St. John's Rehab Hospital: The John C. and Sally Horsfall Eaton Centre for Ambulatory Care

Toronto in the 1930s was bustling to the point that the Sisters of St. John the Divine moved their convent north of the city, where they later founded the St. John’s Rehab Hospital. Today, along with its buildings, the hospital retains 23 acres of lawns, gardens and trees upon which St. John’s Rehab added the John C. and Sally Horsfall Eaton Centre for Ambulatory Care.

The L-shaped wing took shape on top of a paved area left over from a previous building that was torn down in the ’70s. “We chose the site to minimize the loss of gardens and trees,” explains Malcolm Moffat, president and CEO of St. John’s Rehab Hospital.

Moffat admits to an old design flaw that the new centre fixes – making the main entrance accessible. “We created a roundabout that ramps up to the main entrance,” he says,”and it’s under an awning that protects people from the elements. We also put handicapped parking on the ramp down, so it’s easier for people using the centre to get to the main door.”

The entrance makes an impression well before you reach it. “When you arrive, there’s a double row of crabapple trees that were planted at the very beginning of the development of this site,” says Mary Jane Lovering, principal with Vertechs Design Inc. Landscape Architects. “This is a historical aspect of the site, and Toronto’s Urban Forestry department wanted to keep that double row of crabapple trees intact.”

Health-care providers put great emphasis on ambulatory care. “People who would have come to an inpatient unit for three to four weeks now go home in a week to 12 days,” says Moffat. ‘They go home to their loved ones and their routines more quickly, coming back here for ongoing rehabilitation.”

St. John’s Rehab is currently building a new 32-bed inpatient unit and upgrading life safety systems. “We built the outpatient centre first to empty out some space in our inpatient wing, which we were also using for ambulatory care,” Moffat says. “By emptying that out, we had space to create a new inpatient unit.”

The centre stands two storeys tall on the garden side and only one on the entrance side. The architects sought design compatibility with the original 1930s buildings, using elements such as rich clay brick to match the colour of bricks in the existing building and a lantern at the new entrance that mimics a tower in the existing building.

They also disguised mechanical penthouses on the roof using enclosures. “We didn’t want machinery to stick out on a site this beautiful,” says Terry Montgomery, founding principal of Montgomery Sisam Architects Inc.

That beauty also serves as wayfinding. “When entering the building, you see right outside into the gardens and the ravine edge behind the building,” Montgomery says. “That becomes a point of orientation within the building. We sought to make wayfinding more intuitive, less intimidating, less stressful.”

“Every patient treatment area within the building has a significant connection out to either the courtyard or the landscape beyond,” says Tye Farrow, founding partner with Farrow Partnership Architects Inc. “This connection to nature creates a spirit of optimism throughout the building that is transferred to both to staff and patients.”

The main entrance is on the upper floor. As people walk in, they face the courtyard and landscape beyond. Elevators are found to one side. While they’re fully accessible, Farrow notes the importance of putting stairs directly in people’s line of sight rather than hiding them away. “The steps and landings are generous, on a glass line facing south, very light, very inviting,” he says, adding that this stair design decision flowed from the idea that a building should enhance people’s health.

For more formal therapy, patients can use two gyms that contain various machines, walking bars and other equipment. “In our old gym areas, equipment became larger and more difficult to fit in because of set walls,” says Moffat. “We wanted to make the new gyms as open as we possibly could. If we want to put in new equipment, we won’t have to take down walls.”

The pool features a mechanical lift that can lower people into the water or lift them out. Patients can work in depths of one metre, 1.3 metres and 1.75 metres, immersed in water heated to about 93 degrees Fahrenheit. “Heat from the pool is used to heat the space,” Moffat notes. “It’s all recirculated, so you don’t lose much energy.”

“There is a large window on the east side of the space that provides sightlines from within the pool directly up to the sky,” Farrow says. “You feel as if you’re outside, under the
clouds, not in an enclosed space.”

As well as trees, grass and indigenous plants, a therapy garden consists of a concrete terrace and looped walkway system. “A physiotherapist could take patients outside for walks around the loop and monitor how far they go each day,” says Lovering, noting that the concrete surface offers a smoother ride than unit pavers for wheelchairs.

The loop connects with walkways leading to the building’s entrance. “It allows people to go for short, medium and long walks,” Lovering explains. She adds that grades were developed to minimize slopes, allowing people to be as independent as possible.

PROJECT HIGHLIGHTS

LOCATION

285 Cummer Avenue North York. Ontario

OWNER/DEVELOPER

St. John’s Rehab Hospital

ARCHITECT/INTERIOR DESIGN

Farrow Partnership Architects Inc. and Montgomery Sisam Architects Inc. in joint venture

GENERAL CONTRACTOR

Buttcon Limited

STRUCTURAL CONSULTANT

Halcrow Yolles

MECHANICAL/ELECTRICAL CONSULTANT

MMM Group

LANDSCAPE ARCHITECT

Vertechs Design Inc. Landscape Architects

SITE SERVICES CONSUL T ANT

EMC Group Limited

TOTAL AREA

49,000 square feet

TOTAL CONSTRUCTION COST

$40 million

This article originally published in Award Magazine. For a PDF of the printed version, see below.

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