The global pandemic has placed enormous strain on healthcare systems unlike anything experienced in a generation. Healthcare systems reacted by adapting facilities, staffing, patient care – nearly every aspect of how health care was administered. Some popular adaptations, like a pop-up vaccine administration site or a quick reuse of a building for emergency care (like a parking garage repurposed as a healthcare facility), have been reactionary and will mostly revert back to their intended uses once the pandemic is declared “over”. Other trends already in motion prior to 2020 were accelerated to meet pandemic needs and will have a lasting presence. Here are five areas of those healthcare design trends.
Pulling at the strings of mental health, physical health and safe in-person care, I expect to see an increased emphasis in design using the WELL Building Standard.
For those uninitiated, the WELL Health-Safety Rating is not unlike LEED, but while LEED centers around environmental health, WELL places emphasis + certification on the building’s impact on the occupants’ health + well-being. This includes nutrition, fitness, mood, etc. through lighting, indoor air quality, windows, finishes, volatile organic compounds (VOCs) and more.
Paradoxically, healthcare facilities have a difficult time measuring up to WELL because meeting the health + well-being of occupants varies wildly within the facility.
- The NICU cannot necessarily have circadian lighting, certain hues + certain intensity because development can be adversely affected.
- Indoor plants, while are known to boost moods + health, can create air quality challenges in a hospital environment.
- Operating rooms are stark, sterile + very bright because they must.
That doesn’t mean that smart design can’t incorporate the spirit of WELL. Recent projects have seen wonderful incorporation of materials, living plant walls, indoor + outdoor relaxation spaces, and more. I expect to see increased incorporation of health-centric choices made in healthcare design – rooftop terraces, reflection space, natural lighting, path-of-travel, and stairs that encourage walking + fitness – the design choices are limitless.
Social distancing + wayfinding
The most obvious effect COVID-19 has had on our daily lives is in the physical ways we interact with most businesses. Prior to the pandemic, my children’s dentist gave us a storybook on how fun + inviting the waiting room is with its colors, puzzles, books, fish tank, you name it. Now, we do not even stop in the waiting room and the fun items are piled up collecting dust in a corner. Reading the story now makes me take stock on how much has changed in a very short time.
Wayfinding + patient intake have always been an important part of the healthcare design process; it’s vital to connect people with the area + services they need in a clear, concise manner. The technology + process to have patients wait in their cars and enter directly into the exam room may relax, but are likely to continue in some ways. The waiting room might simply become the check-in point or kiosk on the way to the final destination – a transition point, not a place for puzzles + fish tanks. Lobby square footage could be reduced to allow for more socially distanced treatment rooms + staff workstations.
One-way traffic + social distance are being discussed as design drivers. Where you would normally find a grand entrance, I’d expect multiple entrances with individual check points and direct routes to service departments. Perhaps gone or limited are the bustling corridors. To maximize social distance and minimize cross-over, one-way corridors and doors could guide visitors from entrance, to registration, to exam, to exit. The one-way traffic concept could even be expanded to vertical circulation such as stairs + elevators.
Flexibility has always been a hallmark of healthcare design. Operating rooms are planned with more square footage than strictly necessary in anticipation of future technology or additional staff. Floors are expected to eventually be renovated for new + different services. But COVID-19 begs the question if we should design for flexibility of a different sort: surge capacity. Should patient rooms be designed with two headwalls to allow for double capacity? Could additional beds be created by rapidly transforming a department? While these may seem like expensive over-precautions to some, healthcare workers in the hardest hit cities saw the realities of hospitals at maximum capacity.
Steel-framed or concrete buildings are common + viable options for creating additional future flexibility. Open flex spaces, moving equipment around, and switching from strictly office or outpatient to inpatient all pose unique challenges. Open spaces with no walls, few walls or operable partitions should be closely analyzed for walking vibrations + human comfort. Upper floor structures are notoriously challenging + expensive when designing to support imaging equipment. Structural retrofit for imaging on upper floors may be impractical or impossible while remaining operational. Medical office buildings, ambulatory and outpatient buildings are typically not designed to the higher safety factors + seismic demands of inpatient facilities. Could or should today’s healthcare facilities be designed to the higher structural demands for future flexibility or a “surge” transformation?
Numerous studies have revealed a rapid increase in telehealth visits. My own family used telehealth in 2020 for several regular patient visits and even to have a doctor look at a gash in my son’s head (spoiler alert – he needed stitches). Telehealth was quickly + effectively ramped up, and it’s likely to stick around. We expect medical office building design trends to include flexible spaces to better provide care through digital means, whether that’s adapting existing space, providing new space, or otherwise including flexible spaces. The flexible spaces are becoming increasingly equipped with technology to improve the quality of video communication and digital accessing + sharing of medical records + information.
Mental + behavioral health
2020 brought about an increased level of introspection + appreciation for mental health care. December’s stimulus bill, signed into law, included funds for mental + behavioral health that will be put to use in 2021 through increased care facilities, mergers + acquisitions, and increased or new mental health services at existing facilities. Employers, like Schaefer, have increasingly adopted healthcare benefits which include mental health services. As recognition of the need for mental health care increases and the stigmas decrease, we could see new office space, or flexible space as mentioned above, put to use to provide more + better mental health care.
The healthcare industry is one that is almost constantly adapting. With greater knowledge that leads to new treatments, procedures + equipment, the spaces that we turn to in times of illness + crisis have been designed to anticipate adaptability. 2020 showed us the ability for healthcare to quickly adapt to an ever-changing situation and roll-out new technology + safety procedures very rapidly. With the vaccination campaign charging ahead, we all understand that the world can’t simply go back to how it was before. These trends I listed above are seemingly small, but could amount to huge changes to healthcare systems. We may not ever truly feel an “end” to the pandemic, but, some or all of these trends could make an enormous difference in the safety + effectiveness of our communities – in the present, but also in future crises.