While the world was adjusting to life with COVID-19, DPR Construction sought out its industry partners and customers to collaboratively look forward as we navigate this unprecedented pandemic and its effects on healthcare. These discussions delved deeply into current impacts, challenges, and opportunities that are emerging as the pandemic continues to affect the world.

This is the first in a series of briefings sharing collective insights. This introductory briefing provides an overview of key topics. Upcoming installments will include looks at:

• Changes Due to COVID-19
• Innovations and Technology Due to COVID-19
• Lessons Learned and Silver Linings Due to COVID-19
• Construction Delivery Adaptations Due to COVID-19

DPR would like to thank Banner Health, City of Hope, CO Architects, EYP, HGA, HKS, Jacobs, Perkins & Will, Rady Children’s Hospital, Sharp Grossmont Hospital, SmithGroup, Stantec, Virginia Commonwealth University Health System, WSP, and Site Plus, a communications consultant to DPR, for their participation in gathering these insights.

What Did We Learn?

When these conversations began, DPR and its partners were all just beginning to understand the pandemic's effects and implement changes to address new concerns and ways to continue to provide services by and for the healthcare industry. Throughout every conversation, one thing became clear: the future is not predictable. Success means learning to deal with that unpredictability and also refraining from acting prematurely.

Solutions that health care systems and the industries that support them need to be future proof. Measures put into place now must continue to be of value into the future. How? There was agreement among participants that flexibility is paramount.

The challenges posed by COVID-19 generally fall into three categories: safety, capacity, and isolation.

• Safety considerations must take into account patients, staff and essential vendors, including the design and building team. Separating infectious patients, providing adequate PPE to staff and frequent testing are the primary essential strategies that were identified.
• Surge capacity planning must consider the increase in pandemic cases. This was the first area where design and construction professionals had an impact. Initial temporary solutions yielded to planning that can accommodate on-going patient care concurrently with isolated surge needs.
• The use of portable HEPA filters to create negative pressure rooms quickly accommodated the necessary isolation of patients until better separation strategies could be implemented.
• There’s no one solution for all, every system and facility have a different footprint, a different financial position, and different operational considerations. All these things must be considered within the local context.

Additionally, the discussions yielded that there is a silver lining amongst the effects of COVID-19. The pandemic has clearly accelerated several positive changes in healthcare.

• Foremost is the adaptation to a digital healthcare model, telehealth and telemedicine. There was clear acknowledgement that it was not technology and connectivity that were inhibiting telehealth implementation as much as it was insurance payments and the Centers for Medicare & Medicaid Services (CMS) lack of coverage. When emergency waivers went into effect, the use of telehealth exploded. When it was offered by medical practices, it was quickly adopted by patients. Now, it is here to stay.
• Data interoperability has also taken a huge leap forward fueled by pandemic reporting. Patients’ electronic health records had still been maintained in silos between doctors, hospitals, and insurance companies. With the onset of COVID-19, data standards are rapidly being developed, adopted, and implemented.
• While not immediately rectified, the pandemic has demonstrated the need for more of a national supply chain instead of relying on international manufacturers for items such as PPE, drugs, and diagnostic tests.
• Some temporary changes may lead to permanent efficiencies in space usage, such as off-site electronic patient registration and PPE donning and doffing in designated anterooms, and alternate clinical workflows.

There is certain to be another pandemic, disruption, seasonal surge or similar critical healthcare crisis. The convened panel of healthcare leaders all agree that planning ahead now for better flexibility in our health care facilities is one thing everyone can and should be doing.