Walking through the new pavilion at the Verdun Hospital, the difference from the original building — constructed in the 1930s — is immediately apparent. Patients admitted to the new wing benefit from some of the best modern architecture has to offer. Quebec’s hospital infrastructure is aging. Some areas have cutting-edge, modern facilities, but many buildings date back to the 19th century, some even older. How are today’s hospitals conceived? What has been left behind, and what practices are no longer repeated when designing spaces for care? According to Antoine Buisseret, partner architect and director of Health Market Intelligence at the firm Lemay, one of the keys in major modern hospitals is improving how people move through them. That’s clear when comparing the hallways of the new pavilion at Verdun Hospital with those in the original building. The first patients were welcomed into the new space on Feb. 17. Stretchers, wheelchairs and staff can move freely. In the old building, the path is far more challenging. To bring a patient to intensive care, for instance, staff must shift numerous items out of the way like garbage bins, nursing stations, equipment stations. “There’s no space to put equipment in the corridor, so there’s almost nowhere you have the full width to get through. It makes a big difference for staff to have (in the new pavilion) places for their workstations, to have workstations everywhere that take up less space,” said Dr. Mathieu Surprenant, associate medical director, Local Management, at Verdun Hospital and medical co-lead on the project, during a February tour. Wider hallways will also help patient mobility, especially for seniors, said Eliane Favreau, senior adviser at the CIUSSS du Centre-Sud-de-l’Île-de-Montréal and project co-lead. The corridors of the new pavilion, spread over five floors, are far clearer. “It will help us in particular with the walking program for patients. The rooms are large, but we still see patients coming out of their rooms to keep moving during their hospital stay,” Favreau said. Maintaining seniors’ mobility in hospital is crucial to preventing physical and mental decline. Giving existing infrastructure a second life Quebec is “at a tipping point” when it comes to its health infrastructure, Buisseret said in an interview. “It’s shifting today because in Quebec […] there’s a question of sustainability for our hospital infrastructure, sustainability in terms of resources, with staffing shortages; sustainability in terms of investment, since major projects are mostly on hold due to funding issues,” he said. According to the latest data from Santé Québec, 277 hospital pavilions across the province are in poor or very poor condition — rated D or E. The list of hospitals needing work is long. Among them, Hôtel-Dieu de Sorel, in Montérégie, has an accumulated maintenance deficit of $61.1 million. The Saint-Jérôme Hospital, in the Laurentians, has a deficit of $91.7 million. And the Douglas Hospital in Montreal, widely publicized after a ceiling collapse caused by a water leak, has a maintenance deficit of $119.3 million. “How do we give existing infrastructure a second life? Because if we need to rebuild Quebec’s hospital network from scratch, it won’t be possible. It always comes back to sustainability,” Buisseret said. From single-building hospital to the generative hospital Part of the solution lies in the generative hospital, the architect said. “It’s a way of securing the investment, but especially […] making sure each component can regenerate itself,” he said. A generative hospital can expand or reconfigure sections as population needs change. The model is emerging in Europe, Buisseret said, “and we’re looking at how to deploy it in Quebec because it’s very promising.” Older single-building hospitals often have limited capacity to evolve, he noted. The province moved from 19th-century pavilion-style hospitals, where buildings weren’t necessarily well connected, to single-building hospitals that resemble multi-storey towers grouping all services under one roof. “We may need to reconcentrate the hospital’s mission on extremely technical elements, operating rooms and so on, and other functions can be, in quotes, satellites that cooperate with each other,” Buisseret said. Administrative spaces or certain hospitalization units, for example, could be separated from the main building but still operate in tandem. Decision-makers must also anticipate transforming spaces during a crisis, something not currently built into planning, Buisseret said. He argued that public infrastructure projects are viewed “in silos,” and breaking down those divisions is essential to improving health-care services. This report by The Canadian Press was first published in French on March 21, 2026.
