Touching Base
Continued concerns surrounding the COVID-19 pandemic have caused many industry events to be canceled this year. The annual Healthcare Design Forum, scheduled for New Mexico in September, was no exception. But in a desire to come together, we invited our Editorial Advisory Board members, who are the core of Forum’s attendee base, to spend a day together virtually to reconnect and, of course, talk shop.
The online event was held on Sept. 10, kicking off with Editor-in-Chief Jennifer Kovacs Silvis presenting findings from Healthcare Design’s 2020 A/E/C Survey and preliminary results of the COVID-19 Industry Survey (watch for more on this in an upcoming issue). After grabbing a quick off-screen lunch, the board separated into breakout rooms for a mini charrette exercise, with each group assigned a specific topic: telehealth or other at-home/mobile care solutions; evolving healthcare workplace (shift to work from home); improving access to care/health inequity; next-generation infection control strategies; remaining operational in a pandemic or crisis scenario; flexibility and adaptability to respond to patient surge; and improving access to care/health inequity.
Attendees brainstormed several top-of-mind challenges tied to their topic, then came to consensus on one major issue to tackle with an innovative solution, informed by their unique backgrounds. The whole group then reconvened in the afternoon, with each team appointing representatives to share their report-out including the results of their discussion and the design solution created. (Finally, we topped off the day with an online happy hour!)
With COVID-19 top of mind, many of the discussions began with consideration of current strategies and lessons learned from the past months before looking to the future and discussing what solutions are still needed or the lasting impact recent events might have on the industry.
During a discussion on flexibility and adaptability to respond to patient surge, participants shared that one of the biggest lessons learned during COVID-19 has been the location of surge facilities, with consensus among the group that it’s better to keep patients, as much as possible, at the hospital because of proximity to staff, supplies, and equipment rather than trying to get those things to remote locations such as converted convention centers or hotels. Noting that many facilities turned to existing care spaces, such as patient or trauma rooms, to increase bed capacity, the group said one on-campus location deserves more consideration: hospital parking garages. “You’re better off trying to convert a parking garage on campus” where things like utilities and supplies will be readily available, said Randy Keiser, national healthcare director at Turner Construction (Nashville).
Staff spaces are another area that deserves renewed attention, the group added. During incidents related to patient surge, it’s not unusual for access to be limited within a facility or areas such as the cafeteria to be shut down. “As a result, that staff really gets locked into a unit,” said Julie Kent, manager of facilities, planning, and sourcing at Trinity Health (Livonia, Mich.). The group noted that providing respite space as well as changing rooms or shower areas are important to allow staff to mentally transition from work to going home.
A group diving into the topic of telehealth shared how healthcare organizations that already had that capability saw a rapid increase in services during the spring, while those that hadn’t yet adopted the practice were “thrown into telehealth.” The demand resulted in architecture firms being called in to help address a range of issues, from designing rooms to support appointments to working out processes or “helping providers script a better process,” said Scott Holmes, associate principal, medical planning at BWBR (St. Paul, Minn.). While many agreed that the practice is here to stay, the group discussed some of telehealth’s inherent challenges that still need addressed, including disparity in access to technology and network security. Looking to the future, the group discussed how telehealth could impact residential design with homes built to incorporate “Zoom rooms” or have proper data connections to support the exchange of information.
Another example from the day is the exploration of next-generation infection control strategies, which began with a review of initial responses to the coronavirus pandemic. For example, the first step for many organizations was to keep most non-COVID-19 patients out of the hospital, close clinics, screen patients at the front door, and allow in only those who needed treatment (a move that had repercussions for bottom lines as well as access to care). Then, as facilities began opening their doors to resume full services, they began looking for additional infection control strategies, from segregating patient populations, converting patient and trauma rooms to negative-pressure spaces, ramping up cleaning protocols and treatment of spaces between patients, utilizing UV light machines, and more. One positive outcome has been increased collaboration between departments, as epidemiology and infection control teams are now working with facilities engineering more closely, said Carolyn BaRoss, principal, firmwide healthcare interior design director at Perkins&Will (New York).
The group called for research to help understand what’s been effective during the COVID-19 pandemic to inform policy and procedures and proposed that engineering should lead with architecture to inform future designs. One idea was to “turn the hospital inside out” to find solutions, such as improving exposure to natural, outside air and focusing on wellness. “This is going to be a good opportunity for us to rethink design,” added Bill Repichowskyj, partner at Environments for Health Architecture (Williston, Vt.).
The 2021 HCD Forum is scheduled for Sept. 13-15, in Santa Fe, N.M. For more information, visit HCDforum.com.