Medical Construction & Design

JUL-AUG 2018

Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.

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MCDM AG.COM | J U LY/AUGUST 2018 | Medical Construction & Design 33 suites is on an exterior wall of an emergency department to allow direct access into the space without going through the main facility, and to allow easy transfer of patients from the facility to a specialized treatment center. However, the critical care unit may pro- vide a structure and size more fl exible for retrofi tting a HIDS in place and can better serve patients with highly infectious diseases. Designing through understanding of disease spread In an acute event or outbreak, mitigating the threat of spread to the general hospital popula- tion including staff , families and patients is of utmost importance. This requires an understanding of the way the disease is spread and taking eff ective procedures to control this threat. Each facility is made up of zones of safety that include hot (e.g., infected patient room), warm (e.g., exit room) and cool (e.g., public corridor) zones. These spaces must facilitate ease of decon- tamination, have quick access to laboratory results and con- trol the exposure to the rest of the facility and to infectious body fl uids. The HIDS concept helps to achieve threat mitigation by providing unidirectional staff fl ow, a well-sized doffi ng space visible by staff observers to ensure proper protocols and showers between the patient (hot) zone and the public (cool) zone, allowing for staff to fully decontaminate. Waste management using an auto- clave to dispose of contaminat- ed waste or fl uids is strongly recommended. The surfaces in the room should be seamless, easy to disinfect and, whenever possible, self-disinfecting materials should be used. Cleanability can be facilitated by a hard-surface ceiling with the potential to embed UV or high-intensity narrow- spectrum lighting to aid room disinfection. Doffi ng/exit rooms can be placed between two isolation rooms to provide greater space effi ciencies. Minimizing disruption to care In emergency situations, it is important to reduce the risk of error by minimizing necessary changes in operations. This includes both minor disrup- tions to the overall capacity of the hospital, as well as the specifi c care protocols for the infectious patient. To minimize the medical disruption to other patients and disruption to the fl ow of normal care, the HIDS should be positioned away from the main path of travel to reduce the potential consequences of having to shut down more usable medical space. The HIDS should feel similar to standard patient rooms in fl ow and layout to reduce potential medical errors and, since com- munication can be diffi cult in full isolation mode, testing possible communication tech- nologies and protocols will be important for any facility to choose the best communica- tion system. Flexibility for everyday use The fl exibility to convert quickly and to scale up or down the level of protection and number of patients is critical to allow healthcare organizations to utilize space effi ciently and eff ectively dur- ing routine care, while being ready for disease events at any time. This can be created by using a standard room that has removable storage and fur- nishings. However, with many rooms having a large portion of built-in storage, this may be diffi cult to adapt. The HIDS prioritizes staff visibility to the patient without having to enter the room, and in doing so allows for greater patient surveillance during non-emergent and emergent situations. For some options, this means remov- ing the anteroom and instead providing an alcove for PPE and hand-washing as part of the staff core; in other options it means changing the location of the anteroom as not to ob- struct the view to the patient. With a resurgence of Ebola striking the Democratic Republic of Congo, the need for hospital readiness is sa- lient. For healthcare systems to be ready in the face of emergency will require facili- ties that control the disease spread, minimize disruptions to care and maximize fl ex- ibility. Erin Peavey, EDAC, LEED AP BD, is an associate and design research strat- egist with HKS. Dan Thomas, AIA, EDAC, is an associate principal and senior vice president of HKS Dallas. INFECTIOUS DISEASE PATIENT ROOM INNOVATIONS: Prototype of an infectious disease patient room

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