New Integrated Cancer Treatment Centre opens in Quebec City
The integrated cancer treatment centre (centre intégré de cancérologie – CIC) is the new hospital complex of the Quebec City-Laval University hospital centre (CHU de Québec-Université Laval) on the Hôpital de l’Enfant-Jésus campus in Quebec City.
Designed by Groupe A, DMG, Lemay, Jodoin Lamarre Pratte, NFOE, and GLCRM architects in consortium, the 32,230 m² facility is Quebec’s largest cancer treatment centre and one of the largest in Canada.
The starting point for the architectural development of the CIC was the design of a green inner courtyard, surrounded by the oncology program.
The aim was to provide pleasant reception areas, waiting rooms, traffic zones, care facilities and work areas that promote health and healing. An abundance of natural light, outdoor views, green spaces, warm materials and colours, and art characterize this calming new healthcare space, which offers the best practices and the latest technology.
The facility includes a radio-oncology department (teletherapy and brachytherapy); consultation rooms organized into clinics based on the tumour site; a chemotherapy ward capable of treating up to 70 patients simultaneously; an oncological pharmacy; a rapid-response oncology treatment department (SIRO); a treatment planning and simulation department; a medical physics lab; and several support offices for patients and staff.
In order to integrate oncology research activities and bring them closer to medical realities, the CIC has spaces dedicated to research, innovation and teaching and will be connected to the future basic research centre. Two clinical research areas are located on the second and fourth floors, where they will intersect with the future research centre, and other offices are integrated with the consultation clinics to facilitate patients’ participation in research protocols.
The facility’s specialized elements include radiosurgery and adaptive radiotherapy, radiotherapy by orthovoltage and the careful integration of numerous cutting-edge medical devices: linear accelerators, magnetic resonance imaging scanners (MRI), a linear accelerator system with onboard MRI scanner (MRI-LINAC), CT scanners and positron emission tomography scanners (PET/CT).
The north side of the building consists of a podium for teletherapy, with bunkers on the ground floor and electromechanical services on the second. In the centre, a transversal, 6-level volume, which will be connected to the future basic research centre, contains brachytherapy rooms and research labs on the garden (basement) level, further teletherapy spaces on the ground floor and consultation clinics on the next three levels, with the top floor reserved for electromechanical services. On the south side, four levels surround the inner courtyard.
This is where part of the medical physics laboratory is located, along with a cyclotron, a future research imaging space and a teaching area at garden level. The rest of the medical physics centre and the treatment planning and simulation department are situated on the ground floor, under two floors dedicated to chemotherapy, with the oncological pharmacy on the second floor and the rapid-response treatment department on the third. This part of the complex was designed to accommodate two additional floors if a future expansion is needed.
The consultation clinics were designed to ensure patients’ privacy, offer greater flexibility in their use and maximize staff efficiency. To enable a separation of public and private traffic flows, the examination rooms have double doors and are arranged around an interdisciplinary workspace reserved for medical staff.
To give patients more privacy, the chemotherapy ward is divided into six clusters of a dozen rooms arranged around a guard post. In each cluster, chairs are placed along the outside walls to allow patients to take advantage of natural light and views of the outside and rooftop gardens, while a closed room with gurneys is located next to the guard post.
The oncological pharmacy is adjacent to the chemotherapy ward in order to facilitate medication supply, while the SIRO – where patients needing urgent oncological intervention are treated – is located on the third floor near a set of six gurneys reserved for apheresis treatments.
A major component of the new hospital complex was the requirement that the CIC had to be integrated into the existing hospital complex and its urban context with a comprehensive architectural vision. The centre was built near the edge of the site to offer patients as much privacy as possible.
The CIC project’s architecture, which uses the themes of air and light, is restrained and recalls the key characteristics of the existing buildings, such as the use of brick and continuity in the cornice lines.
“The contemporaneity of the groupings is characterized by the desire to fill the project with light. The shades of ochre bricks, the pale mortar joints and the white steel and aluminum components and cladding reflect light, which dances across the surfaces over the course of the day,” said Rémi Morency, partner, architect and urban planner at Groupe A / Annexe U and project leader for volumetrics, the building envelope, urban design and landscaping at the new hospital complex.
In keeping with the theme of air and light, the team of professionals strove to develop a “healing environment” by designing facilities that are ultra-modern, spacious, well-lit, green and highly functional.
While the CIC’s volumes were determined during the early phases of planning for the entire new hospital complex, the design of the centre was also refined from the inside out during the subsequent steps. The courtyard was reworked in tiers with the creation of the rooftop gardens. “The centre was designed to make the gardens visible from all levels. A system of rooftop patios and gardens was developed and refined in the inner courtyard to give it a human scale, so that each treatment space benefits from a garden,” said Lucie Bégin, architect and director at Jodoin Lamarre Pratte architectes, in charge of design for the integrated cancer treatment centre.
Within the framework of the Politique d’intégration des arts à l’architecture et à l’environnement des bâtiments et des sites gouvernementaux et publics (policy for the integration of the arts into the architecture and environment of government and public-sector sites and buildings), strategic locations were identified to ensure that as many people as possible would benefit from exposure to art and so that the art would function as privacy screens for patients undergoing treatment.
“Everyone, whether they have expertise in art or not, can appreciate the benefits of art in their life. These pieces also serve as landmarks, helping people get their bearings and find their way around more easily,” said Raynald St-Hilaire, associate architect at Lemay and lead designer of the new hospital complex.
Based on the wishes of the members of the selection committee, the artwork to be created for the inner courtyard had to be approximately 12 metres tall so that as many patients as possible can see it from every treatment floor.
Inside, a series of works by Ivan Binet called Échos – Passages, Vases-montagnes et Écho du ciel was carefully positioned on three levels at the intersection of the CIC and the future research centre.Exploring the concept of landscape, these large inkjet prints on backlit tempered glass are panoramic images of the natural landscapes of eastern Quebec – the regions served by the CIC.
Two screen works, La valse des fleurs by Émilie Rondeau, are placed outside, facing the glassed-in ground-floor treatment rooms. They provide necessary privacy, while still letting light through for the benefit of patients and care staff. “The composition evokes resilience and hope. The pieces are arranged in successive waves and undulations that form a path lined with reassurance, generosity and renewal.”
The project meets all technical requirements established by the SQI for hospital projects of this scale: optimization of energy consumption, use of materials low in VOCs and/or with recycled content, and improvements in the implementation of electromechanical systems and the building envelope.
Eventually, Quebec City’s new hospital complex will offer, on a single site, care services and the teaching and research activities currently conducted at two hospitals, Hôtel-Dieu de Québec and Hôpital de l’Enfant-Jésus (HEJ).
With a total surface area of more than 260,000 m², the project includes the construction of new buildings on the HEJ site totalling 180,693 m² and the renovation of 27,492 m² of space in the existing complex.
This ambitious project, expected to take more than ten years, includes several components that are already in operation: the clinical logistics platform (2020), a new power plant (2021), a generator building (2021), hospitality (2022) and the integrated oncology centre (2022). The basic research centre, cyclotron, critical care pavilion and the renovation of HEJ will be completed in phases over the coming years.