The Urbanist – How Healthcare Facility Design Can Improve the Lives of All City Dwellers
Date: December 18, 2025
Host: Andrew Tuck (Monocle)
Featured Guests:
- David Martin, Global Design Director, Stantec
- Perry Ashenfelter, Senior Associate & Project Architect, Perkins and Will
Episode Overview
This episode explores the pivotal role that healthcare facility design plays not just in treating patients, but in enhancing the urban environment and community well-being for all city dwellers—including, in a unique twist, animals. Through conversations with leading architects and designers, the episode examines how integrating thoughtful, community-focused strategies into hospital and animal medical center designs can foster inclusivity, socioeconomic impact, and even urban vibrancy.
Key Discussion Points & Insights
1. Rethinking Hospitals as Civic Hubs (00:17 - 02:30)
- Hospitals Today: Modern healthcare facilities now offer services and amenities that extend far beyond acute care, becoming integral civic structures.
- Civic Engagement: David Martin highlights the shift:
“Hospitals… have programs that are integrated into the daily life of the community it serves. It's civic building, effectively.” (01:49, David Martin)
- Drawing inspiration from Jane Jacobs, Martin emphasizes that key buildings should be active gifts to their cities, enhancing the public realm.
- Manchester Example: Central Manchester hospitals united multiple sites, creating the city’s second-largest public space and improving community cohesion through flexible pathways for vehicles, mass transit, and pedestrians.
2. Community Integration & Accessibility Strategies (03:50 - 05:58)
- Breaking 'Invisible Barriers': Architects design campuses to encourage public access and seamless integration with the city.
- Examples:
- Newcastle: Hospital integrates with the university, leveraging the surrounding urban fabric for community outreach.
- Enniskillen: Features a central atrium with natural light and amenities (cafés, dry cleaning, hair salon), attracting local residents—even those not seeking medical care.
"There are people from the town who come out into that nice space because it's well designed, it's light filled, and they come out there to get their haircut… It made us feel proud that the design was working." (04:37, David Martin)
3. Architecture & Healthcare Outcomes—Biophilic Design and De-institutionalization (05:58 - 08:00)
- Biophilic Trends: Incorporating natural elements and daylight helps reduce stress and negative health outcomes.
- Connectedness, Not Isolation:
“Making that sense of de-institutionalization part of the idea of the place… that it really is owned by the community.” (06:38, David Martin)
- Mississauga Hospital Example: Designed to intersect with light rail and urban corridors, offering public amenities (retail, lecture hall) to blend hospital life with civic life.
4. Tackling Challenges of Scale & Specialization (08:00 - 10:47)
- Centralization & Specialization: Larger hospitals create 'centers of excellence’, often on city peripheries, making community integration more challenging.
- Contextual Sensitivity: In locations lacking established context (e.g. Dubai’s new cancer hospital), design draws on local symbols (like the Gaff tree) and creates healing gardens, breaking the structure into “smaller villages within the whole.”
“By creating those… echoes of their surrounding environment that will make them feel it's their own, we're pretty certain that we'll overcome those obstacles of the scale.” (09:02, David Martin)
5. Design Principles for Successful Healthcare Projects (11:40 - 13:48)
- Top Recommendations for Health Authorities:
- Listen First:
“Often these are complex buildings, complex organizations… Together they have most of the answers that we need. We just need to listen.” (11:40, David Martin)
- Context Is Everything: Aim for designs that capture the essence of their place, rather than copying neighbors.
- Patient Journey: Prioritize both the micro (patient experience) and macro (urban integration).
- Sustainability & Wellbeing: Make hospitals perform environmentally and economically, ensuring staff and patient satisfaction.
“The most sustainable buildings in the world are the ones that people can't wait to come back to the next day.” (12:51, paraphrasing Nicholas Grimshaw)
- Listen First:
6. Architecture as a Legacy & Performance (14:08 - 14:54)
- Rewarding Impact: Architects gain deep satisfaction from creating environments where both neighborhoods and individual users thrive.
- Performance-Based Design: Stantec values post-occupancy evaluations—tracking staff comfort, patient recovery rates, and absenteeism to measure success.
Segment Switch: Healthcare Facilities for Animals
7. Animal Medical Center, New York: Redefining Veterinary Spaces (15:48 - 20:21)
- Project Overview: Schwartzman Animal Medical Center is the world’s largest nonprofit animal hospital—renovated and expanded by Perkins and Will to modern standards.
- Scope: The project included complete interior renovations, exterior façade updates, and logistical management to allow 24/7 continuous operation.
- Human Hospital Parallels:
"If I was to place someone in that space, you may actually expect it to support human medicine..." (18:27, Perry Ashenfelter)
- Facilities are comparable in complexity, with dedicated intensive care, operating rooms, and specialty infrastructures.
8. Designing for Diverse Patient Needs—From Dogs to Exotics (20:21 - 22:40)
- Specialized Design for Animals:
- Unique units for canines, felines, and exotics (birds, turtles, even monkeys and ferrets).
- Strict separation to reduce stress for sensitive or different-species patients.
"This is the first time [Exotics] really had their own space..." (20:21, Perry Ashenfelter)
- Comprehensive Care Under One Roof: All specialties—including emergency, surgery, imaging—are now contained in a single building, streamlining the experience similarly to human hospitals.
9. Improving Experience for Owners, Staff, and Animals Alike (22:40 - 24:47)
- Human Experience:
- Focus on staff wellbeing: brighter, airier spaces with views and access to natural light.
- Enhanced rest areas, improved workflow, and stress reduction for veterinary staff.
"That was actually one of the biggest things they said immediately: how nice it was to see outside." (23:10, Perry Ashenfelter)
10. Maintaining Care During Massive Renovation (24:47 - 26:29)
- Logistical Challenge: Keeping a 24/7 hospital fully operational during expansion required meticulous phasing and rapid-response adaptations—sometimes even pausing construction for sensitive patients (e.g. a monkey).
"There was a necessary pause because of how sensitive that patient really was to kind of vibration and noise." (25:17, Perry Ashenfelter)
11. Project Completion and Final Features (26:29 - 27:30)
- Latest Milestones: Final ribbon-cutting coincided with the interview; most interior wards opened earlier, with new features such as dog-walking terraces connected directly to medical wards.
"The providers are able to actually walk the dogs just outside on the same level in their own terrace..." (26:40, Perry Ashenfelter)
Notable Quotes
- David Martin (Stantec):
- “We've really taken on the idea that these big projects really should be giving a gift back to their community.” (02:07)
- "We really work from the macro to the micro to… integrate all of that behavioral that we have on ourselves, all the perspectives we have on ourselves.” (12:39)
- Perry Ashenfelter (Perkins and Will):
- “Designing for the wellbeing is just as important… There are workstations really occupying all the corridors. Most staff did not have access to daylight… That was actually one of the biggest things they said immediately—how nice it was to see outside.” (23:10)
- Host Reflections:
- "You realize here in Europe, often where these hospitals are based… they're fundamental to the health of the community in all sorts of meaningful ways." (10:47, Andrew Tuck/Host)
Key Timestamps for Important Segments
- 00:11 – Opening and episode theme
- 01:49–05:58 – David Martin on redefining hospitals as civic/community spaces
- 06:38 – De-institutionalization and biophilic design in hospitals
- 09:02 – Tackling community integration in large, specialized medical centers
- 11:40 – Design principles for effective healthcare facilities
- 14:08 – Pride and legacy in healthcare design
- 15:48–20:21 – Perry Ashenfelter on Animal Medical Center’s transformation
- 22:40 – Enhancing animal owner and staff experience
- 24:47 – Project logistics: maintaining operations during renovations
- 26:40 – Final project phase and innovative animal-centric features
Conclusion
This episode of The Urbanist spotlights how the design of healthcare facilities—human and animal alike—can go beyond healing to improve the fabric of entire cities. With insights from leading architects, it highlights the importance of accessibility, context, environmental quality, and the social role of hospitals and clinics. Whether treating populations or pets, the blueprint for better health starts with thoughtful, integrative design.