Healthcare Design - August 2020 - 28

spending on facilities that might not be ready before the bed capacity was
needed or wouldn't be needed in the future?"
After re-evaluating its options, the organization determined that converting existing private patient rooms to semiprivate, using alternative
patient care areas such as prep and recovery departments, and bringing
a few closed inpatient units back online for COVID-19 patients were its
best options. Additionally, some of its hospitals worked with the Federal
Emergency Management Agency on off-site alternate care sites, where
nonacute patients could be treated, while others erected tents for patient
screening and ED overflow. Fortunately, Kent says, most of Trinity's hospitals saw patient curves flatten by May without reaching crisis levels, which
reinforced the strategy to increase patient capacity inside existing clinical
areas of the hospital and minimize the time and
money spent on alternate care site solutions
GETTING BACK TO NORMAL
that were never utilized.
WHILE STILL HOLDING
However, after all that preparation, another
realization was hitting the industry, Hankin
CARE AREAS FOR COVID-19
says. "People put so much attention into proPATIENTS IS ONE OF THE
viding care sites and additional spaces for
surge capacity that they soon realized it kind
MANY CHALLENGES THE
of choked the revenue-generating machine
INDUSTRY FACES TODAY.
from any healthcare organization because nonCOVID-19 patients were often moved and elective procedures were canceled, and then the patients-except in a few key
areas-never really showed up in the volumes that were expected," he
says. At Trinity, Kent says net patient revenue decreased $175.3 million in
March 2020 compared to March 2019, while direct operational costs rose
$14.2 million in the last two weeks of the month alone.
Facing significant revenue losses, many healthcare organizations began
holding back on some of their capital expenditures or postponing projects on the boards, while looking for infrastructure, care model, and operational changes that could be implemented in the immediate future to
start bringing patients and elective surgeries and procedures back safely,
Hankin says. For example, when Trinity began shifting from surge preparations to recovery planning in late April, Kent says state regulatory agencies required health systems to show that they had enough inpatient bed
capacity and personal protective equipment (PPE) on hand to support
COVID-19 patients prior to reopening non-emergency clinical services.
The Centers for Disease Control and Prevention also required facilities to
designate non-COVID-19 care zones. "As part of reactivation, there were a
lot of dials that had to be aligned between clinical operations and facilities
space planning," she says.
This reality-getting hospitals back to as normal as possible while still
holding a portion of a facility or physical assets for COVID-19 patients-is
one of many challenges facing the healthcare design industry today, Hankin says. As a result, it's driving new conversations between healthcare organizations and their design partners about what's been learned so far and
the lessons that can be applied to projects going forward, both in the shortand long-term. "I see organizations struggling to prioritize what those
most important things are that they have to do right now, all while they're
seeing the revenue streams and cashflow continue to stay low," he says.
ADDRESSING SURGE

Looking at the lessons to come out of the spring, Hank Adams, senior vice
president and global director of healthcare at HDR (Dallas), says he anticipates healthcare organizations will think differently about surge capacity

28

AUGUST 2020

HCDMAGAZINE.COM

going forward. "Some of the models that were
built out or presented are just too difficult to
staff, equip, and actually activate," he says. For
example, hospitals with existing shell space that
could be converted easily or already had infrastructure in place had an advantage over using
arenas or other facilities such as hotels that require major conversion to serve as temporary
care sites. "They were more cost effective and a
bit more patient- and caregiver-centric," he says.
There were also lessons on alternate care facilities and how they were used in the field. For
example, Trinity's alternate sites represented
5 percent of the organization's overall surge
plan, but not all staff felt comfortable transferring high-acuity patients to tents, so they were
used mainly for patient testing and triage and
not overnight patient care. "It's not the first investment we'd be looking to make in the future,"
Kent says.
Other design professionals suggest creating a
plan to activate alternate care facilities in phases
to prevent overbuilding in the future, while another strategy for systems with multiple locations is to designate one site as a COVID-19 hospital to lessen disruption to the care network.
Looking for long-term solutions to help lessen
the impact on overall operations and the ability to deliver care to patients with high acute
needs, Adams says he'd like to see more widespread adoption of conversion-ready rooms in
new construction and renovation projects. This
concept would include patient rooms and units,
as has been done in the past, but extend to prep
and recovery departments "so that all the different departments of an acute care facility can be
converted to a higher use that can help handle a
surge or higher care needs," he says.
HDR is also assessing projects in progress to
see if nonclinical areas should be prepped with
medical gases and emergency power capabilities
to allow those areas to be used as temporary care
sites. "People are looking at hospitals and recognizing that every square foot is precious real
estate and is there an ability to convert space to a
higher usage, as needed," he says.
Beyond the walls of hospitals, experts are also
rethinking site planning to address how surge
(or future epidemics/pandemics) can be better
addressed on-campus, including looking at how
people arrive, how parking is organized, how
facilities might queue patients, what touchless
technology could be used to register patients
and evaluate their health, and how the site might
be used to stage patients outdoors before you
even start to bring them inside. Additionally,


http://www.HCDMAGAZINE.COM

Healthcare Design - August 2020

Table of Contents for the Digital Edition of Healthcare Design - August 2020

Healthcare Design - August 2020
Editorial
Show Talk
Remote Impact
Signs of the Times
Design Inspiration
Photo Tour
Acute Condition
Holistic Hospitality
Operations Resetting T H E S Tage
Product Spotlight Surfaces
The Center
Welcome
2020 Design Show Case Jury / Award Winners and Finalists
Award of Merit: Trend Setter
Award of Merit: Southern Charm
Honorablemention : Water - Front Wonder
Honorablemention : Iconic Innovation
Honorablemention: Coastal Hero
Right Spots
Project Directory
Healthcare Design Showcase
Face Time
Healthcare Design - August 2020 - Healthcare Design - August 2020
Healthcare Design - August 2020 - Cover2
Healthcare Design - August 2020 - 1
Healthcare Design - August 2020 - 2
Healthcare Design - August 2020 - 3
Healthcare Design - August 2020 - 4
Healthcare Design - August 2020 - 5
Healthcare Design - August 2020 - 6
Healthcare Design - August 2020 - 7
Healthcare Design - August 2020 - 8
Healthcare Design - August 2020 - 9
Healthcare Design - August 2020 - 10
Healthcare Design - August 2020 - Editorial
Healthcare Design - August 2020 - Show Talk
Healthcare Design - August 2020 - 13
Healthcare Design - August 2020 - 14
Healthcare Design - August 2020 - Remote Impact
Healthcare Design - August 2020 - 16
Healthcare Design - August 2020 - Signs of the Times
Healthcare Design - August 2020 - Design Inspiration
Healthcare Design - August 2020 - 19
Healthcare Design - August 2020 - Photo Tour
Healthcare Design - August 2020 - 21
Healthcare Design - August 2020 - 22
Healthcare Design - August 2020 - 23
Healthcare Design - August 2020 - 24
Healthcare Design - August 2020 - 25
Healthcare Design - August 2020 - Acute Condition
Healthcare Design - August 2020 - 27
Healthcare Design - August 2020 - 28
Healthcare Design - August 2020 - 29
Healthcare Design - August 2020 - Holistic Hospitality
Healthcare Design - August 2020 - 31
Healthcare Design - August 2020 - 32
Healthcare Design - August 2020 - 33
Healthcare Design - August 2020 - 34
Healthcare Design - August 2020 - 35
Healthcare Design - August 2020 - 36
Healthcare Design - August 2020 - Operations Resetting T H E S Tage
Healthcare Design - August 2020 - 38
Healthcare Design - August 2020 - Product Spotlight Surfaces
Healthcare Design - August 2020 - 40
Healthcare Design - August 2020 - The Center
Healthcare Design - August 2020 - Welcome
Healthcare Design - August 2020 - 43
Healthcare Design - August 2020 - 44
Healthcare Design - August 2020 - 2020 Design Show Case Jury / Award Winners and Finalists
Healthcare Design - August 2020 - Award of Merit: Trend Setter
Healthcare Design - August 2020 - 47
Healthcare Design - August 2020 - Award of Merit: Southern Charm
Healthcare Design - August 2020 - 49
Healthcare Design - August 2020 - Honorablemention : Water - Front Wonder
Healthcare Design - August 2020 - Honorablemention : Iconic Innovation
Healthcare Design - August 2020 - 52
Healthcare Design - August 2020 - Honorablemention: Coastal Hero
Healthcare Design - August 2020 - Right Spots
Healthcare Design - August 2020 - 55
Healthcare Design - August 2020 - 56
Healthcare Design - August 2020 - 57
Healthcare Design - August 2020 - Project Directory
Healthcare Design - August 2020 - 59
Healthcare Design - August 2020 - Healthcare Design Showcase
Healthcare Design - August 2020 - 61
Healthcare Design - August 2020 - 62
Healthcare Design - August 2020 - 63
Healthcare Design - August 2020 - 64
Healthcare Design - August 2020 - 65
Healthcare Design - August 2020 - 66
Healthcare Design - August 2020 - 67
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Healthcare Design - August 2020 - Face Time
Healthcare Design - August 2020 - Cover3
Healthcare Design - August 2020 - Cover4
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