Pins and needles running up and down their limbs. Vision loss. Exhaustion. These are just a few of the varied challenges faced by those living with multiple sclerosis. The autoimmune disease, which attacks the nervous system, has become synonymous with Canada for reasons that are still not well understood by medical professionals. And yet, until last year, MS patients being treated at Toronto’s St. Michael’s Hospital faced an additional set of barriers. The facility’s MS clinics and research areas were once scattered across the hospital campus — which was especially difficult for those whose symptoms include mobility issues. Worse yet, the physical separation meant a lapse in communication and knowledge exchange between the healthcare professionals and researchers working tirelessly to help patients maintain their quality of life. This all changed with the opening of the BARLO MS Centre, a $42 million project helmed by local firm Hariri Pontarini Architects (HPA).
HPA co-founder Siamak Hariri came to the project with extensive experience in healthcare design, having completed Casey House, a treatment facility for HIV and AIDS, in 2017, and a complete overhaul of the Princess Margaret Cancer Centre‘s ground floor in 2020. With the BARLO MS Centre, he set out to establish what he describes as an “orchestra of care.”
“MS is a very complicated disease,” Hariri explains. “There’s no one thing that you need to do to treat it. It requires constant monitoring, family therapy, regular testing, regular educational programs, physical therapy, infusions — you can spend whole days in treatment. It’s not like going to the dentist and getting your teeth cleaned.” The BARLO MS Clinic addresses this complexity, bringing an array of care to the patient’s disposal.
Located on the top two floors of the Peter Gilgan Tower, the new 2,700-square-metre clinic is the largest specialized MS facility in North America. It integrates a technology-rich lecture space, exam and procedure rooms, a gymnasium, group physiotherapy studio, a medical infusion zone and private consult rooms, as well as a mock apartment where patients and their families can learn to design spaces that accommodate their needs.
In designing the clinic, Hariri consulted not only patients and staff at St. Michael’s Hospital, but also turned to Dr. Xavier Montalban —one of the top MS physicians in the world. Travelling to Dr. Montalban’s Barcelona clinic afforded Hariri a first-hand perspective of designing for this disease, but you’ll find few references to that space in the BARLO MS Centre. Instead, Hariri heeded Dr. Montalban’s advice about what he would have done differently.
“We talked a lot about atmosphere — we wanted it to be warm. I felt the space in Barcelona was very clinical and he agreed with me. I told him that I wanted the BARLO MS Centre to feel like a home and he liked that very much,” says Hariri. There were also cultural differences that needed to be accounted for. “In Europe, there’s more of a sense that ‘we’re in this together’ among patients. But, in North America, you have to be very cognizant that people want their space — and value privacy more. We needed to design a space that could achieve both.”
In keeping with SMH’s person-centred approach to care, the architects employed best practices such as wide corridors to accommodate mobility aids, anti-slip porcelain floors, ample handles and rails, and furnishings and finishings prototyped according to the unique needs of MS patients. Beauty, too, was paramount to the design.
“We wanted to create a place where you don’t feel punished for having this disease,” Hariri explains. Throughout the open yet private floor plan, warm wood and bronze finishes help to deinstitutionalize the oft-sterile healthcare typology, while gentle curves guide patients around the space.
The clinic’s hospitality-inspired experience begins from the moment you enter. A low-slung reception desk accommodates patients who require wheelchairs, while also creating a welcoming space reminiscent of a concierge. Just to the left, the first level houses circular consultation rooms that feel more like a high-end conference room than a medical space, balancing privacy with transparent glazing. Opposite the consultation rooms, infusion pods offer a comfortable space for up to eight hours of continuous treatment with sweeping views of the city skyline and abundant natural light. Both spaces also provide ample room for family to accompany patients to their visits.
At the clinic’s centre, a double-height atrium and feature stair is a visual centrepiece — light beaming down from the oculus skylight above. In addition to its circulation function, it is also used as a gathering spot to make announcements, celebrate victories and build a sense of community. The two-storey space nods to the sense of home the architects set out to achieve. It’s also physical manifestation of the beacon of hope the BARLO MS Centre aspires to be — and the integrated model of care it is renowned for providing. “It’s this big embrace — you’re surrounded by all this care. You feel like they have your back,” says Hariri.