Conversion-Ready Strategies for Pandemic Preparedness

Everything in a hospital should, first and foremost, be designed for patient and staff safety, which includes infection control and biosafety. With a conversion-ready approach to healthcare design, the individual room, the unit and the building infrastructure are designed to accommodate an intensive care room or unit in the future and can be readily modified to operate as an ICU room within the boundaries of its walls, without disturbing the operations of adjacent patient rooms.

The strategies below reveal how a healthcare facility can be prepared to convert patient rooms and patient units to care for high-acuity patients (also called acuity-adaptable rooms)  in the case of a pandemic or epidemic surge.

Conversion-Ready Patient Rooms

Conversion readiness is when the individual room, the unit and the building infrastructure are designed to accommodate an intensive care room or unit in the future and can be readily modified to operate as an ICU room within the boundaries of its walls, without disturbing the operations of adjacent patient rooms. These spaces have the ability to quickly convert to higher acuity.

Features include:

• Larger number of medical gasses than minimum code in general, including a minimum of 1 to 2 medical air outlets for access when using ventilators
• Ability to accommodate the larger bed clearances of intermediate or critical care for future acuity flexibility
• Alcoves and decentral charting stations between every room to accommodate high-acuity staff ratios of 1:1 or 1:2 and additional areas to don and doff PPE, as well as dedicated storage for personal protective equipment
• Additional storage on unit to accommodate highest-acuity patient

Patient Room Conversions

Private patient rooms are especially important; where semi-private rooms already exist, they should be used as private rooms for isolation whenever possible.

Here are 5 considerations when planning for conversion-ready patient rooms:

• Private rooms that include bathrooms with direct connectivity to physically isolate a patient
• Minimum patient movement out of the room to reduce the risk of infecting others
• Staff movement into the room only as needed to ensure proper patient care
• Space within the patient room sized to accommodate any imaging equipment or emergency procedures to be performed at the bedside to further limit patient transports
• Conversions that include the potential to provide care to a behavioural health patient should also include a behavioural health safety risk assessment in addition to considerations for infection prevention.

Patient Unit Conversions

In the case of possible contamination, an inpatient unit or portion of a patient unit that uses an on-stage/off-stage, conversion-ready approach can easily be converted to an all negative pressure unit for containment.

Here are 3 considerations for converting patient units:

• Ensure that the on-stage/off-stage approach provides places to don and doff PPE in protected areas before entering the contaminated zone
• Separate patient elevators from staff elevators for proper division of clean and dirty, or infectious, flows
• Consider providing two sets of corridor doors separating a negative pressure zone to create a space that can function as an anteroom with associated sink and PPE storage

Conversion readiness is a top consideration to ensure any new healthcare facilities are prepared for future pandemics or emergency events. Several of our most advanced projects employ this strategy, including New Parkland Hospital, The Pavilion at Penn Medicine and Humber River Hospital, among many others.