Why JRS + Partners’ hospital network is an ideal model for pandemics such as COVID-19

March 23, 2020



Gabrielle De La Cruz

With the number of confirmed cases in the Philippines raised to 462 as of 5:00 PM today, March 23, 2020, different news outlets have reported certain instances of hospitals having insufficient space to accommodate patients who tested positive for the novel coronavirus. A few local government units have also implemented the use of hotels, open lots, and other public spaces as quarantine centers. 

To explain the role of the built environment in global outbreaks, BluPrint asked several healthcare architects, designers, engineers, and planners how the country can build and equip hospitals with a fervent understanding of the nature of medical facilities and the vast changes in the way people live. Architect John Ryan Santos and Interior designer Pauline Cuevas-Bato of JRS + Partners rediscussed their compact hospital model Sagip Kanlungan and what concepts of this two-story building can be adapted by future health projects. 

About the hospital network 

Most people would probably agree that Philippine hospitals were not completely ready for this kind of outbreak. “There were no written protocols or manuals on how to build and equip hospitals for the COVID-19 as it is a novel disease. Even first world countries are struggling to combat this disease right now,” says Cuevas-Bato. “Being properly equipped means that a hospital has enough inpatient beds, supplies and equipment and staff such as doctors and nurses. It also means that the medical staff has proper knowledge of the disease. When the pandemic arrived in the Philippines, the numbers were off the charts and beyond any feasibility studies the hospitals may have done.”

READ MORE: John Ryan Santos + Partners wins the World Architecture Festival’s nod for their compact hospital design

According to Santos, there is a need to reform the healthcare system in a way that facilities are developed as “a hospital network that has the ability to communicate and operate as one delivery system.” One of the key concepts of Sagip Kanlungan as a base component for other compact hospitals is the Network System Approach. This approach enables compact hospitals to operate as dedicated referral components for a particular pandemic. In the event that one of the hospitals within the network can no longer perform the standard measures and the quality services needed to examine or treat a patient due to a massive number of cases, other components within the hospital network can “absorb the other regular patients of the dedicated referral hospitals.” 

Sagip Kanlungan - hospital network
The main idea of Sagip Kanlungan is to provide rural areas with medical facilities that can perform tertiary hospital services and are within their reach. Furthermore, because the construction of each component within the hospital network is affordable, each municipality or town can be provided with one, making healthcare facilities not only available but also efficiently numerous.

Considering that each component in the Sagip Kanlungan network can cover services such as consultation, critical care, emergency service, hemodialysis, laboratory, in-patient rooms, obstetrics and nursery, and radiology, imagine what the entire link of hospitals can do at a pandemic such as COVID-19. There would be less to no conversion of other structures or spaces into quarantine centers and patients would be thoroughly monitored and given equal treatment inside a medical facility. Furthermore, if the compact hospitals would be distributed into several municipalities and towns, it will be easier to track the number of cases in those areas and carefully assess and trace how the virus came about or even spread in that specific area. The hospital network will provide not only an improved protocol in the healthcare system but also in the dialogue between the public and private health sectors.

“If we were given the chance, we would be happy to work with the public sectors to build a medical facility that can easily be constructed for the purpose of admitting and treating patients with Covid 19 and other novel diseases. This has been done in other countries and we think it can also be done here in the Philippines.” says Cuevas-Bato.

Design features and functionalities

JRS + Partners examined the design implications with respect to the needs of a community. “A good hospital design tailors a building effectively and efficiently based on organized interlace of flows. If you can transport a patient from the Emergency Department to the Operating Room faster by one minute, that one minute can mean the difference between life and death,” shares Santos. “It also helps to keep in mind that designing hospitals is designing for an entire community. It is not only a building. It is a building within a community that everybody will depend on. It is a building that will allow a community to live confidently,” adds Cuevas-Bato. 

In case of natural disasters such as typhoons, the network’s compact hospitals can go into ‘shelter mode.’ The building would shield its windows and other openings with metal shutters as protection from high winds and flying debris.

The hospital network design is not only low-cost in terms of construction, but it is also disaster-resistant. The ramp structure has been turned into what they call the Command Bunker Structure–housing everything that a hospital will need to operate when utilities are cut-off during disasters or emergencies. In a global outbreak such as COVID-19, other technical services may be limited or unavailable. In this case, the command center, redundant generators, water filtration system and satellite-based communication transmitter incorporated by JRS + Partners become more than necessary. 

hospital network evacuation site
Apart from the well-planned building, JRS + Partners also allotted an evacuation area that can accommodate tent housing in each site’s open spaces with the hospital acting as a command post. “If we can not be at par with the equipment as those in more progressive countries, at least we can prepare for the needed space,” says Cuevas-Bato.

The architect and the designer zero on how architecture and design impact healthcare especially in emergency situations like COVID-19. Santos suggests that “one of the best things that healthcare architects can do during times like this is to perform diligent observation and documentation of the events and how the hospital infrastructure was able or unable to respond. These observations should later find its way into a set of systematic improvements on how we design new hospitals and/or how we can retrofit or renovate existing hospitals to meet similar situations in the future.” Cuevas-Bato adds that “if new buildings are not possible, healthcare architects and designers may help to devise ways on how to renovate or refit existing hospitals on an accelerated schedule to be more efficient in responding to a surge of patients with the COVID-19.” 

hospital network - JRS
John Ryan Santos: “I wake up each day knowing that in at least one of the hospitals that we have built so far, someone’s life has been saved that day because we put a hospital there. A father, a mother, a child, a loved one gets to spend one more day with their families because one of the hospitals that we built was there during a time when they desperately needed medical care.”

Watch the presentation of John Ryan Santos + Partners at the World Architecture Festival and know more about the hospital network concept here.


Images courtesy of John Ryan Santos + Partners

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