As the COVID-19 crisis challenges healthcare facilities across the world, several changes are emanating from the coronavirus pandemic that ultimately will affect the design of healthcare facilities going forward. “Healthcare design can be an important defense against COVID-19 and other outbreaks,” says Michael Gillespie, partner and national healthcare practice leader at AKF, an engineering, technology, design, consulting, and commissioning firm (New York). “The novel coronavirus reinforces the mindset that we need to design for the unknown. Our industry often talks about resiliency in the context of weather-related events, but we also need to be thinking about creating healthcare facilities that are flexible and can adapt to future needs.”

Joshua Strugatz, vice president of Manhattan Redevelopment at Lenox Hill Hospital, part of Northwell Health, shares a similar viewpoint. Strugatz is leading the revitalization of the New York City hospital, which is looking to right-size its emergency department, convert all patient rooms to single-bedded patient rooms, and expand the size and number of operating rooms to accommodate new and emerging technology and equipment. “As we navigate this crisis, we can expect COVID-19 to focus attention on how healthcare facilities can be designed to handle pressing healthcare needs in the future,” he says.

As the healthcare industry navigates the COVID-19 crisis, industry professionals identify some of the design changes they expect to remain top of mind.

  1. Converting existing treatment spaces

One of the biggest changes to the industry will be converting existing treatment spaces to flexible and configurable facilities, says Ed Francis, global managing partner at consulting firm Infosys Consulting, Health and Life Sciences (Chicago). For example, he says healthcare leaders will design and retrofit their current facilities to become compartmented within a greater structure to stock medical supplies, equipment reserves, and identify contingent facilities. “A good corollary of this is the U.S. Navy in that warships are designed to close off compartments to prevent water from hull breaches from flowing from one compartment to another. Ships are also able to close off ventilation systems to prevent contamination from chemical or biologic particles from passing into the ship and if in to flow across compartments. This enables the ship to carry on with its mission with only small portion of its capabilities compromised. Similarly, The COVID-19 crisis has shown us that care would benefit from enabling a larger portion of a healthcare facility to be repurposed for highly transmittable airborne viruses while still enabling the facility to provide other services in a safe environment. Once the financial Impacts from the loss of normal services are fully known I believe there will be a significant business case for future facility design to deploy similar strategies.”

  1. Creating a purpose-built facility

Strugatz expects to see an emphasis on constructing new or modernizing current healthcare facilities so that they are purpose-built, operationally efficient, and able to respond quickly to changing patient needs. “We will see an even greater emphasis on flexibility in future design,” he says. For example, emergency departments should be large enough to fully meet the needs of their populations, while providing much-needed space in times of crisis, he says.

Additionally, while single patient rooms have become the industry standard, they are designed to transition to rooms with double-bedded capacity during a health crisis. “Patient rooms will become even more important in the future, as technological advances will allow a broad range of procedures to be performed within the patient room,” Strugatz says.

  1. Separating and quarantining of patients

Following COVID-19, facility design will take a more holistic view of quarantining at scale and how major portions of a care facility can be dedicated to serving a quarantined patient set, Francis says. Conversely, he adds that greater thought should be given to protecting non-quarantined patient services, such as birthing centers and emergency rooms. “Considerations will include dual systems for capabilities for ventilation, laundry, sterilization, meals, locker rooms, and others, essentially creating flexible facilities within a facility,” he says.

  1. Planning for surge capacity

Shortages of facility space, medical equipment and medical supplies has shown that future facilities will benefit from having surge capacity.

Francis predicts tighter public-private partnerships and planning for pandemics among providers and local, state and federal governments. He believes COVID-19 will teach us that our current facilities will require the ability to extend capabilities to remote sites as demonstrated with the use of the HMS Comfort in New York City, as well as ad hoc facilities such as convention centers, schools and mobile hospitals.

“This will create a need for maintenance of strategic assets that will likely require tighter integration with local governments with increased responsibilities from private facilities to store, maintain, and determine what strategic stocks are most appropriate,” Francis says.

“COVID-19 has had a bifurcating effect,” says John Henderson, president and CEO of the Texas Organization of Rural and Community Hospitals, an advocacy group representing rural and community hospitals. He says systems will lean toward telehealth combined with smaller clinics, but as a result will lose critical surge capacity. “There are approximately 6,000 available beds in rural Texas,” he adds. “Normally, that’s an operational liability. For the next few months, it has real value.”

By illuminating many challenges to traditional facility design, COVID-19 has provided an opportunity to rethink the future.

Tracey Walker is managing editor of Healthcare Design. She can be reached at