Following the SARS outbreak in 2003, architects and designers had even more motivation to take into account how their projects could create healthier buildings, especially during epidemics and outbreaks. With this in mind, Parkin has created designs for many hospitals and healthcare facilities that incorporate new concepts. How are our projects incorporating designs to cope with current and future pandemics?
Designing isolation rooms
New hospitals include isolation rooms with improved controls over air quality. The air leaving the suite is filtered before it is exhausted, and is kept under negative pressure, ensuring that air can’t escape from the room through internal doors or windows. Isolation rooms are provided with an anteroom for donning and doffing Personal Protective Equipment (PPE) for healthcare workers. The entrance and exit doors for these rooms are interlocked, with an alarm that sounds if both doors are opened at the same time.
To further protect workers and patients, large pandemic supply rooms are built on site to store PPE and equipment required during outbreaks. This ensures that healthcare workers have the supplies and equipment needed to ensure contagious and vulnerable patients can be cared for safely, and to prevent cross-contamination.
Designing for the current pandemic crisis
Community transmission is a major concern with COVID-19, meaning new measures need to be implemented. An example of this includes working with clients to create safe routes to and from the construction sites for workers and materials, diminishing the probability that they will come into contact or interact with staff and patients. This reduces opportunities for community-type transmission of viruses. Hoarding around construction sites within hospitals are built to meet or exceed the Canadian Standards Association (CSA) standards. The areas under construction have separate air circulation systems from the hospital’s systems, reducing the potential for viruses to enter the hospital. These systems are put in place to protect not only the healthcare workers and their patients, but construction workers and other staff on-site.
We are working with healthcare staff to redesign Emergency departments, including redesigning patient rooms and intake areas with input from front line staff and Infection Prevention and Control (IPAC) teams. These changes also include remodeled walk-in entrances, screening process areas, pre-triage waiting rooms, triage, and the registration area to provide operational flexibility and better protection for patients and staff during a pandemic. For a past hospital project in 2004, Parkin redesigned a pandemic unit adjacent to the Emergency department following the SARs outbreak, with the knowledge gained from staff experiences. Recently, this same client has asked for modifications to this unit to increase the level of isolation rooms in preparation for the intake of patients with COVID-19. In the same vein, a client in the downtown core of Toronto has requested the addition of new anterooms to their isolation rooms in the Intensive Care Unit to improve the level of isolation.
Designing for future pandemics
Parkin has created multiple design interventions that can be used by hospital clients to ease the stresses on hospitals during the COVID-19 pandemic. For example, ambulance garage areas can be used as triage areas for infected patients. This way, those who are potentially contagious can be sequestered, sending all other patients through the walk-in entrance, mitigating any potential opportunities for COVID-19 to spread to patients arriving for other healthcare issues. Adjacent main lobbies can also be used as subacute patient care areas in case of high-patient intake during a pandemic.
The current pandemic has highlighted gaps in the epidemic preparedness of healthcare systems and facilities across the globe, while at the same time has highlighted what experts have done well and what they have achieved through tremendous talent and effort at all levels of staffing. As Bill Gates has said, “It is reminding us that our true work is not our job, that is what we do, not what we were created to do. Our true work is to look after each other, to protect each other and to be of benefit to one another.”