DR. ARCH. ASTRID-MARIA DEBUCHY – UNIVERSITY OF BUENOS AIRES, ARGENTINA POST-PANDEMIC DESIGN
Design for health: past, present, new challenges
Dr. Arch. Astrid-Maria Debuchy reflects on the lessons learned during the health crisis of COVID-19, and considers how to adapt health facilities to new challenges.
The worst labyrinth is not that intricate form that can trap us forever, but a single, precise straight line. Jorge Luis Borges
This article presents an analysis of the effects of the pandemic on healthcare design, highlighting the technical report Hospitals, technology, and networks: the evolution of health infrastructure post- COVID-19,1
authored by the Social
Infrastructure Group (GIS) and the Social Protection and Health Division (SPH) of the Inter-American Development Bank (IDB). This report summarises the discussions held in five workshops that took place between November and December 2021, with the participation of more than twenty experts from various countries, including Argentina, Bolivia, Chile, Colombia, Ecuador, Spain, Guatemala, Italy, Mexico, and Peru. The topics discussed in the workshops were: l The organisation and management of the health network
l Telehealth services l Primary healthcare l Hospitals as part of health facilities.
The workshops highlighted that large health facilities managed patients more effectively during the COVID-19 pandemic precisely because of their ability to expand their care capacity within their premises. Due to their large dimensions, they could easily separate activities, tasks, and processes, and utilise large internal spaces without requiring additional operational structures.
The need for flexibility was another important lesson learned during the pandemic. Flexibility was often not possible due to the design construction some buildings. In many cases, the lack of proper planning, for both the architecture and service installations, led to using spaces neither designed nor equipped for necessary activities when unexpected demand arose. Regarding access to the facility, the pandemic highlighted how necessary coordination is with transportation systems (both public and private) as well as with pedestrian access and pathways. As expected, access to emergency services was the most affected by the increase in patient demand. Faced with uncertainty, patients with mild or moderate symptoms overwhelmed this service. Hospitals acted as the gateway to the system, as primary care centres often failed to fulfil their role as a filter for managing subsequent levels of care. The general lack of space in hospitals
resulted in the need to annex areas often external to the hospital. These new spaces played a crucial role as vital extensions of hospital services, allowing, in many cases, for the organisation and redistribution of activities. The use of buildings and constructions separate from the hospital was also of great importance. Some examples of these facilities included the construction of prefabricated modular structures adjacent to hospitals and using existing buildings such as exhibition centres, sports facilities, out-of-service
health facilities, hotels, schools, and university residences. Different medical technologies and digital transmissions via internet systems complemented these facilities.
Thoughts and reflections Given the experiences and lessons learned during the pandemic, the following question arises: How can a health facility be analysed
to detect problems observed during the COVID-19 pandemic? For this, it will be necessary to propose
an interdisciplinary methodology to study the architectural attributes of the health facility following the Guidelines for the Development of Health Facilities (CIRFS/ FADU/UBA 1990/2010).2
First, we must
analyse the attributes of its spatial system, means three-dimensional system, by conducting a detailed analysis of the systems that integrate it: l the functional system l the circulation system l the installation system l the structural system.
The following sections will analyse each of them:
Functional system The analysis of the functional system requires recognising the various services that make up the health facility (Fig 1). In each service, identify and locate the different spaces, distinguishing between ‘functional units’, where the main activity of the service is carried out (example:
Astrid-Maria Debuchy
Dr. Arch. Astrid-Maria Debuchy has over 30 years of experience in ‘architecture for health’. Since 1990, she has been a member of the Research Center for Health Facility Planning (CIRFS) at the Faculty of Architecture, Design and
Urbanism (FADU) of the University of Buenos Aires Argentina (UBA), where her work links the activities of teaching, research, cooperation and technical collaboration. In 2021, Astrid-Maria participated in workshops developed by
Inter-American Development Bank (IDB) and was the editor of technical report Hospitals, Technology, and Networks: The Evolution of Health Infrastructure Post-COVID-19. Since 2001, Astrid-Maria has been participating in different events for the Public Health Group of the International Union of Architects (UIA/PHG). She is a member of the
Argentinean Society of Architects (SCA) and was appointed, in 2004 and in 2023, Official Representative for the Argentinean Federation of Architects (FADEA). In 2024 she was designated UIA/PHG Director for the Region III ‘Americas’. Dr. Arch. Debuchy is also a consultant in health facility planning for national and international institutions.
66 IFHE DIGEST 2025
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96
