When COVID-19 emerged in spring 2020, the healthcare design industry began the now year-long balance of supporting immediate response while continuing to shepherd existing projects through planning, design, and construction. To better understand the extent of these efforts and, particularly, how the ongoing pandemic is expected to influence the project pipeline going forward, Healthcare Design launched the COVID-19 Industry Survey in September 2020. The survey was open to any industry professional currently working on healthcare projects, with 140 respondents completing the survey.

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The extent of respondents’ involvement in the initial COVID-19 patient surge varied, particularly in terms of consulting on work compared to completing it. For example, 50 percent consulted on/assessed the conversion of existing space to support patient surge and 39 percent consulted on/assessed the creation of alternate care sites; however, just 30 percent and 21 percent reported completing those projects, respectively.

Meanwhile, most industry members were busy with other pandemic-related projects—only 16 percent reported not having personal involvement with additional COVID-19 responses. Forty-eight percent of respondents reported identifying solutions to help providers remain operational in the case of another surge, 36 percent master planning to address future pandemic/crisis scenarios, and 34 percent implementing programs/design initiatives to support reopening.

Looking forward, respondents were largely optimistic about the effect the pandemic will have on the industry. Regarding projects in early planning stages prior to COVID-19, 36 percent said they expect those projects to be slightly adapted and/or delayed and some to be put on hold for at least a year, while 34 percent expect only slight changes/delays. For projects already in progress, respondents had an even more favorable view, with 53 percent projecting that they would move forward as planned with some slightly adapted/delayed and 22 percent expecting most projects to be slightly adapted/delayed and some to be put on hold for at least a year.

Regardless of when project workloads return to pre-pandemic volumes, respondents anticipate that COVID-19 will influence the goals of healthcare organizations in numerous ways; the top three identified were designing for flexibility/adaptability (69 percent), identifying solutions to remain operational during a similar crisis (41 percent), and implementing infection control strategies (38 percent). And when asked to consider the drivers behind projects prior to the pandemic and what provider needs will still remain relevant in this current environment, repurposing space for new use (52 percent), the renovation/modernization of existing space (50 percent), and consolidation of existing facilities/services (34 percent) received the most votes.

As for ongoing challenges and opportunities, many industry members noted in open-ended responses that project funding will remain a concern for some time, particularly as healthcare organizations work to rebound from financial hits taken by the loss of surgeries/procedures during the pandemic in addition to the cost of response measures. However, those measures are anticipated to continue as the industry corrects the shortcomings in design realized in the past year.

Similarly, respondents wrote that new attention given to infection control will inspire the need for more cleanable, durable products. “Designers will need to be sure that every material specified is now extremely cleanable and will withstand even more harsh cleaning chemicals,” said respondent Heather Harris, interior designer at RMK Design Associates LLC (Fort Wayne, Ind.). Other tactics that emerged, such as building system upgrades and integration of telehealth services, are expected to influence projects going forward, as well, requiring lessons learned to be translated into evidence-based solutions. However, respondent Gina Semerad, associate at Jaros, Baum & Bolles (New York), warned: “It’s also important that we don’t overcorrect to solve this immediate problem (COVID-19) and forget about other goals and needs of a hospital, like protecting patients that are in the hospital for noninfectious reasons and finding smart ways to reduce energy usage.”

In fact, the balancing act that’s defined design lately is likely to continue, as all these priorities must be considered against existing best practices, regulations, and cost. Aaron D. Scott, principal at Cromwell Architects Engineers (Little Rock, Ark.), stated that the types of investments healthcare leaders are eyeing include upgrading building systems; creating flexible inpatient space; and revising entry sequences, especially in emergency departments. Added Anthony Treu, healthcare practice leader at Skidmore, Owings & Merrill (New York), “Our clients are asking us about the future … about how their institutions can continue to provide services during similar interruptions. We’re discovering ways to design for this future, balancing infrastructure upgrades and designs for new operational considerations against the issues of rising cost and complexity.”

Jennifer Kovacs Silvis is editor-in-chief of Healthcare Design. She can be reached at jennifer.silvis@emeraldx.com.