1. Will infectious diseases become more common in the future?
‘We must prepare for a future with more outbreaks of infectious diseases,’ says epidemiologist and virologist Marion Koopmans, head of the Virology Department at the Erasmus Medical Center.
For decades, experts have been warning us that more and more infections are jumping from animals to humans (zoonosis) because of the way in which we have decided to live, which includes ever increasing pressure from worldwide trade, passenger traffic, land use, our natural world and climate change.
Source: Utrecht University
2. Is the healthcare system prepared for the arrival of existing and new infectious diseases?
‘Preparation for new infectious diseases should in fact be structural, also in healthcare,’ according to epidemiologist and virologist Marion Koopmans. ‘During the Ebola outbreak in Western Africa, all hospitals had to suddenly practise protective measures when approaching patients who had a fever. You should not only start thinking about such things when there is an outbreak. Preparation for outbreaks must become a lot more structural.’
Source: Utrecht University
3. How can the healthcare system better prepare for a future pandemic?
The healthcare environment must be seen as being part of the solution when containing pandemics. It is essential to create facilities that can continue to function during a pandemic. This must be taken into account when designing new, and adapting and renovating existing, healthcare spaces and buildings. Flexibility plays an essential role in the design.
Source: HKS report.
4. Which overarching design themes can be distinguished in the healthcare system?
HKS pays specific attention to flexibility, safety and cleanliness, and human well-being.
Flexibility
In the future, multifunctional or flexible spaces will be essential in healthcare facilities. For instance, pop-up temporary walls or space dividers made of, for example, Plexiglas.
Patient safety and cleanliness
Attention must be paid to creating a short, direct route from the Accident and Emergency Department (A&E). Furthermore, at facility level, ventilation, power supply and sanitary facilities must be considered as part of every solution in order to improve infection prevention.
For more information, please refer to the 2020 ER Contagion report by HKS.
Human well-being
Healthcare during a pandemic can be extremely stressful for staff, patients and families. Attention must be paid to this when designing hospital interiors, e.g. by assigning specific units for rest, recovery and well-being.
Source: HKS report.
5. Which principles for pandemic-resilient healthcare design can be distinguished?
- Versatility
- Surge ready
- Supports wellbeing
- Clean air and surfaces
- Isolate, contain and separate
- Flow
- Digital/physical
Source: HKS report.
6. What are the main conclusions of the HKS report?
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Continuity of operations and healthcare is crucial to our healthcare system and to patient health. The design of healthcare facilities can help to guarantee this continuity.
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Designs based on flexibility, including the use of multifunctional or flexible spaces, are essential for the future of the healthcare system.
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Designs at facility level must consider ventilation, power supply and sanitary facilities as part of the approach to infection control.
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Solutions will differ for each facility, so there is no ‘one-size-fits-all’.
Source: HKS report.
7. How do viruses spread in healthcare facilities?
In various ways. For instance, via shared use of equipment, mixed visitor and patient flows, door handles (Wojgani, Kehsa, Cloutman-Green, Gray, Gant & Klein, 2011) and airflow, caused by opening and closing doors that provide access to, for example, isolation rooms or operating theatres (Ham, 1999; Kalliomäki, Saarinen, Tang & Koksela, 2015; Mouvasi & Grosskopf, 2016).
Studies showed that factors like the speed of door movements, how long doors are open, door use by healthcare providers and climate control are all factors that affect the level of airflow between different spaces (Ham, 1999; Mouvasi & Grosskopf, 2016; Tang et al., 2013).
Questions 7 to 16 have been answered using the Metaflex white paper about the role of doors in containing infection hazards in hospitals. Further explanations can be found in this knowledge document.