IFHE NEWS Healthcare amidst the pandemic by IFHE President, Daniela Pedrini
The pandemic prevails, and we now know that not only can it last for a considerable time, but also that similar viral epidemics or pandemics may well follow. This makes it almost impossible to make evaluations, even if we have learned many lessons as individuals and professionals working in the healthcare sphere. It also raises important questions – such as what sort of role engineers, architects, and health system technicians, could and should have. Will change be limited only to the built environment – to the health infrastructure – or do we need to address the search for a new ‘normal’ for prevention with different needs and considerations?
One of the IFHE’s major goals is to expand our membership, seeking out new networks and contributing to existing ones, which work to understand the need for prevention and, simultaneously, the achievement of a more sustainable ‘normal’, both within and outside healthcare facilities. Having changed the Federation’s name (from the International Federation of Hospital Engineering to the International Federation of Healthcare Engineering), we’ve expanded our scope of expertise, which was particularly important during the pandemic. Many scientists and policy-makers argued that the weakest point in the battle against the pandemic was the so-called ‘territory’. Against this backdrop, the International Federation of Healthcare Engineering – and our vision as ‘health technicians’ – has the imperative to widen our thinking. We have a duty not only to protect the hospital environment, but also the general environment, and to become more aware of the need to reduce the ‘footprint’ of our healthcare infrastructure, in line with the wider sustainability agenda. In other words, climate change is also our business.
Need for flexibility
We are all aware of the need to develop new models for heathcare facilities and the management of health systems, with modularity and flexibility fundamental in the design and construction of new hospitals. Now, amid the COVID-19 crisis, what can be done immediately to make our homes, healthcare facilities, workplaces, and commercial spaces, safer? The immediate space around us also contributes to the prevention, mitigation, and control, of infectious diseases. We must begin from a mindful design point: from the type of flooring,
to the choice of materials, to the correct air circulation; each design measure is key. The COVID-19 experience has led us to conclude that our buildings and built environment must be adaptive, designed according to the context, and above all, with the long-term goal of protecting people’s health.
It is fundamental to design with physical distance in mind – and not insulation – to allow spaces to ‘breathe’ better, requiring re-assessment of the selection of materials and surface treatments etc.
Lessons on plant and equipment As with plant engineering and construction, healthcare facility design must also draw lessons from what has happened during the pandemic – both as regards the design of spaces, and key plant, with systems designed from a preventative perspective, with a particular focus on energy efficiency and the management and maintenance of equipment with an eye to the future, and to innovation, rather than mere repetition of technologies and techniques. The pandemic has seen some successes – accurate redundancy provision, flexibility, increases in oxygen distribution, the use of materials not fully considered
previously, and more advanced digitalisation, etc. The focus on hospital changes, however, should not be the only priority. As we know now in Italy, greater attention must be paid to ‘territorial’ healthcare infrastructure, with primary care at the forefront. Hospital resilience needs improving, alongside the creation of a ‘territorial network’ of care provision. Both goals will require interventions that will need financial support at a European and national level, and will need to be managed at the appropriate government level, with strong regional collaboration. Planning for mitigating the impact of a future pandemic will need to be on the agenda for every public health agency, school board, manufacturing plant, investment firm, state legislature, and food production and distribution entity. We should stress, however, that even if all this is vital, it is not sufficient on its own. The healthcare system must understand the basic lesson of the pandemic: fighting the spread of a possible new pandemic will need to go hand in hand with the battle against climate change, air pollution, and all the factors that contribute to seriously harming our planet and its biodiversity.
August 2021 Health Estate Journal 25
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