Design Strategies Health Systems Should Consider after COVID-19

As architects, engineers and designers, we need to be mindful of the immense pressures that healthcare systems are facing after a year of dealing with the COVID-19 pandemic.

Keeping facilities operational for routine patient care and protecting patients and staff while caring for COVID-19 patients creates tremendous economic hurdles to overcome. There is not a one-size-fits-all solution to address these issues. What may work for an academic medical center may not be right for a community or critical access hospital. We have developed the "Healthcare Design Strategies for a Post-COVID World" document to concisely outline the potential strategic, operational and design considerations that may be considered, based on the scale of the system or facility, demographics and the rate of infection in the community—and the increasing likelihood of more frequent and deadly pandemics in the future.

By surveying our client partners, hosting virtual discussions, and using predictive analysis tools such as scenario mapping, we are continuously gaining insight into how COVID-19 is impacting our clients. This paper is a compilation of this research, as well as our work assisting multiple clients across the country to adapt facilities, add capacity through temporary negative pressure and anterooms, implement new safety and patient flow protocols, and ramp up testing sites.

Many of these strategies, which were initially considered short-term, may become long-term solutions to correct deficiencies in population health, process, patient care and infection control. The pandemic has pushed us to quickly pivot and re-think longstanding processes and procedures—some of which are long overdue for examination and reinvention.

Some strategic considerations included in this guide are assessing options for alternate care sites within owned real estate and through partnership with local real estate owners. Other strategic considerations are developing protocols for transferring patients, partnerships between health systems, strategies for supporting better health and addressing underlying medical conditions in the community, and plans for improving mental health.

A selection of operational considerations addressed through our research include adapting patient intake models, reconsidering physical waiting spaces and the patient journey through facilities, rethinking in-person care in the context of increasing acceptance of telehealth visits, improving infrastructure to support increased telehealth, deploying temporary and mobile health sites, and advancing respite amenities to support healthcare providers.

Download the complete "Healthcare Design Strategies for a Post-COVID World."

In addition to this document, we have also summarized our knowledge in a decision matrix called The Path Forward, which includes all potential strategic, operational and physical design changes, as well as the associated cost impact, technical complexity and duration.