Abstract
The novel 2019 Coronavirus pandemic (COVID-19) has revealed numerous challenges in coordinating and arranging hospital spaces at both national and international level. The overwhelming number of hospital admissions of people affected by COVID-19 has highlighted difficulties in managing, updating, and refurbishing healthcare spaces. The objective of this study is to provide meta-design indications that demonstrate the value of spatial design in containing pandemic health emergencies and improving quality for different healthcare users. Utilized research methods include a review of existing literature on the current state of the art, analysis of design solutions that emerged in response to past pandemics and comparison of existing planning tools on the subject. Additionally, given the contemporaneity of the issue, a cross-sectional survey was used to collect and compare the experiences and design strategies adopted by some selected Italian hospital. The results of the study highlight the most effective and recurrent solutions that have supported health action in the fight against COVID-19. Emphasis was placed on solutions with a human-centered approach, as well as those that seek to promote the physical and psychological well-being of all users involved. In conclusion, the resulting meta-design indications represent a starting point for developing detailed design solution to enhance pandemic readiness. Additional research is needed to support healthcare facilities in becoming more welcoming and efficient while improving COVID-19 patient care and protecting healthcare workers.
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References
Adibe B, Hebert C, Perticone K, Dowd S (2021) Creating wellness in a pandemic: a practical framework for health systems responding to Covid-19. NEJM Catal Innov Care Deliv. Published online March 24, 2021. https://catalyst.nejm.org/doi/full/https://doi.org/10.1056/cat.20.0218. Last accessed 5 Nov 2021
Albert J (2021) Reimagining healthcare design after COVID-19. Healthcare Design Magazine. Published May 7, 2020. https://healthcaredesignmagazine.com/trends/perspectives/reimaging-healthcare-design-after-covid-19/. Last accessed 18 Nov 2021
Alcimed (2021) The patient pathway of COVID-19: 4 key challenges to overcome in Wuhan. Published March 3, 2020. https://www.alcimed.com/en/alcim-articles/the-patient-pathway-of-covid19-coronavirus-challenges-to-overcome-wuhan/. Last accessed 18 Nov 2021
American Institute of Architects (2021) Preparedness assessment tool V2.0. Published May 2020. https://www.aia.org/resources/6283331-alternative-care-sites-preparedness. Last accessed 16 Nov 2021
American Institute of Architects (AIA) (2021) COVID-19 frontline perspective design considerations to reduce risk and support patients and providers in facilities for COVID-19 care. Published June 2020. https://www.aia.org/resources/6313180-covid-19-frontline-perspective. Last accessed 18 Nov 2021
Amerio A, Bertuccio P, Santi F, Bianchi D, Brambilla A, Morganti A, Odone A, Costanza A, Signorelli C, Aguglia A, Serafini G, Capolongo S, Amore M (2022) Gender differences in COVID-19 lockdown impact on mental health of undergraduate students. Front Psychiatr 12. https://doi.org/10.3389/fpsyt.2021.813130
ASHRAE (2021) COVID 19 guidance. Published March 25, 2020. https://fgiguidelines.org/wp-content/uploads/2020/03/ASHRAE-COVID-19-guidance-20-03-25.pdf. Last accessed 18 Nov 2021
Belanger Y (2021) Healthcare after COVID-19: smart design solutions for clinical spaces. Nelson Worldwide. Published March 13, 2020. https://www.nelsonworldwide.com/healthcare-after-covid-19-smart-design-solutions-for-clinical-spaces/. Last accessed 18 Nov 2021
Blumenthal D, Fowler EJ, Abrams M, Collins SR (2020) Covid-19—implications for the health care system. N Engl J Med 383(15):1483–1488. https://doi.org/10.1056/NEJMsb2021088
Booth R, Brackett J, Peglow T et al (2021) COVID-19 recovery. ASHE. Published May 2020. https://www.ashe.org/covid-19-recovery. Last accessed 16 Nov 2021
Brambilla A, Sun T, Elshazly W et al (2021) Flexibility during the COVID-19 pandemic response: healthcare facility assessment tools for resilient evaluation. Int J Environ Res Public Health 18(21):11478. https://doi.org/10.3390/ijerph182111478
Capolongo S, Gola M, Brambilla A, Morganti A, Mosca EI, Barach P (2020) COVID-19 and healthcare facilities: a Decalogue of design strategies for resilient hospitals. Acta Bio Medica Atenei Parm 91(9-S):50–60. https://doi.org/10.23750/abm.v91i9-S.10117
Capolongo S, Brambilla A, Girardi A, Signorelli C (2021) Validation checklist for massive vaccination centers. Annali Di Igiene. https://doi.org/10.7416/ai.2021.2460
Centers for Disease Control and Prevention (CDC) (2021) Comprehensive Hospital Preparedness Checklist for Coronavirus disease 2019 (COVID-19). Published March 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/hcp-hospital-checklist.html. Last accessed 18 Nov 2021
Chiriboga D, Garay J, Buss P, Madrigal RS, Rispel LC (2020) Health inequity during the COVID-19 pandemic: a cry for ethical global leadership. The Lancet 395(10238):1690–1691. https://doi.org/10.1016/S0140-6736(20)31145-4
CIRSE (2021) Checklist for preparing your IR service for COVID-19. CIRSE. Published April 2020. https://www.cirse.org/wp-content/uploads/2020/04/CIRSE_APSCVIR_Checklist_COVID19.pdf. Last accessed 16 Nov 2021
Daubert G, Gillet G, Guet L, Marini H, Merle V (2021) General practitioners’ practice premises and risk of viral cross-transmission: a French observational multicenter study. J Prim Care Commun Health 12:21501327211043736. https://doi.org/10.1177/21501327211043734
Deb P, Furceri D, Ostry JD et al (2022) The economic effects of COVID-19 containment measures. Open Econ Rev 33:1–32. https://doi.org/10.1007/s11079-021-09638-2
Deng Y, Yang J (2021) Psychological status of frontline healthcare professionals at the outbreak of COVID-19 in Wuhan: a narrative case series. Psychiatr Clin Psychopharmacol. Published online 2021. https://doi.org/10.5152/pcp.2021.21123
Design & Build (2021) Pandemics, healthcare design and the coronavirus. Published June 2020. https://designbuild.nridigital.com/design_build_review_jun20/pandemics_healthcare_design_coronavirus. Last accessed 18 Nov 2021
Dewey C, Hingle S, Goelz E, Linzer M (2020) Supporting clinicians during the COVID-19 pandemic. Ann Intern Med. https://doi.org/10.7326/M20-1033
Disano LED Technology (2021) Human centric lighting/5. HCL nella sanità. Published July 30, 2019. http://disanoledtechnology.it/it/human-centric-lighting-5-hcl-nella-sanita/. Last accessed 16 Nov 2021
Drissi N, Ouhbi S, Marques G, de la Torre Díez I, Ghogho M, Janati Idrissi MA (2021) A systematic literature review on e-mental health solutions to assist health care workers during COVID-19. Telemed E-Health 27(6):594–602. https://doi.org/10.1089/tmj.2020.0287
Eagle A (2021) Supporting evidence: researched solutions for health care interiors. Health Facilities Management Magazine. Published October 1, 2014. https://www.hfmmagazine.com/articles/1388-supporting-evidence. Last accessed 17 Nov 2021
ECDC (2021) Checklist for hospitals preparing for the reception and care of coronavirus 2019 (COVID-19) patients. European Centre for Disease Prevention and Control. Published February 26, 2020. https://www.ecdc.europa.eu/en/publications-data/checklist-hospitals-preparing-reception-and-care-coronavirus-2019-covid-19. Last accessed 16 Nov 2021
Eggs Healthcare Engineering (2021) Design degli spazi ospedalieri. Published July 11, 2017. http://eggshealthcare.it/eggshealthcare.it/Blog/Voci/2017/7/11_Design_degli_spazi_ospedalieri.html. Last accessed 16 Nov 2021
European Centre for Disease Prevention and Control (ECDC) (2020) Infection prevention and control and preparedness for COVID-19 in healthcare settings—4th update. Published July 2020. https://www.ecdc.europa.eu/sites/default/files/documents/Infection-prevention-and-control-in-healthcare-settings-COVID-19_4th_update.pdf. Last accessed 30 Aug 2020
Feuer A, Salcedo A (2021) New York City deploys 45 mobile morgues as virus strains funeral homes. The New York Times. Published April 2, 2020. https://www.nytimes.com/2020/04/02/nyregion/coronavirus-new-york-bodies.html. Last accessed 17 Nov 2021
Gola M, Brambilla A, Barach P, Signorelli C, Capolongo S (2020): Educational challenges in healthcare design: training multidisciplinary professionals for future hospitals and healthcare. Annali di Igiene Medicina Preventiva e di Comunità 32(5). https://doi.org/10.7416/ai.2020.237
Gow C, Kenson J (2021) Healthcare design post COVID-19. PRISM. Published June 19, 2020. https://prismpub.com/healthcare-design-post-covid-19/. Last accessed 18 Nov 2021
Grelat M, Pommier B, Portet S et al (2020) Patients with Coronavirus 2019 (COVID-19) and surgery: guidelines and checklist proposal. World Neurosurg 139:e76–e773. https://doi.org/10.1016/j.wneu.2020.04.155
Harrouk C (2021) Alternative healthcare facilities: architects mobilize their creativity in fight against COVID-19. ArchDaily. Published May 28, 2020. https://www.archdaily.com/937840/alternative-healthcare-facilities-architects-mobilize-their-creativity-in-fight-against-covid-19. Last accessed 5 Nov 2021
Healthcare Radius (2021) 10 hospital design changes, post COVID. Published June 5, 2020. https://www.healthcareradius.in/projects/26279-10-hospital-design-changes-post-covid. Last accessed 18 Nov 2021
Health Facility Guidelines (2021) Isolation rooms—international health facility guidelines. https://healthfacilityguidelines.com/ViewPDF/ViewIndexPDF/iHFG_part_d_isolation_rooms. Last accessed 19 Nov 2021
HKS Architects (2021) Health environments interior recommendations for business recovery day 1 and day X. HKS Architects. Published April 2020. https://www.hksinc.com/how-we-think/research/how-interior-design-can-assist-in-health-care-business-recovery/. Last accessed 18 Nov 2021
Hsu J (2020) How Covid-19 could inform future hospital design. Smithsonian Magazine. https://www.smithsonianmag.com/innovation/how-covid-19-could-inform-future-hospital-design-180974697/. Last accessed 17 April 2020
International Association for Healthcare Security and Safety (IAHSS) (2021) Security design guidelines for healthcare facilities, 3rd edn. Published May 2020. https://www.iahss.org/page/designguidelines. Last accessed 18 Nov 2021
International WELL Building Institute (2020) WELL health-safety rating. Published July 2020. https://v2.wellcertified.com/health-safety/en/overview. Last accessed 30 Aug 2020
Ionescu M (2021) It’s not if, but when: designing healthcare spaces that support pandemic response. Building Design + Construction. Published March 26, 2020. https://www.bdcnetwork.com/blog/its-not-if-when-designing-healthcare-spaces-support-pandemic-response. Last accessed 18 Nov 2021
Joint Commission (2021) Emergency management healthcare environment checklist. Published July 2020. https://www.jointcommission.org/-/media/tjc/documents/Covid19/emergency-management-checklist.pdf. Last accessed 18 Nov 2021
Kashmira C, Peters A et al (2021) Emergency conversion of operating rooms into intensive care units to expand critical care capacity during the SARS-CoV-2 pandemic. Anesthesia Patient Safety Foundation. Published January 27, 2021. https://www.apsf.org/article/emergency-conversion-of-operating-rooms-into-intensive-care-units-to-expand-critical-care-capacity-during-the-sars-cov-2-pandemic/. Last accessed 18 Nov 2021
Kim JW, Stewart R, Kang SJ, Jung SI, Kim SW, Kim JM (2020) Telephone based interventions for psychological problems in hospital isolated patients with COVID-19. Clin Psychopharmacol Neurosci 18(4):616–620. Https://doi.org/https://doi.org/10.9758/cpn.2020.18.4.616
Labs A, Mass Design Group (2021) Redesigning hospital spaces on the fly to protect healthcare workers. ASPR TRACIE. Published April 28, 2020. https://asprtracie.hhs.gov/technical-resources/resource/8768/redesigning-hospital-spaces-on-the-fly-to-protect-healthcare-workers. Last accessed 18 Nov 2021
LeVine E (2021) How to rethink wayfinding to increase infection control and decrease patient stress. nbbX. Published April 13, 2020. http://meanstheworld.co/well-being/how-to-rethink-wayfinding-to-increase-infection-control-and-decrease-patient-stress. Last accessed 16 Nov 2021
Luo M, Guo L, Yu M, Jiang W, Wang H (2020) The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public—a systematic review and meta-analysis. Psychiatry Res 291:113190. https://doi.org/10.1016/j.psychres.2020.113190
MacFarlane A (2021) Light versus the virus. Signify. Published June 2, 2020. https://www.signify.com/global/our-company/blog/innovation/light-versus-the-virus. Last accessed 16 Nov 2021
MASS Design Group (2021) The role of architecture in fighting COVID-19: guidelines for limiting contagion in COVID-19 tent clinics. Published April 13, 2020. https://massdesigngroup.org/sites/default/files/multiple-file/2020-04/Rules%20of%20Thumb%20for%20Limiting%20Contagion%20in%20Makeshift%20Facilities.pdf. Last accessed 16 Nov 2021
McCarthy A (2021) Implications of COVID-19 on healthcare design. healthcare design magazine. Published July 21, 2020. https://healthcaredesignmagazine.com/trends/perspectives/implications-of-covid-19-on-healthcare-design/. Last accessed 18 Nov 2021
McCunn LJ, Safranek S, Wilkerson A, Davis RG (2021) Lighting control in patient rooms: understanding nurses’ perceptions of hospital lighting using qualitative methods. HERD Health Environ Res Des J 14(2):204–218. https://doi.org/10.1177/1937586720946669
Medtronic (2020) COVID19 care pathway strategies. Published April 2020. https://www.medtronic.com/content/dam/medtronic-com/us-en/hcp/services/cardiac-vascular-group/documents/Covid19-care-pathway-strategy.pdf. Last accessed 30 Aug 2020
Ministero della Salute (2021) Elementi di preparazione e risposta a COVID- 19 nella stagione autunno-invernale. Federazione Cure Palliative. Published August 2020. https://www.fedcp.org/cure-palliative/normative/nazionali/elementi-di-preparazione-e-risposta-a-covid-19-nella-stagione-autunno-invernale. Last accessed 18 Nov 2021
Mirco N, Ciocca A, Giupponi A et al (2020) At the epicenter of the Covid-19 pandemic and humanitarian crises in Italy: changing perspectives on preparation and mitigation. NEJM Catal Innov Care Deliv. https://catalyst.nejm.org/doi/full/https://doi.org/10.1056/CAT.20.0080
Naughton C (2021) Hospital room design strategies to increase staff efficiency and effectiveness. HMC Architects. Published March 8, 2019. https://hmcarchitects.com/news/hospital-room-design-features-that-foster-greater-efficiency-2019-03-08/. Last accessed 18 Nov 2021
Nelson C, Hill C, Cantrell J, Mulhall A, Wilcynski J (2021) COVID-19 and how it is shaping the future of healthcare design. Orcutt Winslow. Published June 2020. http://www.owp.com/covid-19.html. Last accessed 18 Nov 2021
Newsweek (2021) Best Hospitals—Italy. https://www.newsweek.com/best-hospitals-2020/italy. Last accessed 9 Nov 2021
Paganini M, Conti A, Weinstein E, Della Corte F, Ragazzoni L (2020) Translating COVID-19 pandemic surge theory to practice in the emergency department: how to expand structure. Disaster Med Public Health Prep 14(4):541–550. https://doi.org/10.1017/dmp.2020.57
Pareti G (2021) È indispensabile una pandemic architecture? Published online August 2020. https://iris.unito.it/retrieve/handle/2318/1747462/634351/BP_Pareti.pdf. Last accessed 17 Nov 2021
Passini B, Carnevale ALF et al (2020) Soluzioni organizzative, logistico/strutturali e clinico/assistenziali per la gestione e la limitazione dell’emergenza COVID-19 nel Policlinico Tor Vergata di Roma. Osservatorio Nazionale delle Buone Pratiche sulla sicurezza nella Sanità. Published June 1, 2020. https://www.buonepratichesicurezzasanita.it/images/Covid-19/Documenti/TorVergata/Soluzioni_organizzative_emergenziali_per_la_gestione_dei_pazienti_COVID_-_19__AGENAS_PTV_01_06_2020.pdf
Peavey E, Kim M, Roark J, Holton S, Schroer S, Scrantom B, Evans J (2021) The pandemic-resilient hospital: how design can help facilities stay operational and safe. Report by HKS—ARUP 2021
Prante FJ, Bramucci A, Truger A (2020) Decades of tight fiscal policy have left the health care system in Italy Ill-prepared to fight the COVID-19 outbreak. Inter Econ 55(3):147–152. https://doi.org/10.1007/s10272-020-0886-0
Putrino D, Ripp J, Herrera JE et al (2020) Multisensory, nature-inspired recharge rooms yield short-term reductions in perceived stress among frontline healthcare workers. Front Psychol 11:3213. https://doi.org/10.3389/fpsyg.2020.560833
Queensland Health (2020) Infection prevention and control guidelines for the management of COVID-19 in healthcare settings. Published June 2020. https://www.health.qld.gov.au/__data/assets/pdf_file/0038/939656/qh-covid-19-Infection-control-guidelines.pdf. Last accessed 30 July 2020
SafeCare (2021) Health system prepardness checklist. SafeCare. Published March 2020. https://www.safe-care.org/wp-content/uploads/2020/03/SAFECARE-COVID19-Health-System-Prepardness-Checklist.pdf. Last accessed 16 Nov 2021
Schaye VE, Reich JA, Bosworth BP et al (2020) Collaborating across private, public, community, and federal hospital systems: lessons learned from the Covid-19 pandemic response in NYC. NEJM Catal 1(6). https://doi.org/10.1056/CAT.20.0343
SIMEU—Italian Society of Emergency Medicine (2020) Organization of first aid and patient care in phase two of the COVID-19 pandemic. Published May 2020. https://www.ordine-medici-firenze.it/modulistica-docman/miscellaneous/400-simeu-organization-of-first-aid-and-patient-care-in-phase-2-of-the-pandemic-Covid-19/file. Last accessed 30 July 2020
Stevens P (2021) Studio prototype designs prefabricated “Vital House” to combat COVID-19. designboom | architecture & design magazine. Published March 25, 2020. https://www.designboom.com/architecture/studio-prototype-vital-house-virus-hotel-covid-19-03-25-2020/. Last accessed 18 Nov 2021
The Royal College of Emergency Medicine (RCEM) (2020) Emergency Department Infection Prevention and Control (IPC) during the Coronavirus Pandemic. Published June 2020. https://rcem.ac.uk/wp-content/uploads/2021/10/RCEM_BPC_Guideline_COVID_IPC_090620.pdf. Last accessed 18 Nov 2021
Ting DSW, Carin L, Dzau V, Wong TY (2020) Digital technology and COVID-19. Nat Med 26(4):459–461. https://doi.org/10.1038/s41591-020-0824-5
Trilux Inspirations (2021) Versatilità nell’illuminazione ospedaliera - TRILUX illumina il nuovo ospedale Isabel Zendal di Madrid. TRILUX. Published May 10, 2021. https://www.trilux.com/it/blog/trilux-progetto-illuminazione-ospedale-isabel-zendal-madrid. Last accessed 16 Nov 2021
Ulrich RS (1991) Effects of interior design on wellness: theory and recent scientific research. J Health Care Inter Des 3:97–109. https://pubmed.ncbi.nlm.nih.gov/10123973/. Last accessed 17 Nov 2021
Ulrich RS, Zimring C, Zhu X et al (2008) A review of the research literature on evidence-based healthcare design. HERD Health Environ Res Des J 1(3):61–125. https://doi.org/10.1177/193758670800100306
Wei EK, Long T, Katz MH (2021) Nine lessons learned from the COVID-19 pandemic for improving hospital care and health care delivery. JAMA Intern Med 181(9):1161–1163. https://doi.org/10.1001/jamainternmed.2021.4237
Wingler D, Nanda U (2020) Reboot readiness: a primer on how to design for contagions. © HKS, 350 North St. Paul Street, #100 Dallas, TX 75201 2020, page range 1–19. https://www.hksinc.com/wp-content/uploads/2020/06/HKS-RebootReadiness.pdf
World Health Organization (WHO) (2021) Rapid hospital readiness checklist: interim guidance. Published June 2020. https://apps.who.int/iris/bitstream/handle/10665/332779/WHO-2019-nCoV-hospital_readiness_checklist-2020.1-eng.pdf?sequence=1&isAllowed=y. Last accessed 18 Nov 2021
WSP (2021) Lighting for circadian rhythm—a desirable trend? Published May 9, 2018. https://www.wsp.com/en-TH/insights/lighting-for-circadian-rhythms-a-desirable-trend. Last accessed 16 Nov 2021
Yang Y, Wu D, Hou Y, Wang X, Dai D, Wang G, Yang Q, Zhao W, Lou Z, Ji Y, Ruan L (2020) Analysis of psychological state and clinical psychological intervention model of patients with COVID-19. medRxiv. https://doi.org/10.1101/2020.03.22.20040899
Zamagni Z, Caporale C, Pirni P (2020) La lezione e il monito della pandemia da Covid-19. In: Pandemia e resilienza. Persona, comunità e modelli di sviluppo dopo la Covid-19. Cnr Edizioni, Roma, Italy, pp 31–39. https://doi.org/10.48220/PANDEMIAERESILIENZA-2020
Zumtobel (2021) Luce per salute e cura. https://www.zumtobel.com/PDB/Teaser/IT/AWB_Health_Care.pdf. Last accessed 16 Nov 2021
Acknowledgements
This research would not have been possible without the exceptional availability and collaboration of the directors and staff from the following hospitals: San Paolo Hospital in Milan, Humanitas Covid Emergency Center in Milan, Territorial Social Health Authority of the Great Niguarda Metropolitan Hospital of Milan, Sant’Orsola Polyclinic - Malpighi of Bologna, Monselice Hospital in Schiavonia, Columbus Covid 2 Hospital of the Gemelli Polyclinic in Rome, and Spallanzani Hospital in Rome.
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Brusamolin, E., Brambilla, A., Capolongo, S. (2023). Learning from COVID 19. A Comparison of Innovative Design Solutions for Human-Centered Healthcare Facilities. In: Anzani, A., Scullica, F. (eds) The City of Care. Springer Series in Design and Innovation , vol 26. Springer, Cham. https://doi.org/10.1007/978-3-031-14608-4_7
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