Hyvee Infectious Control Hospital

Hyvee Infection Control Clinic Lawrence, KS, USA

SQ FT 57,000 SF

OWNER/AFFILIATION Lawrence Memorial Hospital

COMPLETION DATE Speculative

ARCHITECT(S) KU H+W

MORGUE SOILED SUPPLY PATIENT CARE CLEAN SUPPLY STAFF SUPPORT

DIAGNOSTIC ADMINISTRATION

FOOD & GUEST SERVICES

TRIAGE

PROGRAM DIAGRAM

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AIA Academy of Architecture for Health | Research Initiatives Committee Research and Program Prepared By: Rachel Stagner, Owen Starkey, Danielle Voelkerding

Image Sources: Danielle Voelkerding, LJWorld, Google Earth

Surge Hospital Research

DIRTY

CLEAN

Huoshenshan Hospital, Wuhan, China

Staff Decontamination PATIENT

STAFF Campus Plan

ABOUT | DESIGN INTENTIONS As Wuhan, China dealt with the beginning of COVID-19, there was a clear need for more healthcare facilities for treatment.

Huoshenshan Hospital was constructed to solve that need. The modular design allowed for the hospital to be constructed Image Sources: zhuanlan.zhihu.com

Patient Flow

over ten days. The 1,000 bed hopital (with 30 dedicated ICU beds) is staffed by 1,400 medical professionals. Within the building, the confirmed and uncomfirmed cases are separated. Confirmed cases are two paitents per room, while unconfirmed cases are in

single rooms. The circulation for staff is also kept separate from patients in order to have clean and dirty zones. The inclusion of patient hallways around the exterior of patient rooms provides an opportunity for patients to get exposure to fresh air.

HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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MSF, Doctors Without Borders Emergency Units Mobile Unit

MSF Hospital

ABOUT | DESIGN INTENTIONS The MSF facilities are a tent construction, with inflatble "space frames" that act as structure for fabric sides. This allows for a "plug-andplay" model and adaptable use all over the world. The basic unit contains 100 beds and

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Ebola Treatment in MSF Hospital

is set up as a regular hospital continaing: 2 surgical units, recovery area, ICU, emergency room, and rehab services. The rooms can be adapted to any use needed and additional units can be added for additional capacity.

AIA Academy of Architecture for Health | Research Initiatives Committee Research and Program Prepared By: Rachel Stagner, Owen Starkey, Danielle Voelkerding

The "hospital" takes three days to arrive on site and be constructed, including linking up electricity, water, and sanitation services.

Because these units already exist, they can be deployed immediately.

Image Sources: Doctors Without Borders, PA Images

Carolinas Healthcare System, MED 1 Fleet Based in Charlotte, NC, USA

Inside MED 1

ABOUT | DESIGN INTENTIONS The Carolinas Healthcare System has a mobile emergency department contatined in 18 wheeler trucks and field tents.The unit was deployed during Hurricane Katrina to treat 7,500 patients. MED 1 is fully operational within 45 minutes of arrival on site and Image Sources: Atrium Health

MED 1 Campus Set Up

it travels with 72 hours of ED supplies on board. While supplies and equipment travel within the trailer, there are tents that can be used to provide an additional 100 beds.

Within the fleet, there are also vehicles for shower/laundry facilities, and repairs,

towing, and staff transport. The facilities provided on trucks include: digital X-ray, lab and pharmacy, 7 acute care beds, 4 intensive care beds, 2-bed operating rooms, and a dental chair.

HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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Samaritans Purse Field Hospital New York City, NY, USA

Code in Emergency NATIONAL EMERGENCIES ACT Waives federal agency administrative conditions for assistance in declared major disasters JOINT COMMISSION Facilties should have what is required for patient care and minimize injury and loss of life CENTERS FOR MEDICARE AND MEDICAID May waive life safety code requirements if there is an unreasonable hardship on a facility as long as it does not adversely affect health and safety of patients

CURRENTCOVID-19 SURGE HOSPITAL IN CENTRAL PARK

With New York being hit the hardest by the COVID-19 pandemic in the United States, there was an immediate need for more healthcare facilities in the city. This field hospital was erected by a Christian Humintarian Aid group working with FEMA and Mt. Sinai Hospital (across the street in NYC).

The hospital focuses on respiratory care and has 68 beds. The Army Corps of Engineers have set up another hospital of similar size in the area.

New York Governor Cuomo also has intentions to set up a 1,000 bed field hospital, possibly in a sports arena or convention center.

Image Sources: Aleksandra Michalska | Reuters

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AIA Academy of Architecture for Health | Research Initiatives Committee Research and Program Prepared By: Rachel Stagner, Owen Starkey, Danielle Voelkerding

TAKEAWAY: Disaster planning highlights the need for changes within building code requirements to meet the demand for high-volume patient care

Hyvee Infection Control Clinic Lawrence, KS, USA PROGRAM

PROJECT BRIEF

Patient Care

25,800 sqf

Diagnostic and Treatment

Diagnostic Services

12,000 sqf

ACU ICU

Short Stay

Emergency Services Laboratories Morgue Pharmacy Respiratory

Support

Clinical Engineering

8,200 sqf

Food Service Patient Transport Physician Lounge and On Call Rooms Receiving and Distribution

Administration

Building Services

Care Coordinatin EVS

Medical Records

IT and Switchboard

Protective Services

Quality and Patient Safety DGSF in Hospital Gross Up Factors

Estimated BGSF Hospital

With the current COVID-19 pandemic, Lawrence, KS does not have sufficient beds in their hospital to accomodate an overflow of infectious disease patients. To solve this problem, we are proposing the renovation of avacant former Hyvee grocery store on 6th Street to act as a surge facility for confirmed COVID-19 patients.

This facility needs to be constructed on a very quick timeline so we are estimating a week-long construction phase; because of the time constraint, much of the space will be converted with more temporary solutions. With the possibility of pandemic events possibly happening in the future, we would slowly upgrade the interior construction to create a more permanent solution.

PATIENT TYPES

1. Mid-Acuity Patients with a confirmed COVID-19 status (36 Acute Care Beds)

4,400 sqf

2. Short Stay patients with confirmed status that may not have close access to care in their hometown (8 Short Stay) 3. Escalated acuity patients that are waiting for a transfer to LMH for more intense care (2 ICU Beds)

50,400 sqf

4. Drive Thru Testing Site for Unconfirmed Patients

61,980 sqf

HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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Hyvee Infection Control Clinic Lawrence, KS, USA

Site Selection Rationale

The Hyvee on 6th street was chosen for this hospital because of the proximity to LMH, the existing infrastructure, and ease of conversion within a short period. The Hyvee is already equipped with adequate parking, a place for shipping and , has existing plumbing and food service operations. The double entry allows for segregated clean and infected entrances and exits and is quite large at around 43,000 sqft. Because of these unique conditions we found it to be an apt site to service West Lawrence COVID-19 patients.

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KEY: Site Health Care Facilites Senior Living

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AIA Academy of Architecture for Health | Research Initiatives Committee Research and Program Prepared By: Rachel Stagner, Owen Starkey, Danielle Voelkerding

2.7 mi./ 8 min.

Image Sources: Rachel Stagner

Hyvee Infection Control Clinic Lawrence, KS, USA

Patient Volume CURRENT CORONAVIRUS CASES 5,734 State wide 56 in Douglas county

SITE CIRCULATION

Trash

Staff Entry

Staff Parking

Shipping and Receiving Green Space for Patients

Ambulance Drop Off

Patient Admit

Green Space for Patients / Helipad

Drive Through Testing

Patient Entry

RECOVERED FROM CORONAVIRUS ~1200 State wide 43 in Douglas county

Clean Discharge

Patient Parking

Patient Exit

DEATHS FROM CORONAVIRUS 144 State wide 0 in Douglas county

Hard Barrier

Site Design: The flow of the site limits movement for incoming and outgoing patients. We restricted entry to the west most entrance and the exit goes through the main drive to create a loop. We foresee few ambulance arrivals, so they are planned to have the same path of travel as people wanting tests.

The pathway into the parking lot area will allow patients to be dropped off at the main door and admitted without having a far path of travel.

Image Sources: Owen Starkey

HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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Hyvee Infection Control Clinic Lawrence, KS, USA

ABOUT | ADJACENCIES Because of the existing glazing entries, patient entry and exits were located on the southern side of the building. Because of this location, guest services such as food and administration services are near these entries. In addition, the Hyvee shell has a two

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story space where additional administrative services like medical records will be. On the western side of the building, the existing pharamcy drive through will become the ambulance drop off where patients will be admitted to this facility from LMH. Diagnostic

AIA Academy of Architecture for Health | Research Initatives Committee Research and Program Prepared By : Rachel Stagner, Owen Starkey, Danielle Voelkerding

services will be adjecent due to testing needs. The central and northern areas of the 60,000 SF shell will be dedicated for patient rooms and supporting services such as nurse stations. There will be a green corridor so patients can view nature.

Image Sources: Danielle Voelkerding

Hyvee Infection Control Clinic Lawrence, KS, USA

ABOUT | CLEAN & DIRTY ZONES To appropriately place programming and consider circulation patterns, especially with designs centered around infectious disease controls, there are designated zones of clean and dirty services. Dirty assuming the virus is present and clean assuming it is Image Sources: Danielle Voelkerding

not. At the edge of the clean and dirty are decontamination spaces to transfer from one side to another, but ideally these resources would be used as needed and be limited to conserve PPE for the facility.

HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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Hyvee Infection Control Clinic Lawrence, KS, USA Design Goals

OCCUPANCY PROCESSION CONSIDERATIONS

Patient Flow

Since many aspects of patient flow overlap one another, considering the differences between what patients need to go where, and how to best minimize their overlaps, was influential in adjacenies and circulation patterns. Triage and decontamination places are crucial to keep spaces seperated safely while still allowing effective flow.

Patient Volume Total ICU Rooms 2 Acute Care Rooms 36 Short Stay Rooms (Confirmed) 8

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AIA Academy of Architecture for Health | Research Initatives Committee Research and Program Prepared By : Rachel Stagner, Owen Starkey, Danielle Voelkerding

Image Sources: Danielle Voelkerding

Hyvee Infection Control Clinic Lawrence, KS, USA

ABOUT | CLEAN & DIRTY CIRCULATION The best way to confirm effective clean and dirty zoning was to consider the flow of clean and dirty services. For example, once a staff member puts on their PPE and is serving infected patients, they must stay in their PPE

Image Sources: Danielle Voelkerding

as long as possible for the sake of efficiency services and clean supply is important in and material use. Therfore, spaces where its relation to delivery services as well as its they can go to rest while still wearing PPE adjacencies to inpatient services. needed to be considered, for example. Also, the flow of soiled materials to sanitation HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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Hyvee Infection Control Clinic Lawrence, KS, USA

ABOUT | OCCUPANCY CIRCULATION Staff will enter from their designated parking lot to their services such as on call rooms and locker rooms. They will stay in the area of patient care or the clean / soiled as needed for clean and dirty spaces. Administrative staff can enter through the patient exit since

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that is also considered a clean entrance.

Patients admitted from an ambulance will go through the same area of decontamination as those admitted through testing, but most admittance to theis facility will come from LMH through ambulance services. Deliveries

AIA Academy of Architecture for Health | Research Initatives Committee Research and Program Prepared By : Rachel Stagner, Owen Starkey, Danielle Voelkerding

and shipments will occur in the same area, but be split by clean and soiled services.

When patients leave, they will exit through the clean entry and be able to safely interact with guest services.

Image Sources: Danielle Voelkerding

Hyvee Infection Control Clinic Lawrence, KS, USA

Campus Plan

Patient Flow

Staff Decontamination

REFLECTIONS After going through the process of research and collaboration to inform our program choices, we learned about the realities of designing a space for infectious control.

While we can hope an event like COVID-19 does not happen in our lifetimes again, the three of us feel better prepared to take on th challenge of laying out emergency facilities.

We have left with a strong understanding of directional flow within an infectoius disease

unit, as well as understanding how to layout into account the need for additional capacity spaces in order to reduce the possibility of following a devastating natural disaster. transmission.

While planning our surge hospital, we wanted to allow for the possibility of long term use as A problem that often follows crisis events an infectious disease facility. We don't know is that research that follows is not very how long COVID-19 will be affecting society. commonly applied to our healthcare Because of this, we would take our surge facilities. We learned about this issue when facility, targeted to be built in a week, and examining surge hospital capacity following slowly upgrade temporary partitions and Hurricane Katrina; not many hospitals took materials to more longterm solutions.

HYVEE INFECTION CONTROL CLINIC | SURGE HOSPITAL PROPOSAL AIA Academy of Architecture for Health | Research Initatives Committee

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