Architects and frontline workers develop COVID-19 healthcare facility design checklist

John Fowler (Photo: Linkedin)

WASHINGTON – A task force of the American Institute of Architects (AIA) is releasing a new checklist today for health care facilities that was developed in partnership with doctors, nurses, scientists and healthcare administrators working on the frontlines of the pandemic.

“The pandemic has placed an overwhelming stress on health care systems and providers,” said task force chair Dr. Molly Scanlon, FAIA, FACHA, who is an environmental health scientist at Phigenics. “By learning from the experiences and insights of frontline professionals, we’re able to ensure our hospital designs are best supporting health care staff and their patients.”

AIA’s new COVID-19 Frontline Checklist (page 10) provides strategies to support health care staff and patients by specifically addressing the unique challenges imposed by COVID-19, which are only broadly addressed by infectious disease protocols in standard disaster plans.

Disaster plans for U.S. health care systems have been uniquely tested by COVID-19. In the beginning of the pandemic, health care staff began adapting facility spaces, workflows, and operations to mitigate risk of virus transmission within health care settings.

“As we face the ongoing challenges of the COVID-19 pandemic, it is increasingly clear that the built environment is central to effective infection control and our health, safety, and wellbeing,” said Dr. Eve Edelstein, Assoc. AIA, FAAA, of Clinicians for Design. “This work supports the clarion call for clinicians, including doctors, nurses, therapists, and administrators, to consult with design teams as essential partners. Together, they can translate medical and scientific knowledge into design principles that can benefit both healthcare staff and patients.”

Recognizing the need to develop optimal design strategies for these nuanced practices, the AIA’s task force conducted research and interviews with surgeons, physicians, specialists, nurses, therapists, social workers, administrators, and scientists.

Input gathered—during February and March 2020—was used to inform a variety of considerations, including:

  • Spatial modifications for entering, testing, triaging, flexing spaces, setting up isolation areas and creating COVID-19 care rooms;
  • Air handling for spaces where procedures produce aerosols or increase risk of transmission;
  • Spatial modifications for COVID procedures, personnel needs and fluctuating staffing ratios;
  • Approaches for patients and providers during end-of-life care;
  • Spaces for staff respite and recovery during the extreme duress of COVID care; and
  • Strategies for unique environmental and infection control challenges due to the novel coronavirus.

This is the second checklist developed by AIA’s task force. In May, the United States Department of State translated and internationally distributed the task force’s alternate care site checklist, which includes recommendations from various agencies, such as the Centers for Disease Control and Prevention and the United States Army Corps of Engineers. A comprehensive briefing is available online.

AIA’s task force was launched to support the COVID-19 response. It is comprised of architects with a wide range of expertise, including healthcare facility design, urban design, public health and disaster assistance. Task force members and contributors include:

  • Dr. Diana Anderson, ACHA | dochitect
  • Dr. Ilene Brenner, MS, FACEP | Tanner Health Care
  • Dr. Eve Edelstein, Assoc. AIA, March, EDAC, FAAA | Clinicians for Design
  • Dr. Ruth Fanning, MBBChBAO, MRCPI, FFARCSI | Stanford University
  • John Fowler, AIA, EDAC, LEED AP | Margulies Perruzzi
  • William Hercules, FAIA, FACHA, FACHE | WJH Health
  • Dr. Anita Honkanen, MS, FAAP | Stanford University
  • Erin Peavey, AIA, EDAC, LEED AP | HKS, Inc.
  • Dr. John Riordan, MS | University of Virginia
  • Yiselle Santos, AIA, LSSYB, WELL AP, LEED AP | HKS, Inc.
  • Dr. Molly Scanlon, FAIA, FACHA | Phigenics
  • Dr. Ellen Taylor, AIA, MBA, EDAC | The Center for Health Design
  • Kirsten Waltz, AIA, ACHA, EDAC, LEED AP | Baystate Health
  • Marvina Williams, RN, BSN, LSSBB | Perkins & Will
  • Frank Zilm, FAIA, DArch, Emeritus FACHA | University of​ Kansas School of Architecture & Design.