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.

The built environment is a critical part of pandemic solutions and emergency preparedness.

Excerpt: Architects in general, and specifically board-certified healthcare architects, are key and valuable resources for rapid adjustments to current hospital and non-hospital infrastructure – repurposing old healthcare buildings, erecting temporary structures, and considering emergency preparedness in our building’s codes and design guidelines.  Current space utilization in hospitals can be quickly evaluated by these experts to maximize existing areas for use.

Read our complete Open Letter on Architecture and Pandemic Preparedness HERE.

**Also featured in Architect Magazine and Canadian Architect in addition to SALUS Global Knowledge Exchange**

Excerpt: Working at the intersection of architecture and medicine, Dr. Diana Anderson — both a healthcare architect and a board-certified internist — has a unique perspective on how buildings can influence healing and well-being for both patients and healthcare providers.

Founder of Dochitect, a collaborative model for approaching healthcare design from both fields simultaneously, Canada-born, California-based Anderson champions a refocusing of the built environment from being mere backdrops for medical encounters and toward settings that are humanistic and solution-based. Here, she shares insights on how architecture can promote healing.

Read the full article HERE.

Dochitect is interviewed about health design ideas for an aging population.

Older adults represent a large share of patients at doctors’ offices, clinics and hospitals. So why haven’t these facilities created environments they can navigate easily?

Read Judith Graham’s column in Kaiser Health News HERE about why it is time for a change.

Click here to read the Opinion piece