Excerpt:
Covid has also sparked interest in being prepared for other events, said Diana Anderson, a Boston-based physician and architect at Jacobs Solutions Inc. Clients, architects, and designers are thinking more about natural disasters, climate change and other emergency situations that a building might need to be ready for, she said.

Read the full article HERE.

Physicians with design experience dissect what is (and isn’t) working for patients, staff and facilities when it comes to offering quality care with wellness-focused benefits.

DIANA ANDERSON, MD, M.ARCH HEALTHCARE PRINCIPAL AT JACOBS 

• Cofounder of Clinicians for Design

• Instructor of Neurology at Boston University

• Geriatric Neurology Fellow at VA Boston Healthcare System

Health professionals can provide insights into health care operations and, most importantly, patient needs and experiences. These perspectives represent a unique opportunity for architects to experience the world of clinical medicine in a way that is typically hidden. We can walk the halls; we can talk to physicians and other clinicians; we can shadow individuals as they go about their daily routines. Having health providers participate in projects also promotes a data-driven design process, strengthening the built environment to benefit health outcomes.

While the clinical practice of health care and the fields of architecture, planning, and design have traditionally occupied different professional, social, and cultural worlds, emerging professionals are asking to move beyond these infrequent intersections and seek a convergence of career models through the domains of research, education, and practice. This movement has accelerated during the pandemic given the need for rapid, innovative, and often design-based solutions to many problems.

The pandemic exposed the need for a shift toward a data-driven design process, and the role buildings play in our physical, mental, and social health. One striking example is research that demonstrated that smaller-scale nursing homes had better outcomes—significantly fewer COVID-19 infections, hospital admissions, and deaths. What concerns me is the reactive approach to design seen during the pandemic with infection control as the main driver, which in my mind is only one element of health design. Ensuring quality of life and health (which includes mental, physical, and social health) for those who use health care spaces should still be paramount.

We can certainly create sealed spaces to keep infections at bay, but there is often a domino effect. We have seen the negative health effects of social isolation and loneliness—in medical settings, research has shown that long-term-care residents without personal contact with family or friends experienced greater excess mortality early in the COVID-19 pandemic. And this concept spans all spaces and environments. The detrimental effects of forced social isolation can be mitigated through design, even within our own homes. For example, views of nature at home have been shown to reduce levels of depression, loneliness, and anxiety, sometimes more than the actual use of outdoor green space itself. Design of the built environment at all spatial scales—from our homes to our neighborhoods and cities—is a determinant of health.

Read the full article HERE.

Excerpt:

Anderson recommends designating a separate bedroom and bathroom if possible, and ensuring that other household members stay out of both spaces. “Consider signage on the door if small children or elderly, cognitively-impaired family members live in the same household so they do not mistakenly go into this space.” Anderson further suggests removing any belongings from the patient’s room that someone else in the home might need, so they don’t have to risk their health to enter the space and retrieve them. “Hand sanitizer, especially if soap and water are not available at a sink within the bedroom suite,” Anderson recommends.

“It’s important to clean areas that are frequently touched, for example door handles, light switches, etc., especially those that may be between the bedroom and the bathroom or within spaces that other family members have access to,” the dochitect advises. You’ll want to have a supply of masks handy, “to be worn even between bedroom and bathroom if the person needs to walk down a hall where other family members also go,” Anderson says.

Read the full story HERE.

Game Changers 2020: Diana Anderson and General Architecture Collaborative on Wellness and Community

Excerpt: “In a conversation earlier this summer, Game Changers Diana Anderson and General Architecture Collaborative gathered their perspectives on architecture, wellness, and community, informed by their unique on-the-ground experiences, research, and hybrid roles as designers.”

“Medicine is all about shared decision-making,” says Diana Anderson, whose hybrid doctor-architect model points a way toward a more integrated model for health-care design. “As doctors and nurses, we’re not there to tell people what to do; we’re there to guide them and make sure that we understand their goals of care. That’s very important to us, and I think the built environment needs to reflect that as well.”

Read the full article HERE.

Excerpt:

“In North America, people tend to spend more than 90% of their time indoors, and this percentage likely increases with age as people become more homebound,” observes Diana Anderson, a clinical fellow in geriatrics at UC San Francisco, a medical doctor, and an architect. “Older adults may be especially susceptible to effects of low concentrations of pollutants due to a number of underlying chronic diseases,” she says.

Anderson notes that aged lungs tend to have less capacity, elasticity, and filtering power against pollutants than their younger counterparts. “Older adults have an increased occurrence of acute respiratory symptoms and reduced lung function. This emphasizes the importance of good indoor air quality [IAQ] for health.”

Access to fresh outdoor air is also highly desirable, she points out, as is the use of HEPA filtration to address indoor particulates. HEPA stands for high efficiency particle arrestance, largely considered to be the highest level of protection.

Read the full story HERE.

This week’s CBC Cross Country Checkup question: How can we fix long-term care in Canada?

Nearly 80 per cent of COVID-19 deaths in Canada happened in long-term care homes. Months after the coronavirus forced widespread lockdowns, questions remain about what must be done to improve living conditions for seniors across the country. Join host Duncan McCue.

Listen to the discussion HERE.

Dochitect speaks to CBC News about impact of nursing home design on infection control in the context of the COVID-19 pandemic.

Excerpt: How design can affect health

Diana Anderson, a medical doctor and architect from Montreal who has worked on hospital design projects in the U.S., Canada and Australia and specializes in environments for geriatric patients, says the four-person wards, in particular, pose a number of risks. “You’re bringing more pathogens in from the outside based on how many people are coming in and out of that space,” she said. “Not only do you have staff, you have family members and loved ones of the three other roommates with you.”

She says sharing a washroom means more opportunities to spread viruses between residents in the same room, plus it makes staff less likely to wash their hands between patients when they aren’t passing by a washroom each time. When Marketplace reviewed data from homes that lost 20 per cent of their residents or more to the coronavirus, it found 65 per cent of those homes had C-level accommodations.

The fact that so many Ontario homes only meet a 1972 structural standard is an “interesting timeline,” said Anderson, the doctor and architect. She said it wasn’t until the 1980s that architecture shifted to what’s called evidence-based design, which means incorporating research on the relationship between physical space and health into the design of a structure.

In geriatric settings, she said, studies have shown building design has an impact on health outcomes for infection control and fall prevention. “There is quite a convincing data set for the move toward single rooms,” she said, pointing to a medical journal study published in 2019 that showed the benefits of the single-room model for hospitals in slowing the spread of infections.

Read the full story HERE.

Excerpt:
But hospital administrators don’t always see the importance of having clinicians at the table early on, says Diana Anderson, a geriatric medicine fellow at the University of California, San Francisco, and founder of Dochitect, a health care design consultancy informed by both medicine and architecture.

Anderson also thinks it’s important for facilities like Rush to document operating procedures during the Covid-19 pandemic in order to inform hospital design going forward. “What will be important is for those facilities that have been built with pandemic preparedness in mind to study their outcomes during Covid-19,” Anderson says. This way, architects can turn to the research when “making the case for evidence-based design.”

Read the full article HERE.

*Article also featured in Smithsonian Magazine on April 17, 2020*

COVID-19 alternative care sites: Addressing capacity, safety, & risk challenges for our nation’s hospitals during a public health pandemic response

The American Institute of Architects (AIA) task force on COVID-19 Alternate Care Sites provides a new checklist tool for public officials to quickly identify buildings suitable to be adapted for patient care. The task force developed the tool using established healthcare design best practices and standards in combination with federal documents issued during the COVID-19 crisis. Additionally, professional input was provided from trained and experienced health care architects, engineers, life-safety consultants, front line health workers, and hospital facility operations.

Click HERE to view the COVID-19 alternate care sites assessment tool
Click HERE to view a comprehensive briefing of th task force’s initiatives

COVID-19 Frontline Perspective Design considerations to reduce risk and support patients and providers in facilities for COVID-19 care

Health care workers are on the front line of the COVID-19 pandemic. As such, they are at great risk and at the same time possess great knowledge of the effectiveness of health care settings, and what still needs to be addressed during these perilous times.This white paper was written by the Front Line Working Group of the AIA COVID-19 Task Force in the early phase of the COVID-19 crisis from February to April 2020 for the American Institute of Architects (AIA), which established the AIA COVID-19 Task Force to explore the role of architects and the built environment during the COVID-19 crisis. Clinical, scientific, and subject matter experts at the interface of health care and design worked together closely to inform this document and the associated checklist tool. It reflects input from medical doctors, including specialists in emergency medicine, intensive care, anesthesiology, and gerontology; nurses; hospital administrators; researchers; and architectural designers. The document considers findings from a literature review of recent institutional reports, publications, and emerging findings.

Click HERE to view the COVID-19 frontline perspective design considerations

Excerpt: When considering locations that sick patients will be moving to in the coming weeks and months, it’s also important to consider the spaces used in the past to treat other infectious diseases. “We can also learn lessons from prior health care designs, such as the tuberculosis sanatorium,” says Diana Anderson, M.D., an internal medicine physician and a board-certified health care architect and a current clinical fellow at the University of California San Francisco. “These facilities were initially designed so that the building itself could be used as a form of treatment, given the lack of pharmacologic treatments at the time. Similar to the scenario we face with COVID-19, fresh air, ventilation, and isolation are key factors in controlling the spread, all of which have connections to the built environment.”

Read the full article HERE.