| By Molly Hulsey
[email protected] Southeastern architecture firm LS3P Inc. has stayed busy during the pandemic, between crafting an infection-hampering building use strategy for the Medical University of South Carolina and helping design the World Health Organization’s first COVID-19 hospital retrofit in Burkina Faso, Africa. “It’s interesting how that hospital design is informing what we’re doing here in the Carolinas and Georgia where our offices are,” said Willy Schlein, LS3P’s health care practice leader. Across all sectors and locations, making sure that “patient and staff flow” goes in one direction now lies at the heart of Schlein’s designs. “Patient flow, the donning and doffing of protective gloves and masks — that’s universal, whether you’re in Africa or South Carolina,” he said. LS3P’s project with the WHO will renovate an existing Burkinese hospital to accommodate three tiers of care similar to field hospitals that were established across the United States over the past few months. Once LS3P’s models are put into use for multiple hospital retrofits around the world, WHO expects to be prepared to make any existing hospital COVID-19-ready within 48 hours, he said. “The time frame, because people are dying, is incredibly compressed,” he said. LS3P has also been selected by the WHO for consulting work in Rio De Janeiro following COVID-19’s entry into Brazil. For projects closer to home, Schlein has also had to think on his feet to help health care providers prepare for the coming storm of patients – especially as elective surgeries return to the market. Schlein noted that in architecture, there’s a term called Post-Occupancy Evaluation or POE. His team has now turned their attention to COVID-Occupancy Evaluations for at least six medical offices in the 50,000 to 100,000-square-foot-range. After gauging what patient flow might look like at an office’s check-in point, Schlein has suggested that clients allow patients to wait for a phone call in the parking lot instead of a crowded waiting room. Testing could be offered outside at the doorway, while patients and staff alike are encouraged to proceed down hallways in one direction. Some clients have already cordoned off up to 30% of their exam rooms for telemedicine visits — a trend Schlein expects to increase alongside no-contact features and greater reliance on built-in technology. Other more permanent fixtures may be phased into medical building codes, he said, if they haven’t been already. The gang style public bathroom may go the way of buggy whips and powdered wigs — or at least be monitored by an attendant or schedule to keep occupancy limits to a minimum. He also foresees HVAC playing a significant role in preventing potentially contaminated air from cycling through hospitals or assisted living spaces. “It’s a brave new world,” said David Allison, director of Clemson University’s graduate architecture and health program. While hospitals have been “scaling up” since 9/11, their focus for was directed at additional security features. Now, hospitals plan to use features such as negative air pressure and mechanical systems to remain on the defensive against respiratory infection, while expanding room for ventilator use. Health care facilities may also continue to a trend toward designating separate buildings for specific infectious illnesses, which parallels a pre-pandemic trend of gathering professionals who treat a particular condition under one roof — for example, Spartanburg Regional’s Gibbs Cancer Center. Features allowing for greater agility and flexibility in a building will be a game-changer moving forward, especially as the field continues to discover diseases and treatments at an ever-quickening pace. Allison expects that exam rooms will be designed for a variety of uses. “This is going to change the equation for how hospitals plan their facilities, there’s no doubt about that. It’s just a question of how quickly and how soon and at what pace they are able to accommodate those things,” Allison said, adding that some change may be halted as health care providers recover from the financial burdens stemming from cancelled elective procedures. And as more patients opt into telehealth or home health care options, Allison believes hospitals will be used less as a catch-all health care provider and more as a haven for the critically ill, further altering medical infrastructure. “Everything is getting pushed down stream. What used to happen in the hospitals is happening in ambulatory care. What used to happen in ambulatory care settings is moving to the home or wherever, ubiquitously, you may be,” he said, adding that senior care will also drop off in popularity following the pandemic. On the contrary, Rocky Berg, director of business development at Three Architecture’s senior living division and architect of the Woodlands at Furman’s ongoing expansion, thinks that as baby boomers begin to migrate to senior living facilities, they may be more apt to favor in-house services and luxury features than the previous generation. The shelter-in-place mentality shaped by the current pandemic will only further solidify these trends, he said. A Fort Worth client hired Berg to help design a labyrinth of partitions to prepare for the pandemic earlier this year, which enabled the senior care home to isolate a handful of cases and prevent the infection from running through the facility’s halls. Points of entry took on a “TSA approach” with temperature screening and sanitization checkpoints at the front door and at other high-touch environments — all features that may have a role to play in the days ahead. | 