Optimum model of a hospital for pandemic preparedness.

Principal and Design Director
HKS Architects

Architect and Health Design Researcher
HKS Architects

Optimum model of a hospital for pandemic preparedness.

2020 was a wakeup call, highlighting the need to be generally more prepared for health threats. While the vaccination programme in the UK has commenced and provides hope during this third national lockdown, we need to be prepared and able to respond more effectively next time. And not just for future pandemics but other threats that can have a severe impact on our health service such as natural disasters and terrorist attacks.

The impact of the pandemic is not only seen in those who have tested positive and had hospital stays as a result, but also other areas of the health system. It had a knock on effect on the number of people able to go through with elective procedures and surgeries as beds were reallocated to those needing general acute and critical care beds due to COVID-19. Meanwhile, fewer people attended A&E for several reasons including fear of hospital-acquired infection and not wanting to overwhelm the health service.

We need hospitals to be more resilient in future, to reduce this ripple effect as much as possible. We must be able to create the surge capacity when needed, without it being a detriment to other care provision.

At HKS Architects, we have been designing a framework for hospital design over the last couple of years that enables a facility to be future ready: to respond to changes in medical processes and technology, shifting demands and increasing use of telemedicine and remote consultations over five, 10 and 20+ year periods.

We have called this framework the ‘FleXX Hospital’ and it challenges the notion that hospitals are fixed and static buildings. Its aim is to ensure a hospital can continue to perform effectively for its full lifespan and, as the needs of medical services shift, to provide for alternative programmes such as additional research and development space and patient hotels.

To achieve this, key principles for designing the facility are:

Strictly adhere to a regular grid: Including key components such as operating rooms, consultation rooms and all types of inpatient rooms, allowing faster interchangeability and adaptability.
Pull the vertical circulation to the perimeter of the building: Create a layout with the ability to modify or stop flows and allow for cores to form new and alternative entrances/exits when the separation of flows for infectious/non-infectious needs to happen.
Pull the service cores to the perimeter of the building: Design services distribution routes to allow adaptation or maintenance to occur per floor or per core without invading other areas.
Standardise slab-slab heights as “High intensity” and “Low intensity”: Simplify the rationale behind ceiling voids to reduce complexity in converting a space to another use in the future. This approach means the interior of buildings can be much more effectively divided up with the function of each area relatively easy to change. As adaptations are needed in the design it is not too difficult to make them. Through building hospitals in a way that makes them flexible and adaptable, we can ensure that we are giving us and future generations the best chance possible of fighting whatever the world next throws at us.