Mark Warrick

During a pandemic or other crisis that requires a lockdown or isolation, the benefits of breaking down buildings into neighborhoods — smaller areas with separate dining and other accommodations — are multiplied. They also point to a new normal evolving for post-acute and long-term care. This will mean:

  • Caregivers with a focus on both mental well-being and infection control. Having consistent staffing means that residents are receiving comfort and reassurance when they need it most from people they trust the most. This makes a huge difference during a pandemic like we are currently experiencing. At the same time, this prevents “cross pollination” of germs and infections. This is not only beneficial to residents, but it also protects staff from broader exposure. Moving forward, expect caregivers and other frontline staff to receive greater training on how to promptly identify and address issues such as stress, anxiety, agitation and depression during a crisis. They will be encouraged to use their personal knowledge of and relationships with residents to help prevent or manage behaviors. At the same time, they will need to be schooled about how to clean/sanitize various surfaces, including mental, wood and plastic, as well as the effective and efficient use of personal protective equipment.
  • A growing movement toward smaller, more contained units. For instance, separate mechanical and air conditioning/heating systems localizes ventilation and can help prevent the spread of airborne illnesses. Neighbors/units also are likely to include features such sterile isolation or negative pressure rooms.
  • A focus on robust Wi-Fi systems that support telemedicine, video streaming and conferencing, and reliable, fast internet connections. These are essential to ensuring continued care and practitioner-patient engagement/encounters in a pandemic or other crisis. Practitioners are finding telemedicine to be very effective for screenings during COVID-19 lockdowns, where it is a matter of asking appropriate questions, getting answers, and establishing a triage plan. While they can’t conduct a full examination via telemedicine, practitioners can determine if someone is at low risk or if the person needs to be seen right away. CMS has relaxed restrictions on the reimbursable use of telemedicine during the COVD-19 emergency, as have other national payers. Moving forward, it will be well worth the investment in more cutting-edge fiber optics.

Efforts to isolate residents and prevent the spread of COVID-19 while preserving quality of life for residents will contribute to a new normal moving forward. This will come into play with the design and construction of new buildings. However, many of these innovations, such as increased bandwidth and fiber optics, can be retrofitted. Elsewhere, providers may be able to create neighborhoods in existing buildings. Additionally, some valuable retrofits, such as adding UV cleansers to AC systems, may be possible.

We need to think about what we can do to help our residents get through this and how we can create a stronger community through this common experience. The light in the darkness is this spark of innovation that, moving forward, will create communities that use design and technology to improve care, safety, and quality of life during crises and every day before and after.

Mark Warrick, AIA, is vice president of Pi Architects & Engineering in Austin, TX.