Towards a resilient hospital design

Emerging design considerations for future healthcare facilities after the pandemic COVID-19

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COVID-19 has highlighted the importance of the healthcare systems in society. The pandemic overwhelmed hospitals and forced rapid and radical changes in healthcare organizations' working practices and management structures (MASS Design Group, 2020; Ramboll, 2021; Capolongo et al., 2020). The virus led to unfamiliar environments, new spatial configurations of hospitals were necessary to cope with the surge capacity, new protocols and strategies were fundamental to respond to the crisis. Past pandemics have occurred, and other infectious diseases and viruses might come. COVID-19 is not going to be the last challenging situation for the health sector. Thus healthcare systems could become more resilient. Hospitals need to be resistant to future outbreaks, maintaining and adapting critical functions during crises (Ramboll, 2021). It is essential to learn from the experience of the COVID-19 pandemic to be more prepared for future events.
This practice-based research aims to gain insight into the pandemic experience to provide recommendations to future-proof hospital design. A qualitative approach is proposed for this study. First, through a general questionnaire, information on building adaptations and working practices of hospitals in the Netherlands during the pandemic was assessed. Then follow-up in-depth interviews with chosen facility and real estate managers that answered the survey would be conducted to reflect on the crisis period and understand the decisions and choices taken regarding planning, design, and engineering during the different waves in the country's hospitals.
According to findings, the pandemic in the Netherlands increased cohesion and collaboration between healthcare organizations. The national government advised the coordination of the emergency response, and the decisions within each organization were driven by independent Crisis Management Teams (CMT). Clear guidance facilitated the decision-making process of the measures and services that needed to be implemented. In general, hospitals felt well prepared for the pandemic, although changes and improvements were made regarding building, technical and employee-focused modifications to respond to the surging demand of covid-care.
Additionally, an analysis considering three spatial characteristics of hospitals: type, building year, and urban density, was done to determine if there was a distinction in the measures taken. It was found that most hospitals implemented some top measures and that there is also some differentiation between groups of hospitals. Based on the findings and the lessons learned from the interviews, some suggestions for future renovations and developments were made. Recommendations could help build up towards future-proof facilities to a virus-like COVID-19 increasing spatial flexibility, robustness and adaptive capacity of healthcare buildings.