flexiblefullpage
billboard
interstitial1
catfish1
Currently Reading

How to turn a high school into a patient care center in 15 days

Coronavirus

How to turn a high school into a patient care center in 15 days

HKS’s concept paper presents three scenarios.


By John Caulfield, Senior Editor | April 7, 2020

This illustration shows how COVID-19 patients would flow through a high school gym that's been converted to a ward for observation and immediate care. Images: HKS

Between five million and nine million Americans are expected to become infected with the coronavirus, one-third of whom might need intensive care. But there are only 920,000 staffed hospital beds in the U.S., according to the American Hospital Association.

To help fill that gap, stadiums and convention centers have become the focus of many alternate healthcare conversion strategies. There may be other solutions as well. The Army Corps of Engineers has looked at more than 800 existing buildings for possible conversion, nearly half of which are hotels. And the architecture firm HKS, in collaboration with MEP engineer Mazzetti, has released a concept study on how to convert a medium-to-large high school into functional patient care and sequestration space within 10 to 15 days. (The full report can be downloaded from here.)

The paper suggests that high schools are good conversion options because they are found in almost all communities, are big enough to house 200 to 500 COVIC-19 patients (depending on the size of the facility), have wide corridors and mostly nonporous durable surfaces for easy cleaning, are designed for adults (unlike elementary schools), have spaces that are easily convertible to patient care and support requirements, and would require minimal intervention for the conversion.

 

HKS believes that high schools could be converted to meet Tier 1 and 2 guidelines by the CDC.

 

The paper’s three authors believe that high schools can be converted to Tier 1 or 2 alternate care facilities, as defined by Centers for Disease and Prevention Control guidelines. The patients who would be most appropriate for a COVID-19 school stay are those who are suspected of being a carrier, confirmed positive but not exhibiting severe symptoms and/or can’t care for themselves, or are recovering from COVID-19 but still requiring care.

The patients would be ambulatory and would not need special ventilation, machine-assisted breathing or anything more than minimal oxygen assistance.

The paper assumes that some form of assessment, testing and/ or triage is happening on the school grounds. This could be drive-through testing. Now that quick tests (within an hour) are available, assessment and determination can be almost immediate.

The concept assumes that there would be some kind of infection assessment and testing done onsite.

 

 

The paper provides a step-by-step process for converting both classrooms and gymnasiums. It states that converting classrooms for low-acuity patients “can be rather simple” with the following considerations:

  • Remove non-essential furniture to allow for more caregiver space and patient beds/cots. Desks and tables can be moved to unused classrooms or ancillary buildings. If there is enough space in the room, desks may be used as bedside tables.
  • Utilize features already in the classrooms, such as a telephone that connects to a central office, Wi-Fi connectivity, computers and overhead intercoms.
  • Hospital beds would be optimal, but other forms of reclining such as stretchers or cots are likely more available. Recliners may also be used in the case of a bed shortage.
  • If additional observation is necessary, consider off-the-shelf Wi-Fi camera systems that are easy to install and can be monitored remotely.

Each patient areas in a classroom should be about 105 sf, so a typical classroom could accommodate six patients. Infection control would be “paramount,” so if carpeting is present it would need to be separated from patient care spaces or, in post-COVID-19 use, removed entirely.

Most high school HVAC systems aren’t set up to provide negative pressure used in hospitals to ward off airborne disease. But a secondary system could be set up to supplement exhaust and create negative pressurization if required.

HKS recommends converting gyms for higher patient observation areas where beds can be assembled in small groups, one bed per 190 sf. A gym could also support decentralized nursing care spaces.

How a high school's classroom wing might accommodate 70 to 80 beds for COVID-19 patients.

 

There are some advantages to considering gyms for patient care conversions. For example, other support spaces such as a point-of-care testing area, stat lab, central medication storage, supply storage, waste staging and a control center could be accommodated in connected/adjacent classrooms.

On the other hand, gyms tend to have only four to five changes of locally recirculated air with three changes of outside/exhaust air per hour. Temporary ducting from central systems to the patient wards/units might be necessary, depending on the gym’s configuration.

Planners might also need to consider mobile toilets within the gymnasium/ward for closer proximity to and segregation of infectious patients. Bathing and hygiene could be accommodated at the bedside using temporary screens. Locker room showers could be used via a controlled path for ambulatory patients if the pathway to and from these rooms does not cross contaminate other traffic.

Another option within the gymnasium is to set up prefabricated patient care tents or units that can be self-contained. Some provide options for showers, toilets and sinks, if these can be connected properly to domestic water and power. Mobile electric generators should be considered to support the gymnasium function by providing additional power for medical equipment and other patient care necessities.

A gym converted for 70 to 80 patient beds.

 

HKS says that in any high school conversion, a centrally located command center is “essential” to maintaining operations and for organizational efficiency. (A library or the school’s administrative offices would be good places to put this center, HKS suggests.)

HKS’s paper offers three different conversion scenarios and how to achieve each: a high school campus that would accommodate about 400 beds, a 70- to 80-bed gym conversion, and a 70- to 80-bed classroom wing.

 

Related Stories

Office Buildings | Jun 3, 2024

Insights for working well in a hybrid world

GBBN Principal and Interior Designer Beth Latto, NCIDQ, LEED AP, ID+C, WELL AP, share a few takeaways, insights, and lessons learned from a recent Post Occupancy Evaluation of the firm's Cincinnati, Ohio, office.

MFPRO+ Special Reports | May 6, 2024

Top 10 trends in affordable housing

Among affordable housing developers today, there’s one commonality tying projects together: uncertainty. AEC firms share their latest insights and philosophies on the future of affordable housing in BD+C's 2023 Multifamily Annual Report.

K-12 Schools | Apr 29, 2024

Tomorrow's classrooms: Designing schools for the digital age

In a world where technology’s rapid pace has reshaped how we live, work, and communicate, it should be no surprise that it’s also changing the PreK-12 education landscape.

Healthcare Facilities | Mar 18, 2024

A modular construction solution to the mental healthcare crisis

Maria Ionescu, Senior Medical Planner, Stantec, shares a tested solution for the overburdened emergency department: Modular hub-and-spoke design.

Office Buildings | Mar 8, 2024

Conference room design for the hybrid era

Sam Griesgraber, Senior Interior Designer, BWBR, shares considerations for conference room design in the era of hybrid work.

Airports | Jan 15, 2024

How to keep airports functional during construction

Gensler's aviation experts share new ideas about how to make the airport construction process better moving forward.

Apartments | Jan 9, 2024

Apartment developer survey indicates dramatic decrease in starts this year

Over 56 developers, operators, and investors across the country were surveyed in John Burns Research and Consulting's recently-launched Apartment Developer and Investor Survey.

MFPRO+ Special Reports | Jan 4, 2024

Top 10 trends in multifamily rental housing

Demographic and economic shifts, along with work and lifestyle changes, have made apartment living preferable for a wider range of buyers and renters. These top 10 trends in multifamily housing come from BD+C's 2023 Multifamily Annual Report.

Urban Planning | Dec 18, 2023

The impacts of affordability, remote work, and personal safety on urban life

Data from Gensler's City Pulse Survey shows that although people are satisfied with their city's experience, it may not be enough.

Senior Living Design | Oct 30, 2023

Navigating architectural challenges—from 'unbuildable' to unbelievable

Mick Schaefer, AIA, NCARB, LEED GA, recounts the challenges Vessel Architecture & Design had to overcome while designing a state-of-the-art senior living facility.

boombox1
boombox2
native1

More In Category


MFPRO+ Special Reports

Top 10 trends in affordable housing

Among affordable housing developers today, there’s one commonality tying projects together: uncertainty. AEC firms share their latest insights and philosophies on the future of affordable housing in BD+C's 2023 Multifamily Annual Report.



halfpage1

Most Popular Content

  1. 2021 Giants 400 Report
  2. Top 150 Architecture Firms for 2019
  3. 13 projects that represent the future of affordable housing
  4. Sagrada Familia completion date pushed back due to coronavirus
  5. Top 160 Architecture Firms 2021