Big improvements at UHN’s Toronto Western Hospital

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With the initial phases of its multi-year redevelopment nearing completion, the University Health Network’s Toronto Western Hospital is already a far different place.

A soaring new entrance has given a clear identity to the Krembil Neuroscience Centre. A new balcony-lined central atrium has brought order to the previous rabbit warren of corridors in buildings on the western half of the site. Its retail stores and café terraces have created a dynamic public square. Significant expansions and renovations have increased the efficiency and liveability of clinical, office and ambulatory care spaces, and of the emergency department.

Doctors, staff, patients, and members of Toronto’s western downtown community have been involved in the design process from the beginning. As the project progresses, more renovations and a brand new East Wing will continue the improvements – and help confirm this facility as a prime example of urban hospital redevelopment.

BuildingsMost older urban hospitals face common problems:

  • a maze of poorly-connected buildings
  • outdated construction, especially floor areas interrupted by many columns and bearing walls
  • inadequate windows and natural light
  • “institutional”, rather than staff- and patient-supportive design

At Toronto Western, the buildings on the western part of the site created something resembling a discontinuous oblong donut. It was very difficult to find your way from one building to another. Between the buildings, an interior courtyard went almost unused.

That courtyard was the key to the redesign by Dunlop Architects Inc. and Murphy Hilgers Architects Inc. (architects in joint venture). Today, it is a vibrant enclosed public square, with delicate-looking Free-form structural steel soaring 30 m to support an asymetrical steel and glass roof. Connected to the hospital’s main entrances and overlooked by its main wings, this square is becoming the orientation “hub” of the facility.

To its north, the old Bathurst Centre has been demolished and replaced with a new building and main entrance for the recently dedicated Krembil Neuroscience Centre. With its distinctive roof line and mixed glass panels on both sides, the building is a translucent culmination for the north end of the atrium. It also connects seamlessly to the renovated West Wing.

The West wing has been gutted and rebuilt. Previously, this long, narrow building had a central corridor with rooms to either side. Enclosure of the atrium has allowed for a totally new corridor system – a series of balconies added on to what used to be the exterior wall, overlooking the public square/atrium. As a result, the full depth of the existing building was available for redesigned clinics.

Circulation corridors continue into the renovated Fraser Fell Pavilion (which forms the south and east sides of the atrium space) and its new rooftop expansion. Mechanical and electrical systems throughout the buildings have been updated. The colour scheme is soft, utilizing accents and wood panels to further assist in wayfinding and orientation.RetailWith an estimated 1,700 staff, plus more than 360,000 ambulatory, emergency and in-patients per year (and all their accompanying family and friends), the hospital has a built-in market for retail space.

Well-designed retail spaces add life, light and additional community feeling to hospitals. Most people welcome the convenience they offer-with everything from drug/variety, gift stores, and restaurants, to health-related and other services including dry cleaners. Retail areas can also be healthy profit centres, if they are well managed and offer retailers enough potential customers.

Successfully merging retail and hospital uses does pose some challenges. If the retail spaces are too crowded, corridors are too narrow, ceilings are too low, or wayfinding is compromised, people can perceive them as intrusive.

At UHN’s Toronto Western campus, the new retail is located on both sides of the new atrium on the ground floor level, with kiosks down the centre. Stores and restaurants are right on the main route into the hospital from the surface parking area at the north of the site and the underground parking to the south. Creating an indoor “streetscape”, this location is an airy, light-filled space that has greatly improved wayfinding. The hospital’s retail is also helping to enliven the Bathurst streetscape outside.

Now in DesignOriginal plans called for demolition of the pre-1920 Edith Cavell building, and renovation of the existing 1940s-era East Wing. However, the old East Wing was found to be badly outdated and in need of more repairs than originally anticipated. Late last fall, the Ontario Ministry of Health approved funding for a brand new East Wing. Planning is now under way.

The UHN Toronto Western campus is a major teaching hospital with internationally renowned programs. At the end of this redevelopment, its physical structure will reflect that status.