Healthcare facilities worldwide had to repurpose their infrastructure to create additional capacity during the pandemic, and the modular construction industry responded to this need. The use of modular wall systems helped hospitals cope with the influx of infected patients during outbreaks while creating a safer environment for medical personnel and patients.
Though few industry standards for repurposing existing hospital space existed before the start of the 2020 coronavirus pandemic, an emerging trend with pre-fabricated modular components borrowed from occupied renovation helped facilities directors and engineers to rise to the occasion by quickly and efficiently setting up areas to meet some of the hardest-hit hospitals' immediate infrastructure needs.
Through providing temporary and reusable containment systems, modular components helped hospitals globally weather the worst of the storm. Modular wall systems not only demonstrated their usefulness in handling the huge number of COVID-19 patients but also showed how hospitals could deal rapidly with infrastructural needs in other large scale healthcare emergencies, while minimizing disruption to their operations. One of the most significant reasons for this is that modular panels like STARC Systems are pre-designed and have specialized components for environments like Healthcare (which hold the highest standards for minimizing airborne infection risk).
2020 Worldwide Modular Construction Response
The initial COVID-19 outbreak in Wuhan in January 2020 saw the Chinese government rapidly construct modular hospitals that could quickly accommodate the influx of infected patients, with a 1000 bed facility built out of container-like modules in just ten days. This engineering feat showed the world how rapidly a facility could put a modular infrastructure in place to meet healthcare needs during a pandemic.
How Healthcare Renovation Lessons Became Essential During the Initial Crisis and Beyond
In early March, New York Governor Mario Cuomo mandated that hospitals throughout the state increase their capacity by 50%. This foreshadowed a timely call by Thomas Picciano – engineering manager at New York City's Northwell Lenox Hill Hospital – to STARC Systems in Brunswick, Maine. The hospital desperately needed to monitor and isolate COVID patients, and within two hours, Picciano and a small team were able to transform an operating room into a recovery area, using some 30 feet of STARC's see-through modular panels and doors. This allowed the hospital to house more people, with the added bonus that the company's aluminum and foam construction also reduced noise.
Perspectives on Modular Wall Systems
Dr. Janet Haas – former Director of Epidemiology at Lenox Hill Hospital in New York City – noted that though her hospital and its network had a pandemic plan, the rapid spread of the novel coronavirus throughout the city in March and April made such preparation inadequate.
"You can just imagine that what the plan was originally would manage an uptick. But the scale of this was something that was unmatched by anything in our careers, or in our lifetime," Haas stated at a webinar months later. "The whole infrastructure required to manage this was unbelievable."
Modular wall systems made it easier for hospitals to cope by quickly reconfiguring areas to meet the most pressing needs. Whether the demand was for personal protective equipment (PPE) or other storage, increasing capacity for emergency room patients, administrative use, or training areas, these modular wall systems proved effective. While hospitals – particularly in the United States – could deal with small outbreaks, they found they were not adequately prepared to handle a full-blown pandemic. Medical facilities countrywide needed to modify their EXISTING physical spaces to ensure patient safety quickly.
Modular wall systems allowed hospitals to quickly double capacity and more easily turn areas into negative pressure rooms, often separating private rooms with modular wall systems so that they could house two patients privately. These systems also helped create anterooms that could serve medical personnel as places where they could sanitize themselves – along with donning and doffing PPE – especially when hospitals needed to dedicate whole units to COVID patients.
Larger healthcare facilities also used modular wall systems to make one-directional pathways from the emergency room (ER) to the intensive care unit (ICU) to reduce infection risk. These modular systems also allowed hospitals to turn unused operating rooms and other spaces into rooms for COVID patients, along with delineating areas for non-COVID medical emergencies.
Uses for Modular Construction During a Pandemic
While hospitals and other healthcare providers used modular wall systems and other construction to assist their facilities in mitigating the surge that resulted from 2020’s coronavirus pandemic, these uses can be grouped into five distinct categories:
1. Increasing Capacity
While modular wall systems on the whole allowed hospitals globally to increase capacity, the types of spaces these systems created were many and varied. They mainly sought to improve efficiency and safety, though their versatility allowed for a variety of uses, including to:
- Create more isolation rooms in which to segregate COVID patients.
- Create anterooms for entering patient rooms or caregiving areas.
- Section off entire wings with a hallway modular barrier.
- Create donning and doffing areas.
- Increase emergency department and ICU capacity.
- Converting PACU areas to isolation areas.
- Offer quick screening areas for testing at hospital entrances.
- Creating traffic flow barriers.
- Turn unused operating rooms into functional spaces for oxygen therapy and dialysis.
2. Safety Through Separation
Along with enabling healthcare facilities to increase their overall capacity when infections spiked during localized outbreaks, modular construction helped keep people safe by facilitating recommended social distancing guidelines and thus lowering the possibility of spreading COVID-19. Modular wall systems allowed healthcare providers to keep those entering their facilities with probable COVID-19 diagnoses separate from those with other health concerns. Isolating the potentially infected helped ensure patients, medical personnel, administrative staff, and visitors were safer, along with keeping the airborne infection from spreading as quickly.
Modular construction helped hospitals quickly add anterooms, room dividers, hallway and general containment areas, isolation rooms, and other areas to keep people separate and prevent coronavirus infections from spreading. Such temporary construction included:
- Clear panels that allowed visibility in waiting areas.
- Converting ER patient rooms into infection isolation space.
- Long term acute care for COVID patients.
- Separating high and low-risk patients.
The speed at which these modular wall systems could be built made it an ideal method for ramping up healthcare facilities during the pandemic, even as cases spiked.
3. Negative Pressure Areas & Airflow Management
One critical method for reducing the disease spread inside hospitals involves managing airflow, for which hospitals used modular wall systems to create negative pressure rooms. Such rooms keep the air pressure inside lower so that when a door opens, contaminated air will not flow out into the corridor or other areas but rather remain inside the room.
Hospitals needed to build-in exhaust systems to ensure rooms maintained their negative pressure by removing more air than what entered. This also involved installing pressure gauges and alarms, along with the modular wall systems. Such negative pressure areas allowed hospitals to safely quarantine COVID-19 positive patients by reducing the risk of airborne transmission.
Negative pressure areas included rooms for:
- COVID-19 testing
- isolation rooms
- negative air capability for multiple rooms
Non-COVID patients that required hospital care, particularly those who were immunocompromised, also needed protective isolation to keep out airborne contaminants, including the coronavirus. For such patients, modular walls helped save lives by providing positive air pressure.
High-efficiency particulate air (HEPA) filters were used to create these positive pressure areas, with increased airflow that limited pathogens from entering the room. With some pathogens, fresh air intake is essential to recovery, so these modular wall systems also had to incorporate ventilation systems into the new construction.
4. Donning and Doffing Areas
Much like a spaceship's airlock, hospitals used modular wall systems to set up areas where medical staff could change into appropriate protection before entering or leaving a room, reducing the chance that they would either self-infect or infect others. These modular anterooms allowed hospitals to protect other patients, staff, and their family members.
These anterooms allowed healthcare workers to don and doff PPE before entering contaminated areas and allow for the safe transfer of supplies, equipment, and personnel into areas where COVID patients were being treated. It also provided an additional barrier to protect against the potential loss of pressure in negative or positive air rooms.
5. Managing Traffic
Another key use for modular wall systems involved controlling people's flow, particularly COVID patients coming from the ER and going to the ICU. Entryways and thoroughfares required such barriers to help lower the risk of spreading COVID-19 inadvertently. Such modular passageways allowed hospitals to control traffic while improving safety, often funneling traffic in one direction to help prevent cross-contamination.
Future of Modular Construction & Infection Control
The temporary modular wall systems the healthcare industry used to assist it in controlling the coronavirus infections have proven effective in keeping hospitals and other medical environments safer throughout the world. These systems provide better protection than plastic curtains and allow greater versatility in enclosed areas, particularly in preventing the spread of airborne diseases. While hospitals have used drywall to create more permanent structures, these allow less flexibility and take longer to build.
Modular construction can and has been used for various healthcare infrastructure during the COVID-19 pandemic and promises to be a leading method used by hospitals that need to scale up their capacity quickly. It will continue to provide for such large scale healthcare emergencies in the future, including in:
- Assisted living and long-term care facilities
- Diagnostic imaging centers
- Intensive care units
- Medical clinics
- Mobile urgent care units
- Temporary testing facilities
- Triage facilities
While modular design will not prevent crises from occurring, temporary modular wall systems offer a powerful way in which healthcare facilities can effectively respond to such disasters. Its versatility allows frontline health workers an added edge that can prevent healthcare facilities from becoming overwhelmed. STARC Systems is proud to be at the forefront of helping healthcare facilities react effectively to the COVID-19 pandemic and will continue to serve as a partner to hospitals and other medical providers now and into the future.
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