INFECTION CONTROL
Table 1. Facility and installation cost. Item
Portal floor-standing unit equipped with HEPA filter Installation
Camera monitor in the private room including installation Floor screen equipped with HEPA filter in outpatient department Negative pressure canopied bed in emergency outpatient department Construction of corridor door Carbon dioxide sensor
Pneumatic-supported tent Total
large number of possible COVID-19 patients during the pandemic. We believe this is not the best option in most hospitals because we had to maintain standard clinical practice for ordinary patients including patients with malignancy and emergency patients. We converted only a general ward and the hospital forecourt to spaces for COVID-19 patients. Although clinical data demonstrated that the bed occupancy rate and operation volume each decreased by approximately 25 per cent during the coronavirus surge, our hospital activities were maintained relatively well as a result of the hospital integration strategy. In terms of the financial benefit of the hospital integration for the COVID-19 surge, the cost of integration was compared with that of other options. The capital cost for Hospital in Wuhan was reportedly approximately 142 millon USD.10
On the other hand, according to
the literature on hospital construction cost in Italy, the cost varied from approximately 170 to 237 USD per square foot. According to the same literature, this would be approximately 220,000- 206,000 USD per bed. Moreover, according to other statistics in the fourth quarter of 2021 in the US, Los Angeles is one of the most expensive cities in the US for the construction of general hospitals, with an average cost per square foot of over 772 USD. On the other hand, Las Vegas was the cheapest city in the list, with an average cost of 437 USD per square foot. For the sake of comparison,
Cost (USD) 9,750 4,630
48,000 2,370
22,800 5,460 170
60,000
Quantity Total cost (USD) 8 8 8 7 3 2
250 2
78,000 37,040
384.000 16,600 68,400 10,920 42,500 120,000 757,460
we adjusted the cost of the integration, which was compared with the construction cost for a temporary hospital and the construction of a new general hospital. Regarding the cost per bed, constructing a new hospital costs much more regardless of the type of hospital, temporary or new (see Table 2). We believe that the effectiveness of the
above-mentioned measures is proven by the fact that we have not experienced any cluster of infection associated with the cutback of hospital activities since hospital functions were integrated. Our experience also indicates that integration of the functions of the present hospital building is one of the choices under certain conditions, especially in urban hospitals.
Conclusions Comprehensive integration of an existing hospital associated with ward remodelling can be a feasible option to increase the health system’s resiliency to respond to a patient surge in a pandemic, especially in urban hospitals.
4 Environmental Health Position Document Committee. ASHRAE Position Document on Infectious Aerosols. [
https://www.ashrae.org/file%20library/ about/position%20documents/pd_ infectiousaerosols_2020.pdf].
5 Booth RD, Ponce SJ, Corso GJ, Perkins SK. American Society for Health Care Engineering (ASHE) current/updated health care facilities ventilation controls and guidelines for management of patients with suspected or confirmed SARS-CoV-2 (COVID-19). 2022. [
https://www.ashe.org/ system/files/media/file/2021/02/2021- ventilation-guidance-healthcare- facilitiesdocument-2.pdf].
6 Lin Z, Shu H, Jiang D et al. Ward renovation and PPE use procedures to protect medical staff from COVID-19 infection. J Infect Dev Ctries 2020; 14 (6): 554-8. doi:10.3855/jidc.12788.
7 Chen S, Zhang Z, Yang J et al. Fangcang shelter hospitals: a novel concept for responding to public health emergencies. Lancet 2020; 395 (10232): 1305-14.
IFHE
References 1 CDC. NIOSH. Hierarchy of controls. [
https://www.cdc.gov/niosh/topics/hierarchy].
2 Peterson K, Muckey E. Deployment and operation of outdoor treatment tent during the COVID-19 pandemic. Disaster Med Public Health Prep 2022; 16 (2): 460-3.
3 Morawska L, Milton DK. It is time to address airborne transmission of coronavirus disease 2019 (COVID-19). Clin Infect Dis 2020; 71 (9): 2311-3.
Table 2. Comparison of cost between integration and other construction costs. Integration
Total cost (USD) Number of beds Area (ft2
)
Adjusted cost/bed (USD) )
Adjusted cost (USD/ft2 52
757,460 40
19,376 18,937 40
Hospital in Wuhan 142,000,000 1,000
270,000-366,000
8 Shu l, Ji N, Chen X, Feng G. Ark of life and hope: The role of the cabin hospital in facing COVID-19. J Hosp Infect 2020; 105 (2): 351-2.
9 Luo X, Zhang Y, Zheng Y et al. Prevention of SARS-CoV-2 transmission from international arrivals: Xiaotangshan Designated Hospital, China. Bull World Health Organ 2021; 99 (5): 374-80.
10 Cai Y, Chen Y, Xiao L et al. The health and economic impact of constructing temporary field hospitals to meet the COVID-19 pandemic surge: Wuhan Leishenshan Hospital in China as a case study. J Glob Health 2021; 11: 05023.
Hospital in Italy – – –
142,000 220,000-306,000 388-526
170-237
Hospital in US – – – –
437-772 IFHE DIGEST 2023
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