‘They’ve got it under control’

Every sink at UT Health San Antonio’s new cancer hospital will be touchless — no need to turn a handle and risk coming in contact with disease-causing pathogens.

The state-of-the-art specialty hospital isn’t scheduled to open its doors in the South Texas Medical Center for another three years, but the coronavirus pandemic already has spurred changes to the facility.

“We’re hearing nationwide that hospitals are really rethinking their space because of COVID,” said Kimberly Stanley, a health care sector leader at EYP, an interior design and technology planning company with 10 U.S. offices, including in Austin, Houston and Dallas.

Stanley said clients want hands-free options for doors, elevators and sinks and will select materials that are durable enough to withstand frequent cleanings. They’re also looking for more sophisticated air filtration and ventilation systems, some of which contain ultraviolet light to kill germs.

Even before the coronavirus outbreak, hospitals were investing in robots made by San Antonio company Xenex to disinfect surgical suites to kill drug-resistant “superbugs” such as Candida auris. But now the company’s business has grown significantly.

Keep your distance

The coronavirus is spread through close contact, so physical distancing of at least 6 feet is required to reduce the spread of the virus. That’s prompted numerous changes in new buildings, particularly those in the health care industry.

“They’re not just looking at cleanability and durability of materials but also the demise of the waiting room as we know it, because you just don’t want a lot of people sitting together,” Stanley said.

Health care providers with conjoined rows of seats in their waiting rooms have had to place yellow police tape or signs blocking off alternate seats and warning patients to spread out.

Workplace expert Leigh Stringer has been hosting a monthly meeting with leaders from medical institutions across the country to discuss challenges thrust on employers since the pandemic started.

The open office isn’t likely to go away, but companies are finding that some employees can safely and cost-effectively work from home. Stringer said this change will likely boost staff recruiting and retention especially in an industry where nearly 80 percent of the workforce is female.

With employees working from home, some hospitals use now-vacant call centers to store extra supplies and chairs that have been removed to encourage social distancing.

Many providers learned that not all patients need to come into the physical office for medical care, and when their lease is up, they may opt for smaller spaces to account for fewer in-person visits.

While the concept of telehealth has been around for decades, it wasn’t until the pandemic that the modality surged. A major change that prompted that move was that health insurance companies started reimbursing medical providers for doctor visits via video at the same rates as face-to-face visits.

Dr. Sergio Viroslav, an orthopedic surgeon and managing partner of TSAOG Orthopaedics, said offering telemedicine to patients is a way to keep them safe during the pandemic.

In April, telemedicine appointments nearly tripled at TSAOG, which has seven outpatient clinics throughout the San Antonio area and two ambulatory surgery centers.

Online visits have since slowed but are still higher than they were a year ago.

Viroslav says the physician-owned practice couldn’t have anticipated the pandemic but had started to invest in technology and infrastructure that would accommodate a growing, older patient population.

In 2019, TSAOG broke ground on a 100,000-square-foot surgical facility called Ridgewood Orthopaedic Center just outside Loop 1604 on U.S. 281.

“The design of the surgery center was meant for efficiency,” Viroslav said, adding that the building will encourage smooth patient flow. “You enter one way and exit another. No one has to backtrack.”

Newer buildings like the new Orthopaedic Center will be light-years ahead of older health care facilities, and many office have easily installed sneeze guards or clear plastic barriers between receptionist and patient.

But some older buildings are harder to convert and they’re struggling to adapt to pandemic-era demands.

“The devil is in the details,” Stringer said. “I think what providers are wrestling with is what’s going to stick.”

In San Antonio, a primary care office in a shopping center is asking its lab patients to call ahead, then directs them to go to the back of the building and enter through the alley.

More changes

When it comes to the medical buildings of the future, health care providers will need to have flexible spaces.

A surge of infected patients forced hospitals to convert underutilized patient wings into extra ER and intensive care beds. Tents outside served as triage areas. Harder-hit facilities even turned cafeterias into patient treatment units.

“We need to be able to respond to these type of situations so you can swing a patient room into an isolation room by having negative pressure to exhaust the room,” said Charles Griffin, a senior principal with EYP who is consulting on UT Health San Antonio’s future cancer hospital.

Griffin said there’s been a lot of conversation recently about making changes in federal regulations and building codes in health care design to accommodate public health emergencies.

Health care providers may also look for branded wayfinding signs and mobile apps that make it easier for consumers who are already in a stressful situation.

Patients want to come into a health care building and not feel like the administrators are handling COVID-19 with a makeshift solution, Stanley said.

“You want to walk in and feel like, ‘Oh, they’ve got it under control.’”

laura.garcia@express-news.net