The coronavirus pandemic has globally opened the eyes of healthcare organizations to the need for greater flexibility in how their facilities are designed and configured to utilize space–not only to care for more patients during crises, but also to support changes in patient care delivery models and to adapt to emerging demographic and other trends, including a rapidly aging population.
We believe more flexible buildings are smarter buildings that embrace the use of digital innovation in facility management systems and space planning and design. The pandemic dramatically exposed a larger, long-term need in healthcare for this flexibility and adaptability to allow providers to prepare for and respond to a growing variety of potential crises and challenges.
These include everything from changes in healthcare consumer and provider preferences and care delivery models, such as the expanding use of telemedicine and telehealth services in inpatient and outpatient settings, to the need to quickly increase capacity to treat large numbers of ICU and/or infected patients during a pandemic or disaster without disruption in the safety and continuity of services.Building Design & Constructionreported, for example, that in response to the pandemic, more healthcare institutions might start allocating space for acuity-adaptable units to limit the need to move patients around the facility but to bring specialist care to the patient.
In our view, it can be helpful to hospitals as they work to develop the flexibility of their buildings to do some re-thinking of hospital design and functionality, with special consideration for how spaces can be used efficiently in different ways as clinical needs change, and then to plan carefully for the systems and monitoring required to support that increased flexibility. For example, having the right capacity on the electrical system in an acuity-adaptable room to accommodate the additional medical equipment if the patient needs intensive care.
Examples of flexibility, in addition to the one noted above, include the ability to go into pandemic modes and change rooms and spaces from positive pressure to negative pressure and increase air flows to protect caregivers and patients during an infectious disease outbreak. There is also the increasing need to consider exam rooms and how they will need to adapt to either face-to-face consultation or via telehealth. How does the room adapt to ensure the right light levels, acoustics, and comfort?
Of course, this planning must be done with consideration for the strict code requirements in hospital buildings and planned and coordinated with the infection control teams; ensuring that the systems needed to support space utilization integrate seamlessly with other components of the building management platform; and building into the design process the ability to manage and control these systems from remote locations in keeping with the trend among healthcare organizations toward the increased use ofremote servicesto support facility operations and asset maintenance.
Finally, a critical aspect of hospital building flexibility is giving careful attention to the optimal balance between flexibility and cost. The ability to change all rooms into negative pressure in a pandemic is possible but will add considerable cost to the overall project budget, both for installing the equipment but also in maintaining the systems. Weighing cost considerations against flexibility and adaptability is the art and science of resilient design and planning. Hospitals that incorporate flexibility into their spaces while also managing cost will be best prepared for future changes to come