Preventing the spread of COVID-19 through environmental design in Thai community hospitals

Abstract

The unprecedented outbreak of COVID-19 has had a tremendous negative impact on healthcare facilities, especially public hospitals. Thai community hospitals serve as primary care for COVID-19 patients. However, many hospital buildings were constructed in the 1990s and are now becoming outdated. Community hospitals faced many difficulties during the Thailand COVID-19 outbreak. To identify these difficulties this study focused on the physical settings of the community hospital’s outpatient departments (OPD) between 2020 and 2021. Furthermore, the study provided design suggestions for preventing the spread of respiratory infectious diseases. The study used a three-step process of data collection. The first was to observe the physical settings of the OPD buildings of the three hospitals. Secondly, interviews were conducted with thirty healthcare employees: 11 from the first hospital, 11 from the second hospital and 8 from the third hospital. Interviews were transcribed and analyzed using content analysis. Subsequently, the architectural design was produced based on observation and interview analysis. In the third step, the same thirty participants evaluated the architectural design through a focus group. Findings from the interviews led to four themes: 1) factors leading to the accumulation of pathogens, 2) measures for preventing the spread of respiratory diseases, 3) the effect of patient numbers on virus transmission, and 4) suggestions for improving the physical setting of OPDs. The analysis of the four themes led to the preliminary design recommendation, which was evaluated through a focus group, leading to suggestions for the improvement of thirteen areas. The analysis results showed that the participants were satisfied with the architectural design with additional minor recommendations. This study provided originality for the implementation and future development of hospital layout designs that can prevent the spread of COVID-19 throughout Thai community hospitals.

Identifying measures to prevent the spread of COVID-19 in outpatient clinics

“…(2) Step 2: medical staff interviews. The interviews were analysed using content analysis (Corbin and Strauss, 2015;Waroonkun and Prugsiganont, 2022). The researcher transcribed the interviews from the audio recordings and divided the transcript text into meaning units.…”

“…Step 1: building observation . Walk-through observation was adopted as a tool for this step (Waroonkun and Prugsiganont, 2022; Geng et al , 2021; Pilosof, 2021; Fronczek-Munter and Prugsiganont, 2018). Data were collected through photographs and architectural building plans.…”

“…The interviews were carried out between May and June 2021, where the interviews were audio recorded, which lasted between 20 and 50 min. The scope of the medical staff interviews followed environmental design guidelines, focusing on the prevention of the spread of F 42,3/4 infectious diseases (Waroonkun and Prugsiganont, 2022). The interview questions were as follows:…”

“…The CDCP (2022) and Waroonkun and Prugsiganont (2022) describe how COVID-19 can be transmitted in three ways. The first is when airborne pathogens merge with small particulate matter, such as dust (smaller than 5 microns), and enter the respiratory tract.…”

“…This meant that infection control became the most important aspect of hospital services. Moreover, concern about hygiene standards and infection control established by previous studies (Pilosof, 2021; Miedema et al , 2019; Gulwadi et al , 2009; Waroonkun and Prugsiganont, 2022; Alhusban et al , 2022; Setola et al , 2022) and the guidelines provided by the Centers for Disease Control and Prevention (CDCP) (2009, 2021) led to the aim of this paper to show that the built environment can have an impact on infection control and hygiene standards.…”