Sacré-Coeur de Montréal Hospital Expansion: Architecture Review

The Sacré-Coeur de Montréal Hospital expansion, designed by Provencher_Roy with Yelle Maillé et associés architectes, is a useful case study in how to add a large, highly technical healthcare building to an existing heritage hospital. The hospital is affiliated with the Université de Montréal and is one of Quebec’s largest ultra-specialised trauma hospitals. The expansion, completed in 2022, brings together trauma care, a mother-child unit, endoscopy, and research and teaching space. This review looks at the design concept, the envelope, the planning ideas behind it, and what hospital owners and designers in Pakistan can learn from it.

Project Background

Many hospitals around the world face the same problem: an older main building that is valued by the community, and clinical needs that have outgrown it. Demolition is rarely possible because the hospital must keep running. The usual answer is an expansion that connects to the existing building while bringing in modern standards for trauma care, infection control and patient comfort.

Expansions like this are among the hardest hospital projects to deliver. Construction must be fenced off from patients, dust and noise have to be controlled, and new services such as medical gases, power and chilled water must be connected to the old building without interrupting care. Every design decision is shaped by the fact that the existing hospital never closes.

At Sacré-Coeur, the original hospital dates from 1926. The new wing had to sit beside this heritage architecture, link to existing departments and give the hospital new capacity for its most demanding services, especially trauma.

Design Concept: Light, Views and Well-Being

According to the architects, the aim was to create an innovative and contemporary atmosphere. Natural light and views to the outside are provided throughout the building to support the well-being of patients, families and staff.

This reflects a widely accepted idea in healthcare design: daylight and views help people orient themselves, reduce stress and support a sense of normal day and night. For staff working long shifts in trauma and critical care, access to daylight in work areas and break rooms can also make a significant difference to comfort.

A floating patient block

The patient block appears as a volume floating above the lower levels. Separating the inpatient floors from the clinical and technical floors below is a common and logical strategy in hospitals. The lower floors hold departments that need large, deep floor plates and heavy services, such as trauma, imaging and procedures. The upper floors hold patient rooms, which benefit from narrower plans with more daylight and views.

Respect for the heritage building

The expansion uses masonry as a primary material, a deliberate reference to the brick of the original 1926 architecture. Rather than copying old details, the new building borrows the material and weight of its neighbour and then expresses it in a contemporary way.

The Envelope: Brick Bands and Curtain Wall

The most recognisable feature of the expansion is its façade of alternating vertical bands: solid brick wall and glazed curtain wall. The architects describe this as giving the envelope high energy efficiency while preserving daylight and views from inside.

The balance between solid and glazed areas is one of the most important energy decisions in any hospital, because hospitals operate continuously and heating or cooling loads never stop.

Planning a Trauma and Mother-Child Hospital

The expansion combines services with very different needs. A trauma centre requires fast, direct links between ambulance arrival, resuscitation, imaging, theatres and intensive care. A mother-child unit needs privacy, calm, family space and secure access. Endoscopy needs efficient day-case flow and proper reprocessing of scopes. Research and teaching need space for students and staff without disturbing patient care.

The general lesson is that each service should be planned as its own zone with clear entrances and routes, while sharing support services such as imaging, sterile supply and plant. Stacking these zones vertically, with the most technical services at the lower levels, is a proven way to manage that complexity.

Healthcare Design Principles Behind the Project

The published description of the project is brief, but the design choices it describes connect to principles that are well established in hospital architecture worldwide.

Wayfinding

Large hospitals are confusing for visitors, especially in an emergency. Views to the outside, distinct building volumes and a clear difference between the clinical base and the patient block all help people understand where they are. In practice, this reduces the number of staff interruptions to give directions and lowers stress for families.

Family-centred spaces

Mother-child units work best when parents can stay close to their children and newborns. That means space for a parent beside the bed, quiet family lounges, and controlled access for security. The same need is strongly felt in Pakistan, where families usually stay with patients throughout their admission.

Teaching inside a working hospital

As a university-affiliated hospital, Sacré-Coeur must also train doctors, nurses and researchers. Including teaching and research space within the expansion keeps students close to clinical work. The challenge is to give them their own routes and rooms so that teaching does not crowd patient areas.

Building for continuous operation

Trauma centres run every hour of the year. Durable materials, accessible plant and services that can be maintained without shutting down clinical areas are as important as the visible architecture.

Lessons for Pakistan

Pakistan’s climate, budgets and regulations are very different from Quebec’s, but several ideas from Sacré-Coeur apply directly to hospitals being planned in Lahore, Karachi, Islamabad and other cities.

Design for heat, not cold

Montréal’s envelope is designed mainly against cold. In Pakistan, the main enemy is heat. The same principle of a high solid-to-glass ratio still works, but shading, insulation and reflective roofs become the priority. Our article on green hospital architecture covers climate-responsive choices.

Plan expansion from day one

Most hospitals grow. Leaving space on the site, sizing structure and shafts for future floors, and planning how new wings will connect saves major cost later. A hospital feasibility study is the right place to set this out.

Follow recognised standards

Trauma and critical care spaces need correct ventilation, fire safety and infection control. In Pakistan these are usually designed using the Building Code of Pakistan, ASHRAE 170 and NFPA guidance, with licensing by the provincial healthcare commission.

How to Apply These Ideas to a Local Project

Frequently Asked Questions

Conclusion

The Sacré-Coeur de Montréal Hospital expansion shows how a modern trauma and specialist wing can sit comfortably beside a heritage building, with a disciplined façade, plenty of daylight and a clear stacking of services. For hospital projects in Pakistan, its lessons are about planning, climate-aware envelopes and phased growth. To discuss a hospital extension or new build, see ACCO’s hospital design and construction service.