The healthcare design industry is on the front lines of the COVID-19 outbreak, responding to myriad needs tied to the built environment to ensure patients can be tested and treated effectively.

Healthcare Design turned to its esteemed Editorial Advisory Board members and other leaders for an inside look at how they’re responding to the crisis. In this ongoing web series, we’ll share what we hear, as we hear it—the challenges you’re all up against and the solutions being put into place.

In these “Notes from the Field,” you’ll find an industry diving in to combat the COVID-19 pandemic and quickly disseminating ideas to help others manage similar scenarios.

Jeffrey Stouffer, executive vice president, health group director, HKS Inc. 

Even though all our healthcare clients in the U.S. have disaster plans in place, many of them have reached out to HKS to ask for support in various ways. From location and logistics on triage tents in a parking lot to navigation of opening unlicensed beds with the state authorities having jurisdiction, we are responding to our clients’ individual needs with real-time quick response design thinking.

Our first hospital where this was apparent is actually at ground zero in Wuhan, China. What you saw in the media were modular buildings quickly erected to provide multilevel temporary facilities to handle the rush of patients. Behind the cameras, there is a brand new 1,000-bed facility that HKS designed and was able to open a few months early thanks to the construction being ahead of schedule.

Every available bed and patient station there was turned on, and we hear the systems all performed as designed by providing the needed support to the incredible surge of cases presented there.

Here at home, in Miami, for example, we are assisting two health systems with their surge capacity response.

Health System A: We are designing and assisting with COVID-19 screening and triage structures in the parking lot adjacent to the ED.

Briefing: Triage patients outside of the emergency department to (a) avoid unnecessary access to the emergency department area; (b) cohort “at-risk” patients; (c) protect healthcare personnel (HCP); and (d) encourage and direct to home care instructions.

Solution: Tent temporary structures to organize one-way flow of patients, provide for HCP proper use of PPE, and provide for adaptability of spaces and flow to respond to escalating situation.

  • Tents were pre-ordered at dimensions that fit open parking areas
  • Design and clinical teams positioned tents on-site and planned key flow points
  • Use of movable privacy partitions and workstations on wheels to allow for space adaptability
  • Elevated and leveled flooring to avoid stormwater
  • Preference for usage of drop-off canopy areas where available to avoid stormwater and allow for ED connection

Health System B: HKS assisted with identifying surge patient care units.

Briefing: If the crisis pushes hospitals beyond bed capacity, decant noncritical patients to surge units using conferencing areas. Test the implications of usage of surge units by COVID-19 positive patients.

Solution: Maximize bed count in conference rooms, initially utilizing Facility Guidelines Institute multibed unit parameters of bed clearances, position 2-foot-by-4-foot modules for adaptability of space (modules can be counter space for nursing, wire racks, and supply carts).

  • Propose waste stream flows
  • Identify potential pyxis unit position to allow for proper support infrastructure
  • Identify spaces for pharmacy and supplies inventory, diagnostic imaging support, and staff respite

Health System B: HKS is helping with an ED surge unit.

Briefing: Plan implementation of deployable inflatable air shelter patient unit to serve as ED overflow unit.

Solution: Utilize canopy area to allow for connection to existing ED and recently installed screening/triage tent

  • Reroute drop-off lane
  • Connect surge unit to screening unit
  • Elevate and level floor to avoid stormwater

HKS is also responding to a request to assist a firm specializing in senior living to provide the necessary health design expertise on adapting the facilities into health facilities to isolate, protect, and treat their residents. We are also working with our in-house hospitality design teams who have been asked if we can convert closed hotels into temporary COVID-19 treatment facilities.

Unique, unprecedented times call for quick response, design-thinking, and innovative solutions to save and protect lives. It would be great to hear how other firms are being asked to respond to their clients. We will continue to update our website with new stories relating to COVID-19. Our best to all of our colleagues at this challenging time.

If you have insight you’d like to share in this format, email Editor-in-Chief Jennifer Kovacs Silvis at