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FACILITIES MANAGEMENT


Preparing for a post- pandemic society While the solutions for the structures have been prepared during the COVID-19 emergency period (reactivating disused structures or setting up dedicated external structures), it is important to gather proposals and look at innovations that could lead to changes in the designs and projects of the future. We are aware of the need to develop new models of hospitals and management of health systems. Awareness and preparedness are the goals of the post-pandemic society. Technicians have worked


wonders in adapting current hospitals to dramatically new needs, which in the future will have to be included in the planning and design processes related to the healthcare built environment - the architectural models of hospitals must be rethought. The need to respond immediately,


Door at Hospital-University Authority of Bologna – Sant’Orsola Polyclinic.


making available spaces already equipped and always available, for future health emergencies, represents a challenge for technicians who will have to rethink the design of hospital facilities. During the health emergency it became clear that the traditional organization for specialist departments was not consistent with the need to manage infected patients. The principles of reorganization of hospitalization areas by intensity of care (clinical instability and care complexity) have proved to be indispensable for responding to the care needs of COVID patients and guaranteeing the optimal allocation of human resources: intensive care, high intensity areas with workstations monitored and with the availability of ventilators, areas of ordinary hospitalisation, areas of hospitalization with low intensity of care for patients in conditions of remission of the disease. The need to redefine layouts and


spaces is particularly evident, with the opening of new hospitalization areas for COVID patients. Fundamental elements for the redesign of the current hospitals have included the ability to modify and separate entire wards, the preparation of monitoring and ventilation systems and the creation of isolable and negative pressure rooms.


Modularity and flexibility will be fundamental


But what has changed with the COVID-19 emergency? What can be done immediately to make the places where we


IFHE DIGEST 2021


live, homes, health facilities, work and commercial spaces safe? The space that surrounds us also contributes to the prevention, mitigation and control of infectious diseases. It is essential to start from a careful


design: from the type of flooring, to the choice of materials, to the correct air circulation. Every design measure is essential. The experience of the pandemic has led to more reflection on the way in which buildings and the built environment must be constantly adaptive, designed according to the context and in consideration of the long-term implications to protect people’s health. It is necessary to design with physical


distance in mind and not insulation, to make spaces ‘breathe’ better, rethinking the selection of materials and surface treatment, and so on. Opening windows, increasing air movement, introducing filters, avoiding enclosed corridors, waiting areas and other spaces to be designed while maintaining safe distances can also help greatly. The pandemic has also certainly


highlighted important indications on the organization of the ‘building-plant system’, in particular for hospitalization spaces and support areas. In these environments, in addition to a great control of the internal conditions of air quality, temperature and relative humidity, there was a need for ‘aeraulic compartmentation’, designed to prevent the passage of pollutants (and viral agents) between various environments, as well as careful and controlled sizing of ventilation, which is a strong defensive shield for reducing the risk of contagion.


As with the whole world of plant engineering and construction, the design of health facilities must also draw lessons from what has happened during the pandemic period. These are suggestions relating to the design of spaces, but potentially involving the entire building-plant system in general: this must be designed in a preventive perspective, with great attention to energy efficiency and to the management and maintenance of technological systems with a future perspective. Furthermore, it is a question of implementing an integral design, capable of detaching itself from past uses and habits, through a reflection that can lead to a modern concept of design, no longer mere repetition of technologies and techniques, but conscious development of innovation. The goal is to remodel the


spaces, care paths and logistics. The hospital of the future should be more flexible, with hospital rooms designed for transformation into a single environment to expand the capacity of the ward if needs be. The subdivision of the paths within the hospital is imperative in order to avoid contamination. Essentially, the hospital and emergency


networks must work in synergy with the territorial one, because it is on the territory that the battle can be won through early tracing of the infected, home isolation and even home care in order to avoid a concentration of patients in hospitals, which in turn translates into a higher ease of contagion and even mortality. The enormous clinical, diagnostic and


therapeutic information patrimony is, to date, largely dilapidated: one of the most striking examples concerns hospital medical records which, still on paper, ensure that, in the vast majority in cases, the information collected in the patient monitoring phase is dissolved at the same time as the patient is discharged. The road ahead is even longer when


we talk about new technologies to support home care. Undoubtedly, COVID- 19 is accelerating the use of apps, borrowed from trials in the treatment of chronic conditions, which allow you to monitor patient parameters remotely, creating a valuable experience that will certainly be useful even after the epidemic has disappeared. However, if the guidelines relating to the use of telemedicine had been implemented more in the past, we would probably have reduced the impact of the


19


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