Controlling the Spread of Infectious Disease
August 1, 2014 | Kristyna Culp & Katie Fricke
On Wednesday, one Charlotte hospital changed the national conversation about the devastating Ebola epidemic in West Africa when it was forced to close part of its ED to isolate a possible Ebola patient. While the action taken was decisive and appropriate, this event – coupled with Thursday’s announcement that Emory University Hospital will be treating Ebola patients – highlights the role of design in preventing the spread of infectious disease.
Specific to the emergency department, FreemanWhite recommends decontamination and isolation rooms strategically located between the ambulance and walk-in entrances. Not only do these rooms isolate infectious (or potentially infectious) patients in private rooms, but more frequent air exchanges and negative pressure created by air flowing into the room more slowly than it is exhausted prevent germs from spreading throughout the entire area, protecting both nearby patients and the staff. Patients enter and leave through the isolation room through the main door, but staff access through an ante-room that contains personal protection equipment (PPE) and helps maintain air balance and security. Alternatively, direct patient access to the isolation room from triage/intake helps to mitigate the exposure of potentially infectious patients to others. Including a private toilet provides further protection by ensuring that patients remain in the isolation room for the duration of their stay. To maximize its utilization, the room functions as a typical treatment room when it is not needed for isolation purposes.
Hospitals must also accommodate infectious inpatients, and some of the design solutions developed for those units could be applied to the emergency department. For example, one recent NICU design allows staff to isolate an entire pod of bassinets from the rest of the NICU in the event of a seasonal mass outbreak of RSV or other similar disease. We could approach ED design in the same way: physical isolation for individuals who present with unique symptoms and an option to segregate a portion of the department if multiple patients present with similar issues.
As the ease of international travel spreads infectious diseases worldwide, we are considering how to revise our planning and design approach in response. At FreemanWhite, we continue to explore operational challenges, design considerations, and code implications of isolation and decontamination spaces in both infectious disease and mass casualty scenarios.
ABOUT THE AUTHOR Kristyna Culp MBA
Kristyna creates workflow mapping and computer simulation model frameworks to validate, test, and quantify various scenarios to help clients make informed decisions about both operational and physical design improvements. Read more from Kristyna.
ABOUT THE AUTHOR Katie Fricke AIA, LEED AP
Katie is highly efficient in defining and prioritizing clinical objectives derived from client interaction, input, and data and is skilled in implementing strategic direction in diverse planning scenarios. Read more from Katie.