Insufficient and aging infrastructure dating back to the 1920s at BC Children’s Hospital and BC Women’s Hospital + Health Centre’s Oak Street campus in Vancouver, British Columbia, Canada, was significantly impacting the delivery of safe and effective care. “There was insufficient separation of the flow of patient, public, staff, and materials, resulting in infection control challenges; insufficient capacity to meet the province’s specialized care demand projections and needs; and inadequate room size and configuration to allow for the required number of providers and equipment,” says Eleanor Lee, executive director and chief project officer at Provincial Health Services Authority, based in Vancouver. “It also created challenges in meeting teaching and training needs, which was impacting recruitment, clinical resourcing, and, ultimately, patient care.”

To create an operationally efficient facility that could deliver care for the next 50 years, the hospital’s owner, the Provincial Health Services Authority, a publicly funded health service provider in British Columbia, wanted to build a new acute care center on the existing campus. Additionally, the owner set goals for its newest facility to meet LEED requirements, incorporate private rooms to improve the patient experience, and exceed seismic code so that the hospital could remain operational after a mega-quake (a response to the city’s location on a major fault line).

Construction of the $262 million, 640,000-square-foot Teck Acute Care Centre, named after corporate sponsor Teck Resources, at BC Children’s Hospital and BC Women’s Hospital + Health Centre, began in 2014 and was completed in 2017.

Starting fresh
Instead of taking cues from existing campus buildings, the design team wanted the facility to offer a new and fresh look, says Allyn Stellmacher, design partner at ZGF Architects LLP (Seattle), which partnered with local architecture firm HDR | CEI (Vancouver) on the project.

It was also important for the design to feel homelike to patients and their families. “Efforts were made to minimize the potentially intimidating nature of the typical hospital setting,” Lee says. “We aimed to deinstitutionalize the facility and for patients, visitors, and staff to perceive the environment as open and accessible. ”

Starting on the outside, the use of space, daylight, color, pattern, and texture helped to achieve these results. “Playfulness and access to the outdoors were encouraged, where appropriate,” Lee says. For example, a cementitious shingle system on the side of the building provides texture and plays with light from the sun’s movement, while metal paneling featuring a rippled texture along floors 2 through 4 and between some windows on the upper floors picks up on seasonal and diurnal light variations. “The colored sun shades on the side of the building use light to create texture and continue the theme of play,” Stellmacher says.

The building’s exterior also features a mix of natural tones and colors to connect it to the landscape as well as the interior. Because the elevator core is visible outside, designers employed a color scheme on the structure to mimic nature, including brown and aubergine colors on the lower level to reference the forest, greens and yellows on the mid-level to emulate the tree canopy, and blue on the upper floors in reference to the sky. The same color scheme is replicated in the building’s interior.

British Columbia has a wood-first initiative that mandates timber use in buildings, so pine and Douglas fir were used for structural components and in public areas as much as possible. For example, the new entrance features a large wood canopy structure and drop-off area to be immediately noticeable on the existing campus. “The structure uses traditional wood elements typical of northwest architecture at highly oblique angles, to create quite a bit of contrast with the rest of the facility,” says Troy Ransdell, architect and vice president, healthcare at HDR | CEI. “The result is a very recognizable and fun entrance experience.”

Starting lineup
The new hospital serves as a birthing facility for healthy and high-risk pregnancies and houses a neonatal intensive care unit (NICU) and pediatric ICU (PICU). As part of the project, the hospital added mother/baby pods in the NICU, which allow newborn infants to stay in contact with their mothers if one or both need treatment. “Studies have shown the benefits of keeping a mother and baby together during the first hours after birth,” Lee says.

Because the facility is one of the only children’s hospitals in western Canada, the ICU rooms were designed to be larger to house more equipment and larger care teams, as well as family members staying overnight. “Patients come from far and wide, due to their need for high-acute care,” Ransdell says. Additionally, major and minor procedure suites are located on the NICU floors, so patients can be moved directly from the operating room to the ICU, avoiding the need to use elevators or travel long distances and minimizing the risk of infection and cross contamination.

The facility is organized so that the lower floors are designed for short-term patients and the upper floors are equipped for long-term patients, providing individuals spending the most time there with the best views. Inpatient floors utilize 12-bed pods in a racetrack design, with separate front-of-house and back-of-house flows and support spaces in the middle. All of the building’s 231 private inpatient rooms (most were double-occupancy in the prior building) have nearby accommodations, such as kitchenettes, laundry facilities, family lounges, play areas, and resource rooms, to support visitors.

To minimize walking distances for the staff, the nurses’ stations are decentralized and supplies are distributed to patient rooms rather than to a centralized supply room. New clinical education and research space with collaboration and education areas are also incorporated into the team care spaces to promote collaboration, Lee says.

The hospital was designed with larger clinical spaces than the old facility to better accommodate care teams, required equipment, and technology, as well as provide future flexibility. For example, operating rooms are twice as large as those in the old building. “As healthcare develops, we’re seeing a trend toward higher-acuity patients,” Lee says. “This translates into the need for potentially larger and diverse care teams and additional equipment. We also need to be confident that spaces can accommodate future requirements.”

Meeting client goals
An important directive from the owner was for the project to earn LEED Gold certification to help reduce energy and operating costs. To help do that, the facility utilizes air-source chillers, which eliminate the need for a cooling tower and reduce the building’s overall domestic water needs, says Sean Lawler, project manager/mechanical engineer at Affiliated Engineers (Seattle), which provided mechanical, plumbing, medical gas, audiovisual, and technology design services. (The project earned LEED Gold certification.)

Additional sustainable design features include low-flow plumbing fixtures, water-saving autoclaves, and a heat recovery system, which recovers waste heat from electrical rooms, telecom rooms, and imaging equipment and transfers that heat to the building’s heating and domestic hot water systems. “This reduces the amount of energy needed for the building’s heating system,” Lawler says. As a result, the building’s water use has met the targeted 35 percent reduction over the LEED requirement.

Another client goal was to implement a variety of design solutions to mitigate against the risk of natural and human-caused disasters. The new hospital can operate post-disaster at full capacity for three days using emergency generators and incorporates underground systems for both potable water storage and sewage collection to allow for continuous operations. “The architects needed to ensure that the facility could withstand and continue to operate in the event of a major disaster, like an earthquake,” says Stellmacher, adding that the project goes beyond what codes mandated by the city of Vancouver require.

Additionally, the hospital’s ambulance canopy can be converted into a three-lane mass decontamination shower with zones for undressing, showering, and dressing. Most inpatient rooms are outfitted with double headwall capacity to provide for surge populations and six patient wings can be converted into pandemic outbreak control zones. A conference room on every floor is outfitted with equipment and storage and could be converted into an operations hub during an emergency. “If a disaster occurred, the hospital could be used as a general hospital to accommodate anyone in need of care,” Lee says.

In all, the new building delivers both the structural and experiential features the owner set out to achieve—and it’s paid off. “Staff love the new spaces,” Lee says. “They feel a greater connection to the outdoors with the natural light, natural materials, and spaciousness. Operational efficiency has improved.”

The new eight-story Teck Acute Care Centre at BC Children’s Hospital & BC Women’s Hospital + Health Centre is in the center of campus and has five connections to existing buildings, via either bridges or at-grade walkways. “This was necessary in order to still use existing buildings for support and some clinical functions and maintain efficiency,” says Allyn Stellmacher, design partner at ZGF Architects LLP.

To create an over-arching design theme in the new building that would help with visitor navigation, the design team conducted research on colors and themes with 40 children and more than 150 staff, patients, and family members. A coloring book was created by the design team to gather children’s input on graphics of local wildlife. In the end, the theme “Our Beautiful British Columbia” was chosen for the new building.

The wayfinding program begins in the parking garage and moves up vertically through the building’s eight floors, with each level assigned a landscape inspired by the region, including ocean, harbor, meadow, forest, and mountain, as well as an animal native to that landscape and a theme color. To symbolize the hospital’s focus on women and newborn care, animal graphics include adult animals and their offspring. “The graphics are used to minimize stress, help orient guests, provide a sense of place, and offer positive distractions,” says Mackenzie Elrod, lead interior designer at ZGF.

For example, the lobby features a larger-than-life depiction of the forest, with lighting that gives the appearance of trees glowing in different colors. At elevator lobbies, animals peek out from behind trees, while inside the elevators, the icons inhabit a forest scene. “The icons are monochromatic to reinforce the main identity and wayfinding color associated with the unit of the hospital that they represent,” Elrod says.

Additionally, a comprehensive campus wayfinding strategy, including major sign monuments, directional maps, and building entrance numbers, was developed as part of the project and is being phased in over time.

Project details
Project name: Teck Acute Care Centre at BC Children’s Hospital and BC Women’s Hospital + Health Centre
Completion date: November 2017
Owner: B.C. Provincial Health Services Authority
Total building area: 640,000 sq. ft.
Total construction cost: $262 million
Cost/sq. ft.: $409
Design architect: ZGF Architects LLP
Associate architect: HDR | CEI Architecture
Landscape designer: Connect Landscape Architecture
Interior designer: ZGF Architects LLP (design architect), HDR | CEI Architecture (associate architect)
Mechanical and plumbing engineer: Affiliated Engineers Inc., Magnusson Klemencic Associates Inc. (structural engineer), SMP Engineering (electrical engineer)
Construction: Balfour Beatty Construction and Ledcor Construction Ltd.
LEED consulting: Edge Consulting

Karen Appold is a freelance journalist based in Lehigh Valley, Pa. She can be reached at