In the 1980s, labs were often designed like tenant spaces, with a shared corridor, cafeteria, library, and conference rooms, but each lab and related offices were isolated from one another.

“These resulted in minimal interaction between researchers,” says James Weselake, principal at Smith Carter Architects & Engineers Inc. in Winnipeg, Manitoba. “People tended to stay within their own domain.”

“Interdisciplinary contacts become very important in translational research facilities,” he adds.

Labs evolved in the 1990s to add more shared spaces while still retaining private offices. In addition, physical connections to adjacent treatment facilities and universities were developed. Opening up the labs resulted in more interdisciplinary collaboration and a more efficient use of space.

“We now are seeing an evolution with lab planning toward fewer ghost corridors and more inter-lab corridors, where the corridor is actually embedded within the open lab concept,” says Kevin Humeniuk, architect at Smith Carter. “We are seeing an evolution towards more efficient net-to-gross ratios within our laboratory plans.”

The next iteration was to include a public component in the building. Truly translational buildings began coming on line at the end of the 1990s, with fully integrated research, teaching, and patient care under one roof. At the same time these buildings satisfied the rallying cry of the National Institutes of Health to implement “bench-to-bedside” facilities, they also created myriad challenges, chiefly: With all these patients, clients, and students in the building, where should the research and wet labs be located?

The answer is, “everywhere,” as demonstrated by the International Collaboration on Repair Discoveries (ICORD), a spinal cord injury research, treatment, and rehabilitation facility in Vancouver, British Columbia, designed collaboratively by Smith Carter and Musson Cattell Mackey and Partners.

“Schematically the building was conceived of as a layer cake of different functions,” says Humeniuk. “We have different types of clinical care overlapping and being interspersed with floors that are dedicated to discovery science.”

“What is unique about ICORD is the degree to which we are integrating disciplines,” says Chris McBride, Ph.D., managing director of ICORD. “Our motto is ‘from cells to community,’ so we are taking basic scientists, people involved in rehabilitation research, surgeons, doctors, engineers, community-based researchers, and humanities-based researchers, and putting them together in one big mix to try to make an innovative difference for people with spinal cord injury.”

The 122,000-sf, $45-million (Canadian) building is located in the heart of the Vancouver General Hospital site, which is the province’s primary acute treatment center for spinal cord injury. The six-story building is owned by the Vancouver Coastal Health Authority and is associated with the University of British Columbia. Completion is expected in the summer of 2008.

The basement houses a vivarium and building support functions, as well as several workshops for researchers to fabricate innovative research apparatus. The first floor contains the lobby, meeting facilities, and a “living lab,” which allows people with spinal cord injuries to test different living and working arrangements provided by furniture manufacturers.

“In fact, the whole building itself is a research lab for accessible design and technologies,” says McBride.

The second floor contains clinical investigations and rehabilitation research; the third floor houses a large rehabilitation research space with in-floor treadmills for people in wheelchairs to test. The first three floors of the building are accessible by ramp. The fourth and fifth floors are dedicated to medical discovery or research science, with open labs and offices. The top floor contains offices for the Rick Hansen Foundation, and additional office spaces for clinical investigation staff.

“Every floor really is a specialized space of its own,” says McBride. “Within the floors themselves are a number of highly specific services and functions where we not only integrate discovery scientists from disciplines within that area, but we are also trying to get vertical integration between people in rehab, clinical, and basic research.”

Driven to Be Accessible, Flexible, and Usable

Creating a truly translational facility is all about relationships: the relationships between researchers in different disciplines; between scientists and students; and between patients and doctors. At ICORD, it is also about the relationship between the building environment and the people who use it.

A disability is defined as “a restriction or lack of ability resulting from an impairment.” A handicap, on the other hand, is “a disadvantage for a given individual, resulting from a disability.” In other words, injuries cause disabilities; the environment causes handicaps.

The goal of the ICORD design team was to eliminate handicaps by creating a building so universally accessible it would not need the ubiquitous blue wheelchair signs distinguishing accessible features from those that are not. The benefit is that no one is marginalized. The challenge is to make sure the builders and trades people understand that they are being asked to build beyond the code set forth in the Americans with Disabilities Act (ADA). The ADA is not in force in Canada but was used a guide, along with a similar Canadian code, to ensure that the building met all North American guidelines.

For example, it is often difficult for people with spinal cord injuries to reach down to the floor, so all the electrical outlets at ICORD are more than three feet up from the floor.

“We wanted elevated electrical outlets throughout the building, and every time it would come back from an electrical consultant the outlets had been moved back down,” says Lowell McPhail, ICORD’s facilities manager. “We’d say, ‘No, we want them up higher for increased accessibility; we have our reasons.’ It was a challenge to ensure that our innovations in accessibility were being maintained.”

This feature also contributes to the flexibility of the labs, so researchers can rearrange labs without worrying about hiding the outlets.

The public spaces are outfitted with automated doors that slide, and every restroom is a large, single-use restroom with coat hooks, shelving, and paper towel dispensers at lower levels, all touch-free and automated, so they are accessible to everybody.

Some of these features were very cost effective. For example, Steris agreed to redesign its sterilizers the company manufactures so the door could be operated with a push button as well as the standard foot pedal, which would not be functional for someone who cannot use their feet.

There are no carpets anywhere in the building, because hard floors are easier to negotiate. That may make the building louder and create echoes, which the designers will need to mitigate.

Other changes were quite expensive. All three elevators in the building are equipped with large kick-style elevator buttons, both outside and in, at a total cost of $98,000. The “buttons”—which are more like kick plates—take up two walls of the elevator, so they can be operated by punching them or running into them with a wheelchair. They make the elevators more user friendly not only for people with disabilities, but for anyone whose hands are full.

The most obvious element is the ramp, a gracefully sloping racetrack that circles from the ground-floor lobby to the third floor, providing barrier-free access to the three floors of public space, and creating within it a two-story, 5,500-sf atrium. It is built on a five-degree grade rather than the seven degrees required by code to make it easier to use.

“The ramp was a highly contentious issue throughout,” says McBride. “We fought very hard to argue that the functionality warrants the expense. It is important that this building is designed for people with physical disabilities, and that ICORD is sincere in ensuring the inclusion of people with physical disabilities as equal partners in our program.

“It is more than just access,” he adds. “It is not just for people with spinal cord injury. It is not just for people in wheelchairs. It is an option for everyone to use and that is really the critical part here.”

It also pleased the fire department because it could provide emergency egress to the many people in wheelchairs who will occupy and use the building.

Flexible Lab Design Yields Unexpected Results

Technology and research models are changing so fast in the field of spinal cord injury that the smartest lab is the most flexible one.

“More work is done now analyzing behavior and functional outcomes in both humans and animals: the gait, the movements, the physiological responses,” says McPhail. “New and combinatorial approaches are being developed at a remarkable and unpredictable pace, creating the need to shift research focus and space more rapidly than was needed for traditional “slice and dice” and anatomical approaches.

“We want to incorporate this responsiveness to evolving research needs into our building by keeping it flexible,” he continues. “Who would have thought 10 years ago, for example, that we were going to have 30,000 genes on a gene chip the size of a playing card.”

The biggest challenge to flexibility is inertia: It’s hard to get some researchers to think about doing things in ways that feel different or uncomfortable.

“Many users are often resistant to change,” explains McPhail. “One way we tried to get past this was to push our researchers to think about what they are going to be doing in 10 or 15 years. Most of them couldn’t say because it is so difficult to predict.”

The lab planners stressed that multiple use of shared space and greater freedom in how the space is used results in more space for everyone. With labs shifting configuration, spaces open up and become available for use by other groups with different approaches.

ICORD has full- and part-time researchers, clinicians, and administrators working together. They share office space, as well as work spaces that are adjustable to accommodate many uses.

“One day you can use the table at desk height, the next day you can use it as bench space, and people can change and share it,” says McPhail.

The flexibility that allows researchers from various disciplines to work side-by-side yields unexpected results. One of the first projects the researchers at ICORD tackled was the function that people with spinal cord injury want most to recoup: sexual health and fertility.

“We never imagined that we would produce something like this, but at one of the very first meetings, we brought all of our principal investigators together in the offices of a sexual health doctor,” says McBride.

That doctor has helped more than 100 people with spinal cord injuries have babies. As she described some of the challenges related to the technology involved in fertility procedures, someone from human kinetics, who understood how to deliver current and signals to devices, said he could help. Then others, including a psychologist, started suggesting ways they could contribute with R&D and commercialization.

“Within about 18 months, they had produced prototypes of the world’s first fully accessible vibrostimulation device for women and men,” says McBride.

Although the press can be reluctant to report on such subject matters, the enthusiasm of people with spinal cord injury for the device has some retail chains interested in carrying the product, which is undergoing testing and modification.

“This is going to be the first real and tangible deliverable for us at ICORD,” says McBride. “You just never know what is going to happen when you get a bunch of great minds together.”

By Lisa Wesel