Healthcare Design - March 2021 - 19

scrambled to create temporary COVID-19 wings or retrofit existing spaces. Going forward, designers say more attention should be paid to creating
EDs that can handle a number of scenarios-from mass contamination
events to seasonal influenza spikes. " Flexibility, adaptability, and efficiency are things that you invest in, " says Brian Sykes, healthcare practice
leader at Perksin&Will (Washington, D.C.).
For example, an ED project for Orlando Regional Medical Center (Orlando, Fla.), designed by HKS, incorporates a grouping of rooms that
serves as an urgent care pod but can change to pandemic mode at the flip
of a switch to become negative pressure with 100 percent outside air. The
unit also has its own entry and waiting area to use during this mode, to
provide physical separation from the rest of the ED. " That's the kind of
resiliency we're talking about, " says Jason Schroer, principal and director
of health at HKS (Dallas).
Rethinking how patients-many arriving with a variety of needs and
conditions-enter a facility is also key. " What we're learning is that the
ability to initially separate individuals from the get-go is really important, " Wingler says. Solutions for redesigning the threshold can range
from adding a vestibule where screening is done to utilizing an outdoor
triage area to having multiple entrances so that during a crisis, one could
be identified for specific patients while the others continue to serve the
general patient population. " There are many different permutations to do
that, but at the end of the day, there needs to be thoughtful consideration
given to how you begin to isolate, if needed, and protect others, " she says.
At Wellstar Kennestone Hospital's new ED, an isolation room located between two adult and pediatric triage areas on the first floor is used to quickly relocate someone who poses infection risk. To maximize flexibility, the
room utilizes airborne isolation technology and ligature-resistant features
so it can also function as a de-escalation room for behavioral health patients when needed. " When you combine them and use the space in a flexible way, it makes it a lot easier sell and it places
[hospitals] in a much better position to take care
of patients in today's climate or the next situation, " Manning says.
Marianne Hatfield, vice president and chief
nursing officer of patient care services at Wellstar Kennestone Hospital, says although the
system hasn't returned to pre-COVID-19 volumes yet, the new ED has the flexibility and
forward-thinking systems in place to support
care teams as they adapt to changing needs. " We
want our community to feel confident that they
should not delay seeking care due to any fear
about being exposed to infectious patients, " she
says. " We actually think the hospital's the safest
place to be. Our private rooms and multiple specialty care zones have been developed for just
this reason. "

ABOVE: An adult
behavioral health room
on the second floor of
the Wellstar Kennestone
Hospital ED is finished
with clerestory windows; safety hardware
and accessories; and
a calming, natureinspired green accent
paint. BELOW: A trauma
room in the ED at
Wellstar Kennestone
Hospital has direct
connection to imaging
for immediacy and
convenience.

of a mass casualty event. For example, as part
of the University of Virginia (UVA) University Hospital expansion in Charlottesville, Va.,
which included a new ED, the ambulance deck
canopy was equipped with drop-down showers and curtains so water can be brought in to
decontaminate mass groupings immediately,
while electrical connections were added to the
column to support generators or other power
needs. " You want to be able to treat [patients]
outside and not bring them into the facility, "
Sykes says. " Hospitals are becoming more sophisticated about this topic. "
Facilities also are addressing how to treat
specific patient populations arriving at the ED
for care, including behavioral health and pediatric patients-making specialty care spaces
a must-have in the ED. Recognizing growing demand for pediatric services at Wellstar

SPECIALTY CARE NEEDS

Beyond the next pandemic, disaster preparedness is another topic being addressed
in today's EDs, particularly in ambulance
bays where project teams are layering in multiple systems to enable care delivery to support triage or decontamination in the event

MARCH 2021

Healthcare Design - March 2021

Table of Contents for the Digital Edition of Healthcare Design - March 2021