The COVID-19 pandemic has created a skyrocketing demand for critical care hospital spaces, which prompted designers worldwide to propose numerous design solutions widely ranging in style, cost, and permanence. In the long-term solutions, we see solutions in exploring innovative modular adaptable construction techniques to offer life-long flexibility and resiliency to our healthcare infrastructure.
The recent COVID-19 pandemic has brought almost all the countries, and the global economic and health systems to their knees. It has amplified many of the preexisting cracks in the system, but also spurred creativity and innovation, compassion and empathy to combat this crisis.
As part of the solution against COVID-19, the Architecture, Engineering and Construction (AEC) sector has also contributed in providing the much-needed hospital capacities of clean and sterile spaces where the patients can receive the life-saving treatments.
AEC Sector’s Rapid Response to COVID-19
AEC sector’s creative solutions extensively range in permanence, speed, and cost of designing and constructing new hospital capacities.
Given the unanticipated character of COVID-19 and how ferocious it has swept throughout the world, the rapid creation of additional intensive care capacities immediately became the primary focus of architects and engineers. Numerous designs proposed deployment and construction of alternative care facilities (ACFs), which are the “spaces designed to rapidly provide the surge capacity of hospitals which is central to successful combat of pandemic crises” (Lam et. al., 2006), including temporary solutions such as military field hospitals in tent-like structures, temporary modular structures built from redesigned shipping containers, and converting existing buildings such as hotels and arenas into temporary healthcare facilities (Hercules et. al., 2020). Due to their temporary and rapid erection ACFs are suitable for patient triage, preliminary treatment of patients with light symptoms, etc. (Lam et. al., 2006).
Meanwhile, ACFs also require specialized mechanical equipment, emergency electric facilities, educated staffs, and well-trained engineering and design professionals to ensure that these structures adhere to the highest standards of health and safety (Lam et. al., 2006). Otherwise, they could become dangerous hotspots for the spread of the disease and do more harm than good.
Furthermore, once the pandemic is suppressed successfully and life resumes to its regular flow, these temporary facilities become obsolete and are often not suitable for long-term use. The materials and equipment invested become either discarded or highly expensive to maintain. To avoid it, we need to plan for the entire healthcare infrastructure system with long-term flexibility and adaptability.
Long-Term Perspective on Flexible and Resilient Healthcare Infrastructure
The concept of flexibility and adaptability of healthcare infrastructure is not new. Since the 1960s, architects and engineers have already recognized that functional demands on hospital infrastructure changed multiple times within the life span of a typical hospital building (Carthey et. al., 2010). It is primarily caused by shifting demographics, changing medical technologies, improvements in treatment procedures, and attempts to rationalize hospital budgets (Olsson et. al., 2010).
Facing the current COVID-19 pandemic and the related surging demand for intensive care facilities, the AEC industry is urged to take a closer look at the technologies and innovations to provide the long-term resiliency and flexibility to the healthcare infrastructure.
Since its inception, the idea of flexible hospitals has been closely linked to new construction solutions ranging from interstitial floor space construction, prefabrication of building elements, to 3D modular constructions (Krystallis et. al., 2012). However, many of these technologies and the supporting market ecosystems have not been sufficiently developed until recently. Therefore, the complete market adoption of the flexible and modular hospitals had been hindered by the perceived high initial investment, insufficient freedom for creative design, the stagnant state of innovation in the AEC industry, and conservative legislative frameworks (Olsson et. al., 2010).
Nonetheless, recent developments in digital technologies, robotics, and integrative digital manufacturing logistics have instigated a new era of efficient and sustainable modular design and construction (McKinsey & Company, 2019). Besides, surging demand for modular solutions has been fueled by increasing awareness among clients of the long-term economic and environmental benefits. The current COVID-19 pandemic also serves as a positive catalyst for establishing the long-term planning, investment and development of resilient and flexible hospital infrastructure with the innovation in modular adaptable design and construction technologies.
Benefits of Modular Adaptable Hospitals
It was anticipated even before the COVID-19 pandemic that the new modular construction technologies will stimulate a wave of innovation in the domain of design of flexible hospitals worldwide, with a potential to yield over $1 billion of annual savings in new hospital construction in the US and Europe by 2030 (McKinsey & Company, 2019). Additionally, the modular adaptable technologies are capable of accelerating project delivery by up to 50% (McKinsey & Company, 2019), which can prove crucial in any future response to pandemics and other natural disasters, but even more importantly during the regular operations of hospitals.
The superior quality of spaces built for long-term flexibility and resiliency is proven every time the reconstruction is needed for introducing the new digital or robotic technologies into hospitals (Messner et. al., 2017). Facilities built with modular adaptable technologies can be reconfigured for achieving optimal process flows, with minimal disruption of regular hospital operation due to reconstruction related noise, dust, or vibrations, and with maximal level of health and sterility adhered to during the reconstruction process (Kamali & Kasun, 2016).
Finally, modular adaptable technologies allow for design and planning of sustainable life cycles of hospital infrastructure with minimization of on-site construction waste, recycling and reuse of materials within a circular economy ecosystem (Salama et. al., 2017).
As Albert Einstein said, "In the Middle of Difficulty Lies Opportunity”. During the challenging time of COVID-19 crisis we are prompted even more to learn and improve our healthcare systems for future challenges. Hence, exciting times are ahead where new technologies will be innovated to maximize the benefits of modular adaptable design and construction in providing a sustainable system with life cycle economic, social, and ecological sustainability of the future healthcare infrastructure.
About the author
Gordan Kucan is a graduate student at the ETH Zurich’s MSc in Integrated Building Systems. Building upon his integrative educational and professional experiences, he passionately innovates in the AEC industry. He is currently writing his Master Thesis on the topic of modular adaptable hospitals.
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