Key resilient design elements for a hospital

Key resilient design elements for a hospital

Stas Louca, MD, H+A, explains what we as healthcare architects, planners and designers, can do to play our part, in creating a resilient healthcare facilities?

Sengkang General Hospital, Building resilient cities, Resilient design, Healthcare design', Stan Louca, H+A', AECOM, Hospital design

Stas Louca heads up a multidisciplinary design firm, specialising in healthcare, hospitality and wellness design. As founding partner he brings more than 25 years of healthcare experience, while partner and design director David Lessard has an award-winning portfolio of hospitality and lifestyle residential projects spanning over 15 years. Together they explore the boundaries between leisure and well-being with focus on the guest and
patient experience.

In 2012, Louca was appointed project director for one of the largest new hospitals in Singapore, a 1,000-bed facility, covering 385,000 sq m of floor area, with an additional 200,000 sq m available for back of house, public support spaces and future expansion.

This new facility was being built to serve the north east population of Singapore and build additional resilience as a result of the SARS epidemic, which took place in 2002 to 2003, effecting more than 8,000 people across 29 countries and at least 775 people died worldwide.

Along each step of the design process, they were asked to challenge themselves and consider scenarios for natural and man-made disasters, making sure the hospital design could be flexible and adapted at short notice, without disrupting the facility.

1. Dedicated isolation facilities
The isolation of patients who are infected is critical in a healthcare system. At Sengkang General Hospital (SKGH), we provided dedicated isolation facilities attached to the hospital. This facility allowed patients to be screened, tested and isolated without passing through the existing facility. Access to isolation beds and ICU was achieved through dedicated circulation routes, which followed strict protocols. 

2. Decontamination facilities

The hospital incorporated a decontamination facility which was designed with key stakeholders, including civil defense. These decontamination canopies were located outside the emergency department and allowed for the protection of civilians and key workers. Vehicle decontamination bays were also provided as an additional precaution. Again, these facilities allowed for independent operability without impacting the existing operation or putting existing

3. Facility flexibility
Adaptability and Flexibility was a key design principal from the inception of the project. Today we have seen many existing facilities scrambling to convert their existing facilities to cope with the influx of infected patients. Some hospitals have gone as far to convert 100% of their bed capacity to cope with demand. At SKGH we designed the facility to have a large swing bed facility of 400 beds that could be converted into isolation wards within 48 hours. These swing wards were designed to be isolated from the main hospital and could operate independently in all aspects.

Many other departments within the hospital were designed as flexible spaces, ready for change, and this influenced the structural, mechanical and electrical design strategy. Adaptability relies on having a structural system that does not inhibit change. The same applies to mechanical and electrical systems. This was all achieved by creating a modular structural grid, so that partition walls could be adapted within a framework and by creating redundancy in the
MEP Systems.

4. Staff protection spaces
Part of the preparedness strategy was in-built into the design and that included the protection of key workers. This was achieved by providing gowning up and gowning down stations on each ward, and having ample PPE equipment and sanitation points all co-located for easy access. 

5. Technology systems
The use of technology to monitor hand washing for key workers was utilised and linked to monitoring staff movements for safety.
One of the most innovative solutions was the use of automated guided vehicles (AGV's) that could be deployed for bringing supplies to wards including drugs, medical records, medical supplies and food. These self-driving vehicles are an ideal solution during a pandemic when you are trying to protect patients and staff. I saw first-hand how these vehicles can enter lifts and arrive in the right location on time and without the need for a break.

6. Storage facilities
The strategy extended to creating a large material management store that was fully utilised, and stocked in advance in case of an emergency outbreak. The availability of key medical supplies has been one of the biggest challenges facing healthcare providers and having redundancy was a key principal at SKGH and this extended to key medical equipment such as respirators.

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