Identifying built environment solutions, in Thai community hospital outpatient clinics, to prevent the spread of COVID-19

Abstract

Due to the unprecedented outbreak of COVID-19 (Corona Virus Disease - 2019) healthcare facilities, including Thailand community hospitals were mandated to adjust their facilities to both medical and non-clinical areas to prevent the spread of the disease. The study aimed to identify problems focusing on the physical settings of out-patient departments (OPD) in community hospitals during the first Thailand COVID-19 outbreak in March 2020. Furthermore, the study focused on providing design suggestions for preventing the spread of respiratory infectious diseases. The study employed a two-step approach to data collection. First, physical setting observations of the OPD of the two hospital buildings. Second, interviews with 22 healthcare employees; 11 participants from the first hospital and 11 participants from the second hospital. Interviews were transcribed verbatim and analyzed using content analysis. Five main themes were identified: (1) factors leading to accumulation of pathogens, (2) measures for preventing the spread of respiratory diseases, (3) current services and physical settings of outpatient clinics, (4) guidelines for improving the physical setting of outpatient clinics and (5) prevention of accumulation of pathogens in OPD areas. Results indicate that not only improving the physical setting of the OPD areas is required, but a strict patient screening process and an organized building management programme should also be considered. Such actions with workflow management would have played important roles in preventing the spread of respiratory diseases during the first COVID-19 outbreak. The findings from the study contribute to both research and industry. For the research, the study contributes to three literature topics including hospital building evaluation and assessment techniques, hospital design, and design prevention for the spread of COVID-19. For industry, the study contributes to the future development of layout design that can prevent the spread of COVID-19 throughout Thai community hospitals.