Applying Human Factors to Modify and Design Healthcare Workspaces and Processes in Response to COVID-19

The COVID-19 pandemic continues to present unique challenges to healthcare organizations around the world. Members of a provincial Human Factors team supported several workspace design projects prompted by the pandemic. This article highlights some of the challenges identified in a selection of these projects. It also presents the human factors methods and recommendations that were used to improve workspace designs, processes, and patient safety in healthcare environments. © 2023 by Human Factors and Ergonomics Society.

Pinpointing drivers of widespread colonization of Legionella pneumophila in a green building: Roles of water softener system, expansion tank, and reduced occupancy

Introduction: Legionella pneumophila is an opportunistic pathogen that is a key contributor to drinking water-associated disease outbreaks in the United States. Prolonged water stagnation periods in building plumbing systems due to low occupancy, especially during building shutdowns, breaks, and holidays, can lead to water quality deterioration and (re)colonization of buildings with L. pneumophila. Water monitoring in buildings typically relies on grab samples with small datasets. Methods: In this study, a larger dataset was created by sampling a Leadership in Energy and Environmental Design (LEED)-certified data-rich commercial building for L. pneumophila and physical-chemical water quality during the COVID-19 pandemic after reduced building occupancy. A proxy for human occupancy rates using WIFI logins was recorded throughout the study period. Results: L. pneumophila was observed in grab samples taken throughout the building, where concentrations generally increased with greater distances from the building point of entry to locations throughout the building. Factors conducive to microbial growth were identified in the building including fluctuations in water temperatures, lack of chlorine residual, a low water heater setpoint, colonized water-saving fixtures, prolonged stagnation throughout the building;especially in an expansion tank designed to reduce pressure issues during demand fluctuations, and the presence of oversized softener tanks with ion exchange resin that contributed to chlorine residual removal as well as colonization of the resin with L. pneumophila. Discussion: Flushing and thermal disinfection alone did not resolve the problem, and replacement of the expansion tank ultimately resolved the L. pneumophila issue. As ad-hoc approaches are logistically- and time-intensive, more proactive approaches are needed for informing preventative and corrective actions for reducing the risk of exposure to opportunistic pathogens in the building plumbing. Copyright © 2023 Joshi, Richard, Levya, Harrison, Saetta, Sharma, Crane, Mushro, Dieter, Morgan, Heida, Welco, Boyer, Westerhoff and Hamilton.

High-Definition City: An Invisible Horizon of Technological Human Space

Guest-Editors Jane Burry and Marcus White team up with Andong Lu, Lead Professor in Urban Design and Vice-Dean of the School of Architecture and Urban Planning at Nanjing University, to explore the ups and downs of our contemporary condition relative to the exponential rise in the seamlessness of technology – particularly digital technology. This is a complex arena that is both liberating yet can also be invasive to our privacy and dignity, presenting a paradox that they here attempt to unravel for us. Copyright © 2023 John Wiley & Sons, Ltd.

Intra-scale Design and Benefit Assessment of Green Stormwater Infrastructures

By considering the effects of climate change in urban areas, the paper investigates the benefits of environmental design strategies as green stormwater infrastructures. The environmental dimension of spatial planning sits alongside and interfaces with other sustainability challenges in the urban environment. Moreover, the advent of the COVID-19 pandemic focused their crucial importance in the reorganization of places that are “safe” because they allow movement through cities with minimal risk of contagion, providing an adequate opportunity for safe socialization. The research studied the design of green streets equipped with GSI devices in a portion of the town of Aversa (CE), to mitigate flooding, improve the microclimatic conditions and the quality of public spaces. The work was carried out with the support of software simulation of the microclimatic and physical behavior of urban areas (ENVI-Met) and evaluation of the benefits of ecosystem services (iTree Eco), performing in a cyclic way the phases of Analysis, Design and Verification. The approach allowed to refine the results obtained by selecting the most appropriate solutions for the project. The computer simulation of microclimatic conditions is a useful tool for the environmental assessment of limited urban ecosystems, where it would be particularly costly to install a series of small stations to detect the local weather conditions. The holistic approach to urban regeneration planning and project leads to a constant assessment of the increase of the ecosystem services resulting from the solutions chosen in the cyclical process of research through design. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Artificial Empathetic Intelligence for Leadership in Energy and Environmental Design Buildings

The modern era of advanced communications and electronic structures yields with steady steps the enhanced implementation of smart 'leadership in energy and environmental design' (LEED) buildings with artificial intelligence (AI) structures. These structures need development through various studied steps. In this paper, we propose a holistic design of these buildings ranging from the compatibility of people with these kinds of structures to the impact on their health (in times of pandemics such as Covid-19). Moreover, we propose a viable scheme of an AI environment (inside LEED buildings), which includes virtual empathetic companion and colleague versions. This scheme relies on a proposed algorithmic logic of iterations for the best possible machine learning. Specifically, we first describe the iterative architecture of the proposed AI entity consisting of 5 sectors. Then, we present the proposed machine learning pipeline (MLP) that comprises these 5 sectors. Afterward, we give the 7-stage empathetic essence that should reside inside the MLP. Finally, we exhibit a proposed experiment besides our case study under development. Then, after implementation, the acquired technological experience can lead to a more exquisite version of AI software robots that could be adaptable to several labor and safety protocols. © 2022 IEEE.

Remote work: Aircraft noise implications, prediction, and management in the built environment.

The COVID-19 pandemic has greatly changed workplace management. Most workplaces have adopted the work-from-home policy to minimize the risk of community spread. Consequently, housing estates remain largely occupied during office hours. Since some housing estates are situated in the vicinity of an airport, noise pollution resulted from the takeoff and landing of aircraft is now more noticed by residents, causing annoyance. This problem would be most acute for those located directly under the flight path. Before the pandemic, such aircraft operations had lower effect on the residents because most of them were not at home but at workplaces. Evidently, it is timely that more emphasis should now be placed during urban planning to predict and minimize aircraft noise in the built environment. This article first defines the aircraft noise metrics commonly used to assess environmental impact. Preceded by an overview of how aircraft noise affects the built environment, this article reviews how various aircraft noise prediction models have been used in urban planning. Lastly, this article reviews how aircraft noise can be managed for better acoustic comfort of the residents. Anticipating the adoption of hybrid work arrangement moving forward, this article aims to provide urban planning professionals with an avenue to understand how aircraft noise can negatively affect the built environment, which, in turn, justify why prediction and management of aircraft noise should be emphasized from the outset of urban planning.

The International Shanghai Joint Design Studio: A Hybrid and Adaptive Platform to Enhance Cultural Encounter

The International Shanghai Joint Design Studio was a work-in-progress platform that started in August 2019 before the COVID-19 pandemic and ended in July 2020 with the publication of the initiative’s outcomes. It combined the studios of 5 Schools of Design located in 4 different countries with the aim of sharing ideas and reflections about the development of projects located in a common area in Shanghai. Thanks to its adaptive, collaborative, and flexible structure, the joint studio could overcome the difficulties caused by the outbreak through the integration of innovative and hybrid teaching & learning methods while developing both a virtual and a physical space of co-creation and engagement for students, scholars, designers, and citizens. Through the involvement of cohorts of various grades and majors, the students were constantly exposed to very diverse design approaches and planning practices. In this way, it became a place to enhance cross-cultural encounter among different design disciplines and backgrounds while encouraging both the learners and the tutors to develop innovative and multidisciplinary points of view about the city and the built environment. In this paper, the authors draw a general reflection about how cross-cultural practices have been implemented through the activities of the initiative and concretely address shortcomings and suggest possible recommendations for future similar pedagogical experiments. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

How to Make Green Building Certification & Rating Systems More Pandemic-Sustainable?

The present study demonstrates a gap analysis (in response to the COVID-19 pandemic) of the best known widely used green building certification and rating systems (GBC&RSs): LEED, WELL, BREEAM, CASBEE. These systems have been analyzed for their missing responses according to a list of selected pandemic-sustainable indicators. The gap levels for each system have been calculated and then compared to each other. Among four GBC&RSs, BREEAM exhibited the smallest gap score, whereas LEED and WELL held the largest gap scores. Following these results, we suggest courses of action for each system to remove the gaps that will result in achieving a better response under pandemic conditions. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

EDUCATIONAL EFFECTIVENESS OF A VIRTUAL DESIGN STUDIO ON ZERO-ENERGY BUILDING DESIGNS: THE CASE OF THE U.S. SOLAR DECATHLON DESIGN CHALLENGE

Ongoing global architectural agendas span climate change, energy, a carbon-neutral society, human comfort, COVID-19, social justice, and sustainability. An architecture studio allows architecture students to learn how to solve complicated environmental issues through integrated thinking and a design process. The U.S. Department of Energy’s Solar Decathlon Design Challenge enables them to broaden their analytic perspectives on numerous subjects and strengthen their integrated thinking of environmental impacts, resilience, sustainability, and well-being. However, the unprecedented impact of the global COVID-19 pandemic transformed the physical studio-based design education system into an online-based learning environ-ment. Mandatory social distancing by the global COVID-19 pandemic restricted interactive discussions and face-to-face collaborations for the integrated zero-energy building design process, which requires features of architecture, engineering, market analysis, durability and resilience, embodied environmental quality, integrated per-formance, occupant experience, comfort and environmental quality, energy perfor-mance, and presentation. This study emphasizes the educational effectiveness of virtual design studios as a part of the discourse on architectural pedagogy of zero-energy building (ZEB) design through integrated designs, technological theories, and analytic skills. The survey results of ten contests show educational achievement with over 90% of the highest positive tendency in the categories of embodied environmental quality and comfort and environmental quality, whereas the positive tendency of educational achievement in the categories of integrated performance, energy performance, and presentation were lower than 70%. The reason for the low percentage of simulation utilization and integrated performance was the lack of a proper understanding of and experience with ZEB simulations and evaluations for undergraduate students. Although VDS is not an ideal pedagogical system for the iterative design critique process, it can support the learning of the value of architectural education, including integrative design thinking, problem-solving skills, numerical simulation techniques, and communicable identities through online discussions and feedback during the COVID-19 pandemic. © 2021, College Publishing. All rights reserved.

Psycho-environmental processes of hospital design and their role during the COVID-19 pandemic (Procesos psicoambientales del diseno de hospitales y su implicacion durante la pandemia por COVID-19)

Abstarct Despite the popularity of the humanization movement in healthcare environments, there has been no systematic implementation of design changes aimed at reducing the negative effects of hospital environments. This article reviews the contributions made by psycho-environmental research about the psycho-social implications of design for users' health and well-being in the areas of healthcare, patient engagement, social interaction, spatial orientation and environmental stress. It also proposes recommendations for spatial design regarding the dual function of hospitals as a place of care for patients and a place of work for staff members. Finally, it discusses the amplification of the negative effects of hospital settings during the COVID-19 pandemic. This review provides a basic guide to the environmental effects of hospitals aimed at health professionals with a view to improving healthcare.

The Environmental Factors Associated With Fatigue of Frontline Nurses in the Infection Disease Nursing Unit.

The workload in the Infection Disease Nursing Unit (IDNU) is increasing dramatically due to COVID-19, and leads to the prevalence of fatigue among the frontline nurses, threatening their health, and safety. The built environment and design could fundamentally affect the fatigue of nurses for a long-term perspective. This article aims to extract the environmental factors of IDNU and explore nurses' perceptions of these factors on the work-related fatigue. It would produce evidences for mitigating the fatigue by environmental interferons. A cross-sectional design was employed by combination of focus group interview and written survey. Environmental factors of IDNU were collected from healthcare design experts (n = 8). Nurses (n = 64) with frontline COVID-19 experiences in IDNU were recruited to assess these factors individually. Four environmental factors were identified as: Nursing Distance (ND), Spatial Crowdness (SC), Natural Ventilation, and Light (NVL), and Spatial Privacy (SP). Among them, ND was considered as the most influential factor on the physical fatigue, while SP was on the psychological fatigue. Generally, these environmental factors were found to be more influential on the physical fatigue than the psychological fatigue. Technical titles were found to be associated with the nurses' perceptions of fatigue by these environmental factors. Nurse assistant and practical nurse were more likely to suffer from the physical fatigue by these factors than senior nurse. The result indicated that environmental factors of IDNU were associated with the nurses' fatigue, particularly on the physical aspect. Environmental interventions of design could be adopted to alleviate the fatigue by these factors such as reducing the ND and improving the spatial privacy. The accurate interventional measures should be applied to fit nurses' conditions due to their technical titles. More attention should be given to the low-ranking nurses, who account for the majority and are much vulnerable to the physical fatigue by environmental factors.

Redesigning Memory Care in the COVID-19 Era: Interdisciplinary Spatial Design Interventions to Minimize Social Isolation in Older Adults.

Older adults living in memory care facilities are vulnerable to more than just COVID-19; they are especially harmed from social distancing guidelines, as social isolation and loneliness have important medical consequences in this population. COVID-19 has changed the way we perceive the built environment, and almost all public spaces are now adopting new design strategies to create safe indoor and outdoor environments. Eight interdisciplinary, evidence-based spatial design interventions and action plans are explored in this article with the aim of redesigning future memory care facilities to combat social isolation and loneliness in older adults during this unprecedented time and beyond.

SARS-CoV-2 Viability on 16 Common Indoor Surface Finish Materials.

AIM: This study investigated the stability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 16 common environmental surface materials. BACKGROUND: SARS-CoV-2 is the causative agent of severe coronavirus disease, a significant public health concern that quickly led to a pandemic. Contamination of environmental surface materials is of concern, with previous studies identifying long-term detection of infectious particles on surfaces. These contaminated surfaces create an increased risk for contact transmission. METHODS: Surface materials were inoculated with 10,000 plaque forming units and samples were collected 4, 8, 12, 24, 30, 48, and 168 hours post infection (hpi). Viral titers were determined for each sample and time point using plaque assays. Nonparametric modeling utilized the Turnbull algorithm for interval-censored data. Maximum likelihood estimates for the survival curve were calculated. Parametric proportional hazards regression models for interval censored data were used to explore survival time across the surface materials. RESULTS: There was a sharp decline in recoverable virus after 4 hpi for all tested surfaces. By 12 hpi, infectious SARS-CoV-2 was recoverable from only four surfaces; and by 30 hr, the virus was recoverable from only one surface. There were differences in survival curves based on the materials although some groups of materials are similar, both statistically and practically. CONCLUSIONS: While very low amounts of infectious SARS-CoV-2 are recoverable over time, there remains a risk of viral transmission by surface contamination in indoor environments. Individuals and institutions must follow appropriate procedures to decontaminate indoor environment and increase diligence for hand hygiene and personal protective equipment.

Use the Environment to Prevent and Control COVID-19 in Senior-Living Facilities: An Analysis of the Guidelines Used in China.

OBJECTIVE: To identify the environmental factors essential for infection control in senior-living facilities. BACKGROUND: In the COVID-19 pandemic, older adults are more likely to be infected and develop serious outcomes than young people. Worldwide, senior-living facilities face a battle to protect their residents. Compared with age-related declines, the built environment is more modifiable and can be used for infection control. METHODS: This research conducted content analysis of the guidelines on COVID-19 control issued by the State Council of China in February 2020 for senior-living facilities. Six senior-living facility managers in China were interviewed and shared their experiences using these guidelines. Quantitative and qualitative analyses were conducted to identify the essential environmental factors for infection control. RESULTS: Environmental factors suggested in the guidelines were analyzed for three groups of infection-control strategies: keep COVID-19 from entering the facility, prevent COVID-19 spread in the facility, and manage infection and illness. Key topics of experience using the guidelines were identified, including residents' needs for social interaction and the difficulties of providing dedicated air-conditioning and circulation systems. Based on these analyses, from the perspective of environmental design, environmental factors essential for COVID-19 control in senior-living facilities were summarized at the site, building, and room levels. CONCLUSION: Proper planning and design of the built environment promote strategies for infection control in senior-living facilities. Findings can be used to guide the new design, renovation, and modification of senior-living facilities for COVID-19 control and future public health emergencies.