‘Equitable and free of barriers’: Canada’s first gold-level certified accessible clinic opens its doors

With almost one in five Canadians living with a disability, accessibility and equitable treatment were top of mind for Adarsh Rao and Pinder Sahota, specialists in physical medicine and rehabilitation (physiatry), when they went searching for a clinic to purchase.

Now, Canada has its first medical clinic to earn gold-level certification from the Rick Hansen Foundation. The Ability Clinic, which opened in early August, is one of 59 gold certified spaces in Canada.  

Throughout their five years of sub-specialty training, the pair worked in multiple private practice clinics and hospitals across southern Ontario. Recognizing that not all doctors’ offices are created equally, they noted some had set-ups that made it difficult to examine and treat patients ­– spaces where they couldn’t transfer a patient from a wheelchair to the examination table because there was no mechanical ceiling lift available or because the height of the bed could not be adjusted. They watched as patients were turned away because they couldn’t access the second-floor clinic in a non-elevator-accessible building.

Through the lens of physiatry and the viewpoint of inclusion, Rao and Sahota set out to design a space that would be accessible to all.

“To best serve our patient population, it was important to us to have a clinic space that was as equitable and free of physical barriers as possible,” Sahota explains.

Enlisting the help of Cubecom Project Management, a full-service realty construction and design firm, the two physicians used their knowledge of movement, mobility and impairments to consider what might be required to make their space truly accessible.

They started with the physical space – widening doors, hallways and washrooms to accommodate mobility devices such as walkers and wheelchairs. They designed the path from the front door to the clinic rooms, eliminating all obstructions. They lowered the height of the reception desk, making it reachable for those in wheelchairs. And they used vinyl flooring for better tire traction. For the visually impaired and blind, signs were created using large font sizes and braille was added.

Chris Stigas, a Rick Hansen Foundation Accessibility Certification Professional and a wheelchair user himself, was tasked with ensuring meaningful accessibility for all, including complying with standards of the Accessibility for Ontarians with Disabilities Act.

Stigas knows first-hand that going to a doctor’s office can be stressful, especially if the office does not have the proper equipment, and advised how to make The Ability Clinic a more relaxed environment.

Some ideas were simple – recommending paint colours and ensuring all examination tables be height-adjustable. But he also incorporated impactful design elements that on first glance, might not even be noticed. A hearing loop system at the reception desk to provide clear communication with those who wear hearing instruments; cutting-edge wayfinding tactile indicators on the floors, allowing visually impaired patients to manoeuvre around the unfamiliar space with ease.

For the kitchen, Stigas suggested moving the location and height of counters and appliances for knee clearance from a seated position and choosing a fridge model with a freezer bottom for all to reach.

Sahota explains that “as physician leaders, we feel that the physical environment is often an underrecognized determinant of health. Universal design is much more than just accessibility, it is a marker of both health and wellness.”

The outdoor-facing windows capitalize on the natural light in patient areas instead of staff spaces. Frosted glass and sound insulation were installed between rooms for privacy. A faux green living wall panel was created for an increased sense of wellness and Scandinavian wood accents provide warmth.

Finally, while designing a space through a global pandemic, COVID-19 influenced health and safety features, including touchless wave to open doors and hand sanitizer stations. Ceiling heights were maximized to improve air flow and easy-to-clean seat coverings were purchased for chair types of various heights for the waiting room.

Says Shafin Jadavji, president of Cubecom: “You can go 95 per cent of the way and leave 5 per cent but that 5 per cent is the hardest,” Jadavji said. “Pinder and Adarsh were phenomenal. They did not compromise on the final 5 per cent.”