Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation.

Andrea Brambilla,Göran Lindahl,Tian-Zhi Sun,Stefano Capolongo,Ahmed Ghazy,Paul Barach,Waleed Elshazly

doi:10.3390/ijerph182111478

Abstract

Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.

Highlights

IntroductionThe Challenge of Hospital Flexibility in COVID-19 Pandemic and Beyond
The search focused on the following issues: flexibility of space in healthcare facilities, strategies of flexibility and its impact on hospitals
Flexibility was the most emerging and trending principle in healthcare facilities including a detailed explanation of the levels and types

Summary

Introduction

The Challenge of Hospital Flexibility in COVID-19 Pandemic and Beyond. Healthcare systems and their hospital facilities are facing huge challenges since the outbreak of COVID-19, in regards to the management of healthcare settings and building layouts [1,2], environmental contamination risks [3] and infection prevention and control operational demands [4,5]. Hospitals have been running out of space and resources to treat COVID-19 patients, whilst simultaneously caring for patients presenting with mild symptoms or who are asymptomatic, who pose an infectious risk to healthcare workers and other patients. The acceleration and stress caused by the pandemic have made the existing structural, organizational and technological challenges of worn-out and obsolete healthcare facilities even more compelling and increased the sense of urgency to redesign present facilities [6].

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