In a medical clinic where the doctor wears all black instead of a white lab coat, it is not a surprise to hear that Dr. Stein did not want interior design; he wanted architecture. This is exactly what Peter Cardew Architects gave the clients in a design that manages to be both clinical and comfortable without being either devoid of humanizing elements or full of clichd symbols of domesticity.
Clean lines, often associated with a clinical feeling, are not just an aesthetic in this project; they are used for hygienic reasons as originally intended when the phrase was first coined by the modernists in the 1920s. Surfaces are smooth and materials are used that can be easily wiped down ensuring patients don’t pick up anyone else’s germs. The smallest exam rooms measure only 7-0* by 8-0* but do not feel cramped because they are so uncluttered. All of the fixtures are designed to float above the floor, which makes mopping easier while the exposed floor lends the space a larger reading. The exam rooms were designed more like a boat than a building according to Cardew, with drawers for supplies carved out of any unused space to utilize every square inch. Most of the millwork was constructed in maple to warm the rooms while stainless steel was used for counters and wherever else hygiene was paramount.
The driving force behind the entire design was a concern for patient comfort. Unlike too many medical clinics that achieve this by introducing domestic finishes, the Stein Medical Clinic takes cues from the modern prototype for a doctor’s office, Pierre Chareau’s 1932 Maison de Verre; it is comfortable because it ensures a feeling of professionalism and privacy through acute measurement and careful placement. The beds in exam rooms are not visible from the waiting area, even with the doors fully opened, and confidential patient charts are tucked around the corner rather than directly behind the receptionist. In the waiting area the patients do not sit uncomfortably facing each other, but in a row along a wooden bench. The awkwardness of handing over a urine sample during a checkup is also avoided through an architectural solution–a pass-through from the washroom to the lab.
Overheard conversations from other rooms make patients reluctant to divulge their own personal information; therefore, sound attenuation between rooms was an absolute necessity for the clinic. For this reason the glazing in the clerestory is laminated and the doors are flush with the wall, leaving no cracks through which sound could transmit. The seamless doors also lend the main area more space through the unbroken lines of two skewed walls that extend the room through forced perspective.
The entire floor area of the pie-shaped clinic is 1,300 square feet. Not a lot of space in which to fit ten rooms: three for examination, two for massage and one for minor surgery, as well as reception and waiting areas, two doctor’s offices, a lab, and a washroom. Yet there still manages to be such a high degree of intention throughout the clinic. The length of the surgery room, which doubles as another examination space, is exactly how far a patient needs to stand from the room’s eye chart; a comfortable distance between doctor and patient in each room has been established as being neither too close to be threatening nor too far to feel detached; and the space between the receptionist and waiting patient feels more generous than it is, one more example of the clever use of perspectival depth in the triangular plan.
Located in the base of a downtown Vancouver office tower, the Stein Medical Clinic is entered either from the landscaped area facing Burrard Street or off of the tower’s main lobby. When approaching the walk-in clinic in either direction, a glimpse of the red wall through the storefront glazing is inviting, but alternating bands of translucent and transparent glass simultaneously give the waiting patients inside a semi-private feeling. The large granite tiles are set orthogonally to the entrance doors and continue unbroken throughout the entire clinic so that the space is perceived as one entity. In the rooms the flooring pattern is skewed, creating dynamic lines that subliminally inform of where the room sits in relation to the rest of the space. There is no welcome mat at the entrance; in its place, the same granite tiles used throughout the project are flamed to create a slip-resistant texture.
The stone from the floor wraps up the side of the reception counter with maple plywood nestled overtop. The tactility of the natural materials bathed in both natural and indirect light are the only adornments in the waiting area; there are no medical posters and signage to remind patients that they are sick. The only signage in the clinic was a code requirement: the pictograms for the unisex washroom. Even this is unobtrusive as it is carved out of the door and visible only as a shadow line. The attention to detail in the Stein Medical Clinic is inescapable. Peter Cardew Architects have refined the walk-in clinic experience through architecture and they have redefined patient comfort through thoughtful design.
Helena Grdadolnik, MArch, MRAIC teaches design history at the Emily Carr Institute of Art and Design and is a member of SPACEAGENCY.
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Client: Dr. Jeff Stein, Kaity Stein
Architect Team: Peter Cardew, David Scott, Rob Grant, Angie Jim
Structural: Rob Smith
Mechanical: Keen Engineering
Electrical: Schenke / Bawol
Acoustic: Brown Strachen Associates
Contractor: CDC Construction
Area: 122 m2
Budget: withheld
Completion: October 2003
Photography: Martin Tessler unless noted