We Need More ICU Beds. Rethinking America’s Individualized Healthcare Mentality Can Help Get Them

With Prefabricated, Open Ward-Style Treatment Spaces We Can Rapidly Scale the Number of Beds

April 16, 2020

Partner, NBBJ

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 initially appeared on Forbes. It was co-authored by Ryan Hullinger and Bryan Langlands.


For years, America’s healthcare industry has operated from an abundance mentality, with hospitals assuming access to virtually unlimited resources. But we are just a month into the United States’ Covid-19 crisis and hospitals across every corner of America are finding themselves in the midst of a threefold lack of resources — of appropriate space, of healthcare workers needed to address the crisis, and the necessary level of personal protective equipment (PPE) to keep frontline staff and patients safe.

Though the outlook feels bleak, the current pandemic is a chance for the healthcare industry to reevaluate deeply held beliefs around patient care and comfort. Most notably, the primacy of private patient rooms and specialized nursing units as across the board solutions. Both healthcare professionals and the general public need to forego the ideal patient experience as a primary focus for the American healthcare system. Instead, it is imperative that they move to an emphasis on patient safety and survival.

It sounds like a paradox in the midst of an infectious outbreak, but augmenting single-patient rooms with prefabricated, open ward-style treatment spaces ensures we can rapidly scale the number of beds in our country. While some hospitals at the forefront of the crisis are beginning to adopt versions of this model, the scale of this crisis requires solutions that are more integrated, faster to build, and easier to deploy across geographies.

One solution is pre-fabricated ICU units: a process that builds the components offsite to allow easy assembly onsite, saving time and money. Developed recently for use in future hospitals on the East Coast, these ICU units can be integrated into unorthodox and temporary treatment areas inside hospitals like cafeterias, clinics, conference centers, and parking structures. It can also be used beyond the hospital in civic spaces like arenas, schools and community centers.

Hospitals can arrange these temporary units in modules of 12 to 18 beds that come pre-fitted with essential ICU functions like regulated gasses, air and data. Grouping beds into larger modules maximizes caregiver sight-lines and allows nurses to oversee a greater number of infected patients in a smaller area, minimizing the staff required to care for patients. These groupings also have the potential to extend the average length of use for some PPE by reducing the need for staff to don and doff protective equipment repeatedly, as they do in typical nursing units each time they enter and exit private patient rooms.

Specialized medical equipment manufacturers have been developing and producing key elements found within the ‘plug and play’ solution for years as a part of the nation’s hospital building boom. By marrying the two together — the “plug and play” ICU unit and redirecting existing units intended for construction projects — we may be able to help quickly offset some of the stress on today’s hospital systems.

Now we must shift that energy to respond to the crisis today. Doing so means that, at least temporarily, we must focus less on the individualized and specialized care model that has been a hallmark of American healthcare, and more on the infrastructure and solutions that will save the most lives.


How are you and your healthcare organization dealing with the coronavirus? We’d like to hear from you. Drop us a line at socialmedia@nbbj.com.

Banner image courtesy Frank Ooms/NBBJ.

Share this:  envelope facebook twitter googleplus tumblr linkedin
Follow nbbX