Displaying items by tag: COVID19

Tuesday, 02 February 2021 19:11

A Tumultuous Time


I am glad that 2020 is behind us and we can look forward to Covid resolution in 2021.  As I examine the toll the virus has taken on hospitals, I realize that many fiscal as well as physical changes are necessary moving forward.  I believe that future hospital design will feature a dynamic tension between infection prevention and flexibility.  Hospital bed counts for overnight stays will be the sole purpose of the main hospital building for the foreseeable future.  We will protect our vulnerable populations by further isolating care for seniors, heart patients, diabetics, emergency patients and children.  We have already seen this movement towards free-standing specialty clinics and this concept will continue to grow.  We call it the "hub and spoke" model.  The hub being the main hospital with the spokes formed with individual specialty services.

As planners and designers, we will become proficient in the needs for each population and assist owners in rebranding these facilities.  We will select materials not only based on durability, but also review the finish or fabric's ability to stop the growth of microbes.  Careful considersation as to the properties of materials will require research and a proven track record for success.  Healthcare organizations will depend on our knowledge and foresight to recommend the best possible design selections for the budget.  These organizations are in a critical balance between addressing the need for separating patient populations, making the most of outpatient options, and in the end, making money to offset the costs of the pandemic.  Historically, outpatient business has been a lucrative venture for healthcare owners.  This will be even more important in the coming years.

Our expertise in planning and our experience in mitigating the transfer of infection through our designs will be paramount to our clients. We have never seen such importance placed on our knowledge as we perceive it now..  Take the baton and be sensitive to revamping the delivery of healthcare.  Architects, designers and engineers need to understand that we are shaping the future of healthcare with careful consideration to patient groups. It is a tumultuous time in healthcare, but perhaps a positive leap forward in the evolution of healthcare design.

Published in Healthcare
Wednesday, 16 September 2020 15:05

From Crucible to Phoenix

The hospital that we knew in 2019 is no longer there.  Hospitals are in a crucial state of being remolded.  I believe that the phoenix that will result is a hybrid model of care, highly specialized, with nothing but positive attributes for patients.

Everything we knew to be true about the healthcare experience has transformed into a environment of cost containment and competitive care.  Just using PPE purchasing as an example, we no longer tolerate price gauging and shortages.  Communities have chipped in and taken up the mantle of what needs to be provided to insure hospitals have the products they need.  We have re-invented resourcefulness and have leaped years into the future of telemedicine success.  We are now at ease with electronic interactions with physicians and nurses.  All age groups have embraced the speed at which we can talk to our physicians through electronic interface.  It saves time and money.  

To be sure, there will be much to accomplish with renewed infection control mechanisms.  Air flow and a fresh appreciation of the power of the outdoors has eclipsed inoperable windows of tightly sealed hospitals of yesteryear.  Cleaning, disinfection, and sanitation have taken on new meaning in day to day discussions of the average American in all work environments.  Ultraviolet filtration and overall education of what kills germs is now a household topic of concern.

The key word is efficiency.  What would have taken ten or more years to achieve has happened in seven months of intensity.  I am of the belief that we will be glad the Pandemic sped up the process.  The platform for care in the United States will move forward with less redundancy, separating functions into a retail marketplace of services.  The future will address individual service centers of care, with highly acute recovery centers separate from the "big house" of the hospital proper.  We have already seen free-standing emergency departments, and we will see more of these.  Singular buildings with children's services separate from adult care are already abundant.  Now we will reap the benefits of known infection control measures and plan for specific environments of care for cancer and compromised people.  There will be more sensitivity to specialized care platforms.

We are a great country and we have proven that time and time again.  The phoenix is rising from this crucible of change as it always does here in the United States and the term, "made in America" will be the key to many successes, not just in healthcare.

Published in Illness
Thursday, 21 May 2020 23:41

What We Know Now

When Covid was discovered, every hospital had predetermined protocols for the diagnosis and treatment of patients. The C Suite and department directors painstakingly developed these standards and protocols after years of input.  I listened to a webinar this week where 3 hospitals agreed that those were all negated the week that the virus hit their doors! The frontline workers have re-worked the standards and have adapted to the best and most effective ways to treat patients. Those who have the experience have set the protocols for the new normal.

I watched as photos were pinned to the webinar screen to illustrate how one hospital created a more human approach to care starting with the staff having facetime with the patient. Patients were issued Ipads and while the healthcare worker was outside the room, the patient conversed with the staff face to face through electronics. In an effort to save costs on PPE's, the staff moved ALL EQUIPMENT out of the patient room and into the adjacent corridor. All leads from the equipment to the patient were lengthened and flowed under the door to the bed. This was genius! The corridor became the patient bedside! Most work could be conducted without PPE's. There were, of course, times when the staff suited up and entered the room for hands-on care, but the patient knew who was working on them and had established a relationship with the nurse or physician. The patients felt less isolated.

Is this a contingency that hospital design might need to plan for in the future?  Possibly. What we know now is that more flexibility needs to be built into care patient environments. If a hospital system can set up beds in a parking deck to address a pandemic, then designers and architects can certainly address flexibility in the future plans for hospitals. I believe that building codes will be re-written to allow more temporary conditions to prevail, that privacy curtains will be eliminated or replaced with disposable ones, that wood arms on chairs in a patient room are no longer viable with current cleaning methods, and paints and wall finishes need to pass muster with aerosol disinfection. This is just a small portion of the changes that will come out of the last couple of months.

Published in Healthcare
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Friday, 27 March 2020 17:34

What Does Healthcare Look Like in 3 Months?

ScreenHunter 519 Apr 22 1614

Three months from now, when the Covid-19 virus is under control, what happens to hospitals and healthcare as we know it in the United States? How will hospitals fare financially? This is an unprecedented situation which has cost hospitals money and supplies.

I believe the answer to that question lies in the basic economics of how to recoup the costs of a pandemic. While we thank those brave souls on the front lines of caring for the afflicted, we need to recognize this may have caused their careers to be fundamentally changed forever. When all is said and done, will they go back to the same job as before the pandemic or will they have a new role?

Hospitals have set up beds in parking garages to address the numbers of patients. This all costs money and the implications continue to grow. Will big donors help? Will our future healthcare plans start to look more like socialized medicine? The U.S. as a whole will need to step up and support the people and systems who literally gave everything they had to keep our citizens healthy. Large philanthropic organizations need to keep this in mind and continue to give in the coming months to keep our hospitals viable and able to go back to "normal."


Published in Healthcare
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