Designing healthcare projects: when sustainable health shapes architecture

Every year, awareness days are held to draw public attention to health issues, including mental health initiatives such as Bell Let’s Talk Day and Mental Health Week in May. These initiatives highlight concerns that deserve our daily attention. Mental health encompasses many realities: everyday stress experienced by individuals—exacerbated by the pandemic, particularly among caregivers—as well as addiction issues and mental health disorders, which are often intensified among vulnerable populations.

This so-called vulnerable population, which health services unfortunately struggle to adequately support, includes people living with substance use issues, homelessness, mental health challenges, individuals involved in or at risk of involvement with the justice system, people facing social integration difficulties, youth in vulnerable situations, and others.

As part of the relocation of activities from Hôtel-Dieu-de-Québec to the new hospital complex at Hôpital de l’Enfant-Jésus, an idea emerged: why not use some of the spaces that will be left vacant to rethink the services offered to vulnerable and disengaged populations? Seizing this opportunity to develop a sustainable health hub in the heart of Québec City appeared all the more relevant given the demographic profile of the area. The objective of this project is not only to provide care and services to the population, but also to raise awareness of, deepen understanding of, and promote the concept of sustainable health, while encouraging healthy lifestyles among both care providers and the various client groups.

But first, what do we mean by sustainable health? The concept is defined as follows:

“A complete state of physical, mental, and social well-being achieved and maintained throughout life through healthy, enriching, and fulfilling living conditions, and through access to appropriate, high-quality resources that are used responsibly and efficiently for the benefit of present and future generations.” [1]

According to Dr. Jean-Pierre Després, “Sustainable health is not just about managing illness—it is about caring for the person as a whole. We work with and for people.” One of the major challenges facing the healthcare system is addressing social inequalities in health. Achieving this requires a change in approach. Rather than treating only the illness that brings people to seek care, it is essential to also consider their life circumstances and the environments in which they live.

Our real estate planning team had the privilege of supporting the Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale in this stimulating project, whose innovative vision is particularly strong. Although the project is still at a preliminary stage—namely the functional programming phase—we sincerely hope it will come to fruition for the well-being of the population.

The uniqueness of this project lies in the design of inclusive spaces that reflect the diverse profiles of the Old Québec community, with particular attention to the needs of vulnerable populations. The project therefore integrates the sensitivities and specific needs of these groups through a range of strategies related to spatial planning, communication, care delivery, and activities.

For example, at present, people experiencing homelessness who have companion animals and require physical or mental health services often face significant barriers to accessing care, as facilities rarely allow animals. This project addresses that reality by planning dedicated spaces to safely accommodate animals, while also creating welcoming environments that encourage this population to seek services and feel accepted. Another example is the inclusion of a Knowledge Centre designed to offer health promotion and prevention activities for the general public—both on-site and virtually—as well as activities focused on well-being, not solely on healthcare.

Bringing together several regional partners, the project adopts an approach inspired by international best practices in sustainable health. It represents a strategic and unique collaboration of organizations dedicated to intervention, expertise, research, and training in public health and sustainable health, whose synergy is essential to improving population health and well-being. The project would therefore offer complementary services by co-locating all stakeholders working with vulnerable populations. This shared environment facilitates coordinated responses to more complex cases.

Medical, social, and primary services—preventive, curative, and follow-up—would also be provided, along with a sexual health clinic and a community dental centre. The goal is to foster autonomy among vulnerable populations in terms of health and social integration by allowing them to access the help they need in one single location. A caregiver support laboratory is also planned to promote caregiver well-being, along with spaces dedicated to informal caregivers.

At STGM, sustainable health is also a value actively promoted within the organization. Among other initiatives, employees were offered access to a well-being course platform (meditation, Qigong, yoga, inboxing, etc.) last spring. This initiative is part of the Global Health component of STGM’s upcoming Campus training program, which identifies a real opportunity to integrate WELL© certification criteria into activity planning—particularly those related to comfort, health, and well-being—with the aim of improving the employee experience, one step at a time.

As an organization, STGM believes that the best way to support its people is to make relevant information accessible and to take concrete actions that foster a healthy work environment. Being well in both body and mind is what allows people to thrive at work—a vision that aligns perfectly with the principles of sustainable health.

[1] Alliance Santé Québec, from Une infrastructure sociétale en santé durable pour la grande région de Québec, Atelier Kaisen 1, Regroupement des équipes en santé publique, en santé des populations et de première ligne, April 27, 2018, p. 1.