Redesigning Hospitals for Covid-19 Treatment in Resource Limited Setting: A Real Challenge

I am Dr. Temesgen Tilahun currently coordinating COVID-19 treatment center at Wollega University Referral Hospital and the aim of my letter is to put some recommendation on how to redesign hospitals in resource limited setting for treatment of this disease.

It is vivid that purposely designed hospitals are better treatment sites for COVID-19 treatment as they yield better patient outcome, decreased infection rate among care providers and positive effects on psychology of patients and health task force [1]. However, resource limited settings are redesigning the already functioning hospitals for COVID-19 treatment. These settings have very few aged hospitals dealing with many patients. Because of highly spreading nature of the disease and lack of adequate financial resources, the affordable option is to redesign or repurpose these hospitals. However, the process of redesigning the hospitals is challenged by their inflexible nature, limited number of rooms and limited finance required for renovation. Whatsoever, it should be done with great care.

 As one of practitioners and hospital managers working in Africa, I would like to make the following recommendations [2]. The first is to give due attention to health of care providers because the health system, particularly in developing countries where there are few health professionals, cannot afford infection of care providers at this difficult time. Thus, the hospitals should be redesigned in a way care providers will not get infected and feel safer [3]. Putting clear physical mapping of within the hospital and availing infection prevention facilities from local sources through engagement of local innovators are critical point to prevent infections.  The rooms should also be renovated in a way that negative pressure is maintained [4].  Once the mapping is made, is to make sure that health task force is strictly using it based on local guidelines which are developed considering the existing situation. My second recommendation is these hospitals better keep elderly professionals away from direct patient care. They must preferably be used as advisors to young colleagues and health science students. Professionals with comorbidities shall also play some other roles [2].

1. Jeremy Hsu. How the Covid-19 Pandemic May Reshape US. Hospital Design.
2. Ramakrishnan, Angarai Ganesan, Kanishka Sharma (2020) The need to redesign the hospital  ICUs for  COVID-19  patients to save the medical fraternity.
3. Lancet T (2020) COVID-19: Protecting health-care workers. Lancet, London, England 395(10228): 922.
4. Jocelyn Stroupe, Margi Kaminski (2020) How Redesigning the Patient Journey Will Save Lives During COVID-19 and Beyond.