Carlington Community Healthcare Centre in Ottawa, Ontario, Canada, a community-based health and social services provider, had outgrown its 18,000-square-foot facility, which comprised a former school building and two additions. The center’s main service line was primary care, yet most of its exam rooms were less than 90 square feet. Administrative offices were housed in a nearby trailer, and many of the community rooms, including the demonstration kitchen, were grossly undersized, as well.

Another community organization, Ottawa Community Housing, had its own growth challenges, too, with more than 10,000 people on a waiting list for affordable housing.

The answer to solving both organization’s needs was found in the growing “community hub” model, which is designed to break down barriers and not only improve the well-being of patients but also the communities where they live. At the 2018 Healthcare Design Expo & Conference, Nov. 10-13 in Phoenix, speakers shared the benefits of the model, some of the challenges in implementing one, and a case study on the Carlington Community Hub during the session, “‘Community Hubs: An Integrated Approach to Facilities.”

For example, some community hubs have been designed with acute care at the center with supporting services, such as a pharmacy and imaging, included. Others are designed with senior housing as the focus, with assisted living, medical care, and social services tied into the hub. “Hubs are customized around each community’s needs,” says Alison Wesley-James, principal, healthcare, Colliers Project Leaders. “It’s a great opportunity to address silos in care.”

For Carlington and Ottawa Community Housing the “hub” vision was a three-story facility built on the healthcare clinic’s property, with a primary care clinic on the first floor and 42 units of affordable senior housing on the second and third floors, operated by Ottawa Community Housing. Additionally, the existing community healthcare center would be remodeled with updated social services and community programming space on the first floor, offices and staff space on the second floor, and administrative offices on the third.

Cameron MacLeod, executive director, Carlington Community Healthcare Centre, says the benefits of bringing the two organization together in The Carlington Community Hub include addressing social determinants of health, addressing the risk factors for underprivileged populations, improving case management, and community development.

After the partnership began in 2016, MacLeod says, with the organizations explored five models of ownership before finding the right solution as a two-unit condo. But that didn’t mean the project was smooth sailing from there. With two different government funding streams—each with its own requirements and timelines—the project management required some creative problem-solving, risk taking, and a lot of trust between the partnering organizations, MacLeod says.

For example, while the healthcare center project was approved in 2014, it’s still awaiting funding, while the housing project, on the other hand, received its funding within four months of project approval. This resulted in the first phase of the project focusing on building construction and build-out of the housing units, with the first tenants expected to move into the building in early 2019.

The future clinic space will include larger exam rooms, a new main entrance and central registration desk, and bridge linking the existing and new buildings.

The challenging structure and timeline has resulted in the project team outlining four phases of construction, says Darryl Hood, principal, managing director, director of sustainability, CSV Architects.

As the partners continue working on bringing their vision to fruition, they shared some of the lessons they’ve learned so far:

  • Reimagine how assets may be used, leveraged, and shared.
  • Don’t let funding end the conversation.
  • Educate decision makers about how you can help them solve their problems.
  • Trust is key—but ensure that agreements are crafted to endure changes in leadership.

“There’s power in working jointly together toward common goals,” says Wesley-James.