>> Sreenivasan: AS COVID-19
CASES SURGED IN MARCH AND APRIL,
THERE WAS A SCRAMBLE TO SECURE
PROTECTIVE EQUIPMENT FOR
HEALTHCARE WORKERS ON THE FRONT
LINES.
BUT WHAT ABOUT CHANGES TO THE
MEDICAL SPACES THEMSELVES TO
PROTECT BOTH WORKERS AND
PATIENTS?
NEWSHOUR WEEKEND'S CHRISTOPHER
BOOKER HAS A LOOK AT ONE
HOSPITAL RETROFITTING ITS SPACES
TO FIGHT THE VIRUS.
>> Reporter: ON THE AFTERNOON OF
APRIL 15, 2013, TWO PRESSURE
COOKER BOMBS DETONATED NEAR THE
FINISH LINE OF THE BOSTON
MARATHON, KILLING THREE AND
INJURING HUNDREDS.
WITHIN MINUTES THE HOSPITALS IN
THE AREA WERE FLOODED WITH
PATIENTS AND QUICKLY RESPONDED.
>> THE HYPOTHETICALS WERE THE
9/11 TYPE OF HYPOTHETICAL.
THE BOSTON MARATHON DISASTER,
YOU KNOW, THAT TRAGEDY IN WHICH
THERE WAS A HUGE INFLUX OF
CRITICALLY ILL PEOPLE THAT WERE
GOING TO COME IN.
YOU KNOW, THAT, THAT IS
ABSOLUTELY IN PLACE.
>> Reporter: ACCORDING TO DR.
JOHN BUCUVALAS OF MOUNT SINAI
HOSPITAL, TRAUMA CENTERS PREPARE
FOR THESE MASS CASUALTY EVENTS.
WHAT ISN'T IN PLACE ARE PLANS
FOR HOW HOSPITALS NEED TO
PHYSICALLY CHANGE TO RESPOND TO
WHAT THE GLOBE IS FACING NOW:
THE OUTBREAK OF AN AIRBORNE
PANDEMIC DISEASE.
>> ONE OF THE BIG TAKEAWAYS IS
THAT OUR MEDICAL SYSTEM IS NOT
DESIGNED TO MANAGE A SURGE OF A
PANDEMIC OF THIS NATURE.
AND THAT SHOULD KIND OF AWAKEN
ALL OF US TO THE CHALLENGES WE
HAVE OF OUR HEALTHCARE
INFRASTRUCTURE, FULL STOP.
>> Reporter: MICHAEL MURPHY IS
THE EXECUTIVE DIRECTOR OF THE
SOCIALLY-MINDED ARCHITECTURE AND
DESIGN COLLECTIVE, MASS DESIGN
GROUP.
>> OUR HOSPITALS ARE DESIGNED
WITH VERY TIGHT MARGINS TO FILL
BEDS AND HAVE THEM LARGELY FULL
ALL THE TIME.
THEY'RE NOT DESIGNED TO HAVE
EXCESS OF BEDS.
AND WHAT THAT MEANS DURING THIS
OUTBREAK AND SURGE IS THAT THE
SYSTEM ITSELF HAS BEEN PUSHED TO
ITS LIMITS.
>> Reporter: AT DOCTOR
BUCUVALAS'S HOSPITAL IN NEW
YORK, THE MEDICAL CENTER WAS
FORCED TO RAPIDLY TRANSITION
TRADITIONAL CARE SPACES TO WARDS
EXCLUSIVELY FOR COVID-19
PATIENTS.
>> EVEN AT BASELINE, THE
CLINICAL WORLD HAS NOT THOUGHT
VERY DELIBERATELY ABOUT THE
BUILT ENVIRONMENT.
>> Reporter: AS THE PANDEMIC
GREW, THE HOSPITAL BROUGHT IN
DR. NEEL SHAH OF THE GLOBAL
HEALTH INNOVATION CENTER,
ARIADNE LABS, AS WELL AS
ARCHITECT MICHAEL MURPHY, TO
STUDY HOW A HOSPITAL REDESIGN
COULD KEEP PATIENTS AND HEALTH
WORKERS SAFE.
>> BASICALLY EVERY DELIVERY
SYSTEM IN THE COUNTRY AND IN THE
WORLD HAD TO ADAPT ON THE FLY.
AND NEW YORK CITY AT MOUNT SINAI
HOSPITAL WAS LITERAL GROUND ZERO
FOR THIS GLOBAL PANDEMIC FOR A
COUPLE OF WEEKS.
IT WAS AN EXTRAORDINARY
OPPORTUNITY TO TRY TO FIGURE OUT
HOW WE NOT ONLY LEARN WHAT MOUNT
SINAI IS DOING, BUT CREATE
LESSONS FOR THE REST OF THE
WORLD VERY QUICKLY.
>> Reporter: OVER A THREE WEEK
PERIOD IN EARLY APRIL, MOUNT
SINAI USED REMOTE OBSERVERS TO
EXAMINE THE VARIOUS SPATIAL
CHANGES THE HOSPITAL
IMPLEMENTED.
USING GOPRO CAMERAS, DOCTORS
WALKED THROUGH THE MEDICAL UNITS
TO GIVE THE OUTSIDE CLINICIANS
AND DESIGNERS A SENSE OF THE
INFECTION CONTROL DESIGNS.
>> WE TOOK VIDEO, WE INTERVIEWED
PEOPLE, AND THEY COULD THEN PEER
IN.
AND THAT ALLOWED US TO DO, MAKE
THE OBSERVATIONS INCREDIBLY
QUICKLY.
>> Reporter: WHAT WERE SOME OF
THOSE KEY DATA POINTS THAT YOU
LEARNED FROM THIS STUDY AS IT
RELATES TO THE DESIGN OF THE
HOSPITAL?
>> INFECTION CONTROL PROTOCOLS
USUALLY ARE USED TO PROTECT,
THEY'RE TO PROTECT PATIENTS.
IN THIS SITUATION, WE HAVE TO
PROTECT EVERY ONE-- PROVIDERS,
THE PEOPLE THAT DO ENVIRONMENTAL
SERVICES, THE PEOPLE THAT WORK
MOVING IN AND OUT, THE CLERKS
AND THINGS LIKE THAT.
THERE'S A LOT OF ADMINISTRATIVE
SUPPORT STAFF.
SO IT'S A WHOLE DIFFERENT
MINDSET.
>> Reporter: THE SHIFT IN
MINDSET MEANT MAKING STRATEGIC
DECISIONS THAT COULD WORK WITHIN
THE STRUCTURE OF DECADES OLD
BUILDINGS.
I.V. MACHINES THAT TYPICALLY SIT
INSIDE A PATIENT'S ROOM WERE
MOVED OUT INTO HALLWAYS TO
MINIMIZE MEDICAL STAFF
INTERACTING WITH INFECTED
PATIENTS.
FOR CONTAGIOUS DISEASES LIKE
COVID-19 THE STANDARD OF CARE IS
NEGATIVE PRESSURE ISOLATION
ROOMS.
BUT HOSPITALS TYPICALLY DON'T
HAVE VERY MANY.
DURING THE SURGE OF COVID-19
PATIENTS MOUNT SINAI CONVERTED
260 REGULAR ROOMS TO SPECIALIZED
NEGATIVE PRESSURE ISOLATION
ROOMS.
>> WE'RE ALSO ABLE TO SEE WHERE
CLINICIANS WERE ALSO PUTTING
TAPE ON THE FLOOR, PUTTING UP
VISUAL CUES TO TRY TO ARTICULATE
TO STAFF WHEN THEY'RE WALKING
INTO A RED ZONE, IN A
CONTAMINATED ZONE, WHEN THEY
WERE LEAVING THAT ZONE, SO THAT
WE COULD BE MORE COGNIZANT OF
THE AMOUNT OF P.P.E. THAT WE
WERE WEARING.
AND THOSE SIMPLE SPATIAL MARKERS
ARE REALLY ESSENTIAL NUDGES THAT
COULD ALLOW US TO, YOU KNOW,
REMIND OURSELVES, HEY, WE'RE
ENTERING A MORE DANGEROUS ZONE,
BE MORE PROTECTED.
>> Reporter: MASS DESIGN GROUP
HAS WORKED IN THE MIDDLE OF
EPIDEMICS IN THE PAST.
IN 2015 IT DESIGNED A HOSPITAL
TO HELP FIGHT THE CHOLERA
OUTBREAK IN HAITI.
AND DURING THE 2014 EBOLA CRISIS
IN WEST AFRICA THE FIRM
DEVELOPED A SET OF NATIONAL
STANDARDS FOR HEALTH
INFRASTRUCTURE DESIGN IN
LIBERIA.
MURPHY SAYS THESE EXPERIENCES
INFLUENCED THE WAY HE THINKS
ABOUT PHYSICAL SPACE AND HOW IT
IMPACTS HEALTH.
WHAT CHANGES HAVE BEEN MADE
SINCE YOUR STUDY?
>> ONE OF THE FUNDAMENTAL THINGS
THAT'S CHANGED IS NOT JUST FOR
HOSPITALS, BUT FOR ALL OF US, IS
THIS INCREDIBLE SPATIAL
AWARENESS.
ARE WE GOING TO BE CONTAMINATED
BY LEAVING OUR HOUSE?
ARE WE GOING TO CONTAMINATE
OTHERS?
AND THAT INCREDIBLE SPATIAL
COGNITION THAT THE SPACES AROUND
US ARE POTENTIALLY INFECTIOUS OR
POTENTIALLY HEALTHIER IS A
SIGNIFICANT PARADIGM SHIFT IN
THE WAY WE THINK ABOUT THE WORLD
AROUND US, I THINK, AND SHOULD
AND WILL SHAPE, THE WAY WE
DESIGN HOSPITALS A LITTLE MORE
DELIBERATELY IN THE FUTURE.
AND HOW WE CAN DESIGN FOR TRUST
ARE GOING TO BE CRUCIAL FOR
EVERY ONE OF OUR PUBLIC SPACES.
