Editor’s note: Our healthcare clients are on the front lines of the coronavirus crisis. We seek to support them as they courageously care for the sick. So we’re posting design ideas based on work with them, in the hope that we can contribute from our base of expertise to help combat the epidemic. From all of us at NBBJ to the many doctors, nurses and support staff in hospitals and clinics, thank you from the bottom of our hearts.
This post was co-authored by Tom Sieniewicz, George Takoudes and Tim Pranaitis.
As countries around the world respond to the coronavirus (COVID-19) pandemic, healthcare systems feel tremendous strain — from mask and ventilator shortages to a lack of patient beds. With the number of global cases on the rise, how can hospitals safely and efficiently test the “walking worried” — people who present with coronavirus symptoms or may have been exposed — before they step into the emergency department?
One strategy is to open a hospital triage tent, a temporary outdoor structure that is separate from a hospital’s emergency department. Here are a few factors to keep in mind when creating a similar space at your healthcare organization:
Employ empathy. Going to the hospital in any situation can be stressful, and especially so today. Creating a patient-provider experience that people can trust is crucial. This starts with understanding needs, from the “walking worried,” to nurses, doctors and security guards.
Select the right location. Identifying the right site is an important step. Is there an available parking lot nearby? Different than the drive-through testing model that was developed in South Korea, a hospital triage tent needs to be accessible to those on foot who may not have access to a car.
Consider the appropriate amount of space. Being able to test the highest number of people at one time while maintaining CDC protocols, such as social distancing of at least six feet, is critical. For example, a triage tent of 25 feet by 45 feet should hold no more than 15 people seated (but can accommodate up to 30 people total if accounting for the queue). Typically a space of that size can accommodate up to 50 people.
Select a tent with easy-to-clean materials. Providing a space that is as simple as possible to disinfect and sanitize is of utmost priority. On a recent triage tent in Boston, we coordinated with a tent company that has worked with the city’s fire department. The hospital is renting the triage tent on a weekly basis, which includes important essentials such as lighting, smoke detectors and HVAC. The walls are vinyl-wrapped tent fabric, which can be wiped down as needed and meet flammability requirements. The tent structure is aluminum and features concrete blocks to weigh it down and prevent uplift. All the furniture and fixtures were reused from the hospital.
Accommodate a safe and streamlined screening process. A triage tent must provide at minimum, space for four activities: a place for visitors to queue, a check-in zone, a waiting area and one or two private screening rooms.
Build in flexibility. In the rapidly evolving coronavirus situation, creating a space that can flex on a moment’s notice is key. The interior of the triage tent doesn’t contain interior walls, but instead uses screens that can easily move to different parts of the space for additional privacy.
Prioritize collaboration. Maintaining open lines of communication among all parties during a super-compressed timeframe can expedite the delivery process, and also make sure issues are resolved as quickly as possible. With the right approval frameworks in place, it’s possible to develop and assemble a triage tent in just a few days, which means employing rapid-fire decision-making and a design-permit-build process (that typically takes two years for a regular hospital project) that leaves no room for error. Having frequent conversations between ER staff, permitting authorities, project managers, lighting specialists as well as security and tent representatives lays the groundwork for a successful, speedy and safe project that supports providers, patients and visitors alike.
In these unprecedented times, we’re all learning new ways to be resilient, to adapt and to be resourceful. We hope the above framework helps provide insight into a new method to tackle this crisis.
How are you and your healthcare organization dealing with the Coronavirus? We’d like to hear from you. Drop us a line at firstname.lastname@example.org.
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