PANDEMIC
production on this subject, thus enabling us to reconsider various aspects of architecture and engineering for health. A pandemic will probably not repeat itself on the same terms and with the same characteristics as that of COVID-19. Although it can be assumed that unforeseen events will happen in the future, no one knows what its characteristics and consequences may be.
However, the traumatic experience of these years, which forced the modification of many behaviours and practices in society in general and in the health system in particular, can and should leave a series of lessons learned about strategies for building healthcare projects that allow new projects to adapt and/or position themselves better in the face of emergency and unforeseen situations that are likely to occur. We also understand that healthcare projects are expensive and have significant ‘inertia’ (long planning, design and construction processes, as well as a long useful life) for which they cannot be easily modified or redone. The installed capacity (the built and operational infrastructure) in a health system is also a strong determinant and guide for the care model and health actions. This research work, carried out within
the framework of the Research Secretariat of FADU UBA by members of the postgraduate course on Buildings for Health Project at FADU UBA and AADAIH, has aimed to study and conceptualise these changes and their applicability in the architectural project for health. The objective has been to elaborate recommendations for architectural design for health, identifying new project criteria to take into account based on the experience of the pandemic. Given that the complexity of the problems in healthcare architecture makes it difficult to approach it from a single perspective, it was decided to work with an analysis from the concept of dimensions (understanding theme as a field of study) that would allow visualisation of different aspects. A total of 327 files in electronic format from different national and international sources, specialised and non-specialised journalistic sources, international organisations, official agencies, and professional associations were analysed and interpreted. The complete document containing the list of analysed bibliography and the interpretation of the 11 dimensions is available to anyone who requests it.
Goals The objective of this work was to elaborate a series of project recommendations on new criteria in architecture for health, based on the
IFHE DIGEST 2024
experience of the COVID-19 pandemic, understanding how the new care modalities condition architectural characteristics.
Methodology A determining point in this process to combat the pandemic was the review and adaptation of physical health care resources. Spatial and circulatory adaptations, the relationship with the environment, new concepts in ventilation systems, the functional organisation of buildings, the use of materials, cleaning and disinfection protocols, among others, forced health centres to quickly adapt and reformulate, not only the specific care of infectious diseases but also the entire provision of health services and the necessary infrastructure for it. The document is structured from the
concept of ‘dimensions’, which allows the analysis, understanding, and interpretation of different aspects of architecture for health: l Environment and access: The projection of exterior and intermediate spaces necessary to contain the influx of patients and the setup of a triage according to high demand is taken into account. The differentiation of access for patients, staff, and providers is another issue considered, complemented by a simple and efficient visual communication strategy (indicative signage).
l Circulation structure: Circulations are analysed according to the structure of the physical plant (horizontal or vertical), the types of flow (public or technical), and the levels of asepsis required. The supply routes of inputs and clean material, the discharge of pathogenic material, and the presence of antechambers or locks are also considered.
l Functional organisation: The general criteria and also the internal structure of the services are considered, highlighting the possibility of sectorising areas and providing support sectors to the staff. The need to have isolation sectors and even exclusive areas or pavilions for the treatment of infectious diseases is taken into account.
l Adaptability, flexibility, and growth: For the analysis of these concepts, the issue is addressed on a decreasing scale, from the sanitary network, passing through the building structure, until reaching the internal conformation of the services, focusing on the possibility of incorporating new spaces for attention in the event that the demand so requires.
l Comfort: In order to contribute both to the recovery of patients and to the comfort of the staff, the issue is approached from a comprehensive
perspective, addressing aspects of visual and acoustic wellbeing, environmental issues related to air conditioning and circulation, and the concepts privacy and health management.
l Biophilia:With the intention of reducing the feeling of confinement and achieving a quick and efficient recovery for patients, direct design strategies (views towards green areas, incorporation of gardens and natural light) or indirect strategies (through materials or images) that emulate natural settings are analysed.
l Materiality: Construction aspects tending to prevent the spread of infectious diseases are taken into account, with care given to the finishes and coatings.
l Facilities and Maintenance: The facilities are analysed from the perspective of infection control, with the air conditioning installation having played the greatest role in the development of the pandemic, together with the gas installation, medicines, and communication technologies.
l Equipment: Spaces for unforeseen equipment, mobile equipment, equipment parking, aspects of furniture, and the possibility of interposing physical barriers between staff and patients are considered.
l Cleaning: Aspects related to the hygiene of the physical plant, facilities, and equipment, as well as waste, food, and clothing management, are taken into account here.
l Illnesses and care modalities: The last of the dimensions addresses questions about new care practices such as telemedicine and telephone triage, as well as a series of measures and concepts specific to the structuring of the physical plant, arising from changes imposed by the pandemic.
Conclusions More than 358 documents that dealt with the issues of action, re-adaptation, projection, and assembly of the Physical Resource in Healthcare were analysed, allowing us to: l Systematise how the care modalities of COVID-19 have conditioned the architectural characteristics of buildings for healthcare.
l Understand that COVID-19 changed the priorities of the health sector, imposing a so-called ‘new normal’, establishing lasting changes.
l Capitalise on what has been learned as a result of the urgency that led to interventions in the physical resource based on experiences suffered.
l Structure and categorise new project guidelines based on what has been learned.
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