Pandemic resilience in Dutch hospitals

Abstract

The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as increasing their ICU capacity and enabling physical-distancing measures to prevent infectious spread. They also needed to co-house suspected COVID patients and nonCOVID patients with different requirements and enforce separate entrances and routes to keep staff and patients safe. It is suspected that even in a fully vaccinated world, other pandemics are waiting in the wings. In a design brief, flexibility is typically mentioned as an important target, and single occupancy inpatient accommodations may be considered as a way to enhance flexibility. To gain insight into and inform future hospital design, this study evaluated what operational coping strategies and design solutions were considered important enablers to increase ICU capacity and support different patient flows, and what design solutions enabled physical distancing. We have collected data from 30 Dutch hospital organizations, including some recently opened hospitals, with 100% single occupancy inpatient accommodation. Using a practice-based approach, in-depth interviewing was combined with document and multimedia analyses to analyze and compare successful operational strategies and design elements that helped provide the flexibility needed in this recent crisis. As we looked at existing facilities and alterations made to allow hospitals to operate in ‘crisis mode’ during the COVID-19 pandemic, we presented emerging design considerations for future healthcare facilities that, preferably, can also be implemented in renovations or refurbishments. We add the perspective of staff as a limiting factor in a hospital’s pandemic preparedness.