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Healthcare / Service redesign

Last-minute design changes help US medical centre plan for COVID-19 surge

By Andrew Sansom 21 May 2020 0

Health leaders at the University of Virginia (UVA) Medical Center realised that an accelerated construction schedule to its bed tower project – along with some last-minute design changes – were critical if it was to prepare adequately for a potential surge in coronavirus patients.

The decision was taken in early March with the hospital’s bed tower, then in the final stages of construction as part of a larger University Hospital Expansion (UHE) project, designed by architects at Perkins + Will, originally scheduled to open in June.

The patient rooms in the new 440,000 sq ft bed tower were designed to offer maximum flexibility – accommodating emerging technologies, changing patient demographics, changes in clinical practices, shifting economic markets and reimbursement models, and future growth opportunities.

Prior to the pandemic, nine of those rooms were designed to accommodate negative air pressure – a strategy that’s employed when care providers need to treat patients with highly infectious diseases. The negative pressure prevents the room’s air from circulating to the rest of the hospital, reducing risk of airborne contaminant transmission. 

At the time the UHE was being designed, a total of nine negative pressure rooms was considered sufficient based on all available public health data, known trends, and best practices worldwide. But the arrival of COVID-19 changed all of that.

“When a crisis like COVID-19 hits, there isn’t a rule book to tell you what to do,” said Brian Sykes, associate principal and health practice leader based in Perkins + Will’s Washington DC studio. “We all knew we had to think – and act – fast.”

Quick creative thinking, swift action

The challenge was how to immediately refit 84 patient rooms in the new bed tower so that they could accommodate COVID-19 disease patients. Such an undertaking would require the creation of negative air pressure in rooms that weren’t originally designed for it – and in only the span of a few short weeks.

Two solutions were devised. First, the design team temporarily repurposed an existing smoke-evacuation system, which provided slight negative air pressure for 12 intensive care unit (ICU) rooms. Combined with three existing airborne infection isolation rooms, UVA was able to provide a total of 15 COVID-ready patient rooms in under 14 days.

The second solution involved installing three high-velocity stack fans on the roof of the bed tower to give additional patient rooms negative air pressure. These 17-foot-tall fans accelerate the speed of departing indoor air, diluting pollutants and releasing them outdoors at an elevation high above the facility.

The power of teamwork

The whole redesign was completed in just three weeks, thanks to the collaborative efforts of UVA and construction project partners at Skanska and BR+A, enabling the hospital bed tower to be ready to open well ahead of schedule.

“Everyone at the table was brainstorming and looking at the challenge from different angles,” said Jim Woody, a senior project architect based at the Washington DC studio. “It was rewarding, because there was a real sense of not wanting to let the team down and to do the right thing.”

Chris Hoy, senior supervisory construction administration manager at UVA, said: “The team moved things quickly and gave me the confidence to represent drastic system changes with expedited review and approval protocols. What we’ve accomplished is truly amazing.”