We must plan and design our healthcare facilities to be flexible and adaptable.
1
Include flexible intermediate spaces that serve as negative pressure ante rooms to allow operating rooms to remain positive pressure while protecting people in surrounding areas
2
Provide one-way circulation through
clinics to minimize crossing clean and
soiled traffic.
Uninterrupted Patient Care
In the first few months of the pandemic, hospitals cancelled elective surgeries and outpatient visits for patient and staff safety, but with flexibility planned for during design, then care (and revenue) can continue in a pandemic.
When designing for flexibility in operations, two elements are critical:
Option A:
Scrub areas and equipment rooms can be adapted to serve as negative pressure ante rooms on an interim basis to provide a pressure buffer.
Option B:
Scrub areas can be designed formally as negative pressure ante rooms creating a buffer and providing safe access during a pandemic.
CLINICAL SPACES
How can clinical areas flex to coordinate with a pandemic response?
1
Plan infrastructure into soft spaces and underutilized areas to facilitate a transition to temporary clinical sites. This allows for surge flexibility without overbuilding permanent structures.
2
Employ modular construction and furniture systems for rapid, low-cost reconfigurations. These spaces include parking structures, shelled spaces, conference and meeting rooms, or simulation labs.
Anticipating Surges
Hospitals can activate interim alternative environments for
the delivery of care, whether triaging with sorting tents or
making use of alternate structures.
Two things you can do:
Examples of temporary surge solutions are the Forward Triage Surge Tents activated in just two weeks by the Advocate Outpatient Collaborative in Illinois and Wisconsin.
1
Depending on the type of isolation, designate a single isolation room with an anteroom or convert a partial unit or entire unit into a negative pressure zone. *HVAC design should align with the space planning compartmentalization concepts
2
An on-stage / off-stage circulation approach facilitates one-way flow and creates space for zoned donning and doffing that protects all occupants
Scalable Isolation Strategies
When designing inpatient units or emergency departments, consider that patient isolation can occur individually, or in flexible, scalable, cohorted models.
Two things to remember:
Cohorting infectious disease patients separate from disease-based isolation
HVAC separation and redundancy
Features:
Ante room entering unit extends PPE use
Donning and doffing space includes handwashing
Internal point-of-care testing
This ICU floor at Humber River Hospital was planned with scalable infectious disease control in mind as part of a comprehensive facility and operations strategy in the event of a pandemic.
1
Patient units and rooms can be quickly converted up to a higher acuity level.
2
PACU rooms can be converted into patient treatment rooms during periods of high surge.
3
Equipment storage is sized to accommodate the needs of highest acuity nearby.
Conversion Ready
Healthcare facilities must integrate appropriate infrastructure and plan for adaptability in patient units. The ability to adjust for acuity level is critical for any facility’s capacity to handle epidemic or pandemic emergencies in the future.
Consider these benefits:
Planning and designing a healthcare space for the future now requires flexibility, adaptability and anticipation to avoid interrupting care delivery and to keep patients and staff safe during a pandemic surge.
Can Never be ICU
ICU Structural Grid
ICU Room Size
ICU Unit Size
Med Gas to Floor
Med Gas to Room
Med Gas to Headwall
Licensed as ICU
Equipped as ICU
Med Gas Building Capacity
Operated as ICU
Conversion ready spectrum
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Entire 24-Bed Unit
Single Isolation Room with Ante Room
12-Bed Pod
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