HEALTHCARE
RIPPLE EFFECT How COVID-19 will change healthcare facility design By STEVE BURKS
W
hen the COVID-19 virus began spreading throughout the globe, the call to action rose up in the medical world. Healthcare professionals did their best to prepare for an expected wave of patients in need of treatment, some requiring standard levels of care, while many others requiring intensive care, including intubations. By and large, the healthcare community in the United States rose up to meet the challenge. Part of the way healthcare professionals prepared for what was coming, was by taking a hard look at the space they had available and how they can make better use of it to treat the maximum amount of patients. Some communities converted convention centers into treatment facilities. In Arizona, a closed hospital, St. Luke’s Medical Center in Phoenix, was activated and utilized by the Army Corps of Engineers to ensure there were enough beds to meet the growing demand. Valley architects sprung into action, as well, to help local facilities make the best use of their space. “Here locally, our focus has been on helping Banner Health,” said Craig Passey, vice president and health studio leader for SmithGroup. “Banner has reached out to their architectural and engineering partners in the community to help maximize their ability to accommodate as many patients as possible.” Passey said his firm helped Banner look into non-clinical spaces, such as conference rooms, dining areas or cafeterias, to see if they could be
46 | May-June 2020
activated as treatment areas. “The intent is to see how we can perhaps repurpose and maximize the number of beds they can get into their existing footprint,” Passey said. SmithGroup was also part of a group of firms that were contacted by the City of Los Angeles mayors office. The group looked into converting the Los Angeles Convention Center into a space to treat patients if the need arose. “The study was to understand how to work with the existing facilities and create a M.A.S.H. unit in the facility,” Passey said. “It yielded about 1,600 bays or stations. It also looks at some of the necessary support provisions that would be required.” Passey agrees that the COVID-19 pandemic and the stress it put on healthcare facilities around the country will be something that healthcare design firms like his will be examining closely. AZRE Magazine reached out to Valley architecture firms to get their perspective on what the pandemic revealed as issues with healthcare facility design and what architects can do to make sure the facilities are better prepared for the next pandemic. Below are some of their answers. For complete responses, visit azbigmedia.com.
AZRE: From a design and function standpoint, what are healthcare operators and engineers and designers learning about the limitations of their facilities during this pandemic? STEVEN STACK, president of Devenney
Group Ltd., Architects: Air distribution systems are not designed to provide the
amount of negative pressure required to create isolation spaces for COVID-19 influx. Negative pressure rooms are distributed across hospital units by design, to deal with the need across different clinical specialties. What is needed with COVID-19 is a large cohort of negative pressure rooms, notdistributed.
CARL NELSON, partner, healthcare
leader at Orcutt | Winslow: Most facilities or organizations are realizing they are ill-prepared to handle the surges they are experiencing especially when it comes to converting existing spaces into temporary ones. Acuity has a tremendous impact on what spaces can be converted more readily than others. We are finding that it is difficult to convert large open areas such as conference and training rooms into high-acuity spaces. However, they can more easily be converted into non-COVID holding or observation units fairly quickly. Another major limiting factor is just availability of any unoccupied space. We are seeing the lack of space resulting in temporary “tent structures” or make-shift structures.
JOHN CANTRELL, principal, design leader at Orcutt | Winslow: One of the biggest concerns of hospitals is managing the flow of visitors to the right service line for care. Hospital facilities managers and administrators are telling us that people infected with COVID-19 are showing up at any entrance to the campus and wandering around until they find someone to assist them. Two observations are being made regarding this: One is
