There’s an evolving threat that a viral pandemic could overwhelm U.S. healthcare systems and their treatment sites. Healthcare providers are preparing for a possible tsunami of COVID-19 patients, while managing seasonal illnesses or struggling with concurrent issues of bed shortages and staff recruitment.

But can this mobilization spur a rethinking of processes and healthcare settings, boosting new ideas that are just beginning to take hold and reinvigorating best practices?

The Centers for Disease Control & Prevention (CDC) has guidelines for healthcare facilities preparing for and managing community transmission of this disease that could significantly affect healthcare practice and facilities in a positive way for the future. Here are a few:

Explore alternatives to face-to-face triage and visits. Healthcare facilities will likely need to adjust the way they triage, assess, and care for patients using methods that aren’t face-to-face, including telephone consults, patient portals, online self-assessment tools, and telehealth interactions. Algorithms already exist that can identify which patients can be managed by telephone and advised to stay home and which patients need emergency care or hospitalization, minimizing surge on facilities. Recent reports suggest that most COVID-19 patients have experienced only mild illness that can be managed remotely to reduce the strain on hospitals. Many health systems have already developed robust telehealth and online portals but a COVID -19 patient surge could be the “tipping point” that triggers widespread adoption of these technologies.

Separate known or suspected COVID-19 patients from other patients. The last place that you want suspected COVID-19 patients is in a crowded emergency department or clinic waiting room. We’ve already started seeing approaches such as drive-thru testing sites in South Korea, as well as in cities in the U.S. Washington State is converting a former hotel into a “fever hospital” to quarantine less acute patients. Hospitals such as Mt. Sinai Health System in New York already have “hospital-at-home” programs treating acutely ill patients who would otherwise require hospitalization. One could imagine these types of programs growing more rapidly during a quarantine.

Prepare your facility to safely triage and manage patients. The CDC recommends suspected COVID-19 or other respiratory infection patients wait in a separate, well-ventilated space that allows patients to be separated by 6 or more feet. Though the general goal has been to reduce waiting times and therefore seats/space in waiting rooms, we may need to rethink how waiting rooms are designed or how other spaces can be repurposed for patients awaiting treatment, if needed.

Most hospitals are ill-equipped to handle an influx of patients requiring private airborne isolation (AII) rooms.  The current Facilities Guideline Institute’s Guidelines for Design and Construction of Hospitals and Outpatient Facilities specifies a minimum requirement of one critical-care AII patient room per hospital. Though the trend has been to create more AII patient rooms or isolation units throughout all acuity levels, the COVID-19 epidemic may “seal the deal.” Hospitals are also experimenting with robots to interact with isolation patients, reducing staff exposure.

The response to COVID-19 may lead to positive discussions on how inpatient facilities are configured, especially in regard to biocontainment and surge capacity. They say that “necessity is the mother of invention.” I’m hopeful that the new ideas and practices that evolve from this current crisis will positively inform how we plan our healthcare settings in the future.

Sheila Cahnman, FAIA, FACHA, LEED AP, is president, JumpGarden Consulting, LLC. She can be reached at