EMERGENCY DEPARTMENT DESIGN IN RESPONSE TO PANDEMICS: A Systematic Literature Review

ABSTRACT

The COVID-19 pandemic has presented serious challenges to emergency departments (EDs). EDs play an important role in responding to pandemics, as they make the first substantial strides to recuperate patients and protect them from infectious diseases, as shown in experiences of earlier infectious disease surge events (e.g., SARS-CoV, H1N1, Ebola, etc.). However, there is limited evidence on how facility design can support EDs’ response to pandemics. This chapter aims to provide a systematic literature review (SLR) of EDs’ challenges and responses to pandemics, with a primary focus on facility design strategies. After screening 2489 studies covering the literature from March 2000 to March 2021, 20 articles were reviewed to extract ED design strategies. Key findings include (a) negative-pressure rooms and (b) split flow and cohort isolation that can create various zones for patients with different risk and acuity levels are the most addressed approaches for infection control and accommodating surge capacity. Convertibility and flexibility concept (e.g., reconfiguration of spaces, temporary separation within spaces, reversible air pressure, flexible use of spaces within and adjacent to ED) is key to addressing the unique challenges of the evolving nature of pandemic outbreaks. This chapter provides a summary of existing design strategies for EDs to respond to pandemics. Multiple design strategies need to be combined to minimize the disease transmission in EDs during pandemics and provide surge capacity for the overflow of patients. Detailed design principles were synthesized based on the SLR and translated to a design prototype that aims to address the needs during various stages of pandemics. © 2023 selection and editorial matter, AnnaMarie Bliss and Dak Kopec;individual chapters, the contributors.