built in the region, the most famous of which arguably remains the Faryon Bridge (1969) designed for the original Trent University campus by Ron Thom and Morden Yolles.

Located west of the downtown core, the 39acre hospital site overlooks the city of Peterborough. The main access to the site is through a ring road from the east, where the slope drops a height of 20 metres from end to end. The site’s topography is used to break down the mass of the building and to establish an appropriate community scale to the facility, thereby providing multilevel entrances fostering numerous public connections to the area, such as the surrounding singlefamily residential neighbourhoods to the north, west and south. Neighbours to the east include a nursing home, an apartment building, a medical clinic, a healthservice building, and a synagogue. Because housing mostly surrounds the site, neighbours were concerned that the buildings were going to be too tall. In actual fact, the new hospital is lower in height than the preexisting facility.

The program for the Peterborough Regional Health Centre includes a fullservice healthcare facility offering diagnostic and treatment facilities including rehabilitation, intensive care, emergency services, surgical services, ambulatory care and support services. The building itself is clad using a mix of locally quarried stone, red clay brick with steel channel inserts, and corrugated metal siding to reflect the rich industrial and agricultural traditions of the region. The design also includes numerous courtyards and roof gardens that deinstitutionalize the feel of the facility while improving users’ orientation through a variety of visual experiences.

The lake, the rocky outcroppings and the city’s historical connection to the idea of the crossroads influenced Moxam’s approach early on in the design process. The “crossroads” metaphor is largely achieved by the intersection of two main axes that converge in ways that are visible from many vantage points throughout the hospital. An eastwest path establishes a main entrance and the central lobby space is defined by a wall of locally quarried stone. Visitors can reconnect with the Kawartha landscape as they pass through the fully glazed lobby wall that faces east, offering wonderful panoramic views overlooking the city. The northsouth axis comprises the prime circulation spine on all six levels of the hospital. To heighten the sense of crossroads, several interior courtyards help punctuate the building mass while bringing natural light deep into the building. Applying Moxam’s “bridges” metaphor, the northsouth axis through the new hospital passes through the internal courtyards and overlooks some of the public spaces below.

In keeping with the intention to bring in natural daylight wherever possible, large expanses of glazing–both clear and fritted–are used to connect patients, families, visitors and staff to the Peterborough community, creating a lively rehabilitative hospital environment. In the clinical program areas where patient visits are frequent or lengthy, panoramic views of the everchanging landscape in the Kawarthas are provided through large windows. The spectacular colours of the region’s trees during the fall season were the design inspiration for the coloured glass elements that punctuate the glazed enclosure surrounding the community courtyards. This leafinspired colour scheme can be found elsewhere in the hospital, such as the inpatient and public areas, the cafeteria, courtyard and library spaces. To add warmth to the materiality of the facility, cedar slats were used to clad the underside of overhangs and some of the ceilings in the public areas.

In addition to being a hospital, this new facility also needed to incorporate community facilities to host meetings. Moxam claims that on a per capita basis, Peterborough raises more money than any other city in Ontario. And since much of this charity work and philanthropy is healthrelated, it comes as no surprise that the Peterborough Regional Health Centre needed to accommodate local groups and community associations. The efficacy of

hospital administration is another programmatic challenge that the Stantec design team addressed, resulting in the positioning of the main executive boardroom near a highly public area. This was motivated by a desire for the hospital to exist as a true community centre for Peterborough, one where a greater perception of transparency is expected from a modernday public institution.

The complex and demanding programmatic requirements also meant that the Stantec design team broke up into a variety of smaller teams covering the broad challenges of intensiveand complexcare units, public space, and food services. Various consultants joined the project team to offer their own specific expertise. The necessity of testing the level of design efficacy and programmatic resolution meant that the architects needed to build a fullscale nursing station in the basement of the preexisting hospital. This is the first time that Stantec had done anything like this for a hospital client, but the mockup was necessary to ensure that the stakeholders’ objectives were met. The mockup was also indispensable in testing new technological innovations in nursing and health care with the architects’ new designs. For example, ubiquitous hospital communication and monitoring devices like the traditional squawk boxes installed above patients’ beds have been replaced by newer generations of equipment, resulting in reduced ambient noise in the patient wards and a more efficient means of monitoring patient progress. Because of this new technology, the Stantec team introduced new ways
in which visual connections could be broadened to create a more patientand stafffriendly hospital environment. Simple modifications of the typical nursing station have been achieved to provide views in multiple directions. For a typical inpatient room, floortoceiling windows were installed adjacent to the patients’ beds to give them enhanced views of the outside world, without compromising the efficiency of the hospital room layout.

The Peterborough Regional Health Centre was the last to use the traditional Ministry of Health delivery system. The hospital was built using the largest stipulatedsum contract for a hospital that construction company EllisDon ever undertook. To guide the design and construction process along, Stantec went through a lot of rigorous exercises to ensure that the design integrity was kept intact. By the time the hospital officially opened, few compromises had to be made, and certainly, the importance of maintaining critical vistas to the exterior as well as the architectural concepts of the “bridge” and “crossroads” were preserved. In one instance, Moxam had to argue for extrawide corridors, which initially contravened the Ministry of Health’s tight space requirements for healthcare facilities. Nevertheless, the request was eventually allowed, and for the betterment of the project.

This new healthcare facility illustrates the importance of designing highcalibre architecture for a smaller urban centre. The Peterborough Regional Health Centre has the warmth and appeal of a community centre, and it includes important design features that help both hospital patients and staff to remain connected to Peterborough and the surrounding landscape. We can only hope that more hospitals like this will continue to be built in the future. CA


Client Peterborough Regional Health Centre

Architect Team Michael Moxam (project principal/design principal), Norm Crone (health-care planning principal), Stephen Phillips (support project principal), Anthony Cho (project manager), Eugene Chumakov (designer), George Bitsakakis, Lisa Gregg, Ko Van Klaveren, Kevin Plant, Tommy Ong, Norma Angel, Terence Tam, Stacy Fleming, Gordon Martyshuk, Christine Andrews, Grant MacEacheron

Structural Carruthers & Wallace (A Trow Company)

Mechanical/Electrical H. H. Angus Ltd.

Civil D. M. Willis Associates Ltd.

Landscape Basterfield & Associates Landscape Architects

Interiors Stantec Architecture Ltd.

Costing Marshall & Murray Inc.

Code Consultant Larden Muniak Consulting Inc.

Facility Programmers Agnew Peckham & Associates Ltd.

Building Envelope Brook Van Dalen & Associates Limited

Acoustics Aercoustics Engineering Limited

Roof Morrison Hershfield

Contractor EllisDon Corp.

Area 715,000 ft2

Budget $205 m

Completion August 2008


1 Main Entrance

2 Public Lobby

3 Courtyard

4 Library

5 Cafeteria

6 Admitting

7 Multi-Faith Centre

8 Mental Health Inpatient (Level 1)

9 Medical Inpatient

10 Surgical Inpatient

11 Rehabilitation Inpatient

12 Palliative Care Inpatient

13 Complex Continuing Care

14 Maternity

15 Critical-care Respiratory Services

16 Surgery

17 Day Surgery & Ambulatory Procedures

18 Ambulatory Services

19 Dialysis

20 Emergency

21 Diagnostic Imaging

22 Rehabilitation Therapy

23 Orthopaedics

24 Oncology

25 Breast Assessment

26 Cardiac Catheterization

27 Pharmacy

28 Laboratory

29 Sterile Processing

30 Kitchen

31 Nutrition Services

32 Health Records

33 Staff Facilities/Services

34 Offices

35 Materials Management

36 Information Technology

37 Morgue