Facility Layout COncepts
Designating Zones and Rooms for Patient Evaluation
Principles
One strategy to contain spread is the division of patient flow into COVID (+) or Covid Possible: Red vs Non-COVID: Green zones. Some facilities will use a Yellow Zone for COVID possible.
For simplicity and due to resource limitations, one can divide into Red and Green zones to start. You can move to a Red, Yellow, Green system after.
At some point it may collapse to Red and Green as anyone with symptoms will be considered COVID+ once there is enough community spread.
You must examine your facility and start to divide it into Zones for patient flow:
Important Tips:
Set your system up so that you do not have to Go Backwards
Avoid converting COVID rooms back into Non-COVID rooms.
Your COVID Zone should expand unidirectionally
At the beginning you will only need one or two rooms for Red. As things ramp up, more rooms will need to be added to the COVID Zone.
When patients are not kept separate, especially with resident patients, tragedy can ensue. Witness the loss of 27 29 residents in the 65 bed Pinecrest Nursing Home in Bobcaygeon, Ontario.
Introduction To Surge
Keep Green (COVID Negative) separate from Red (Covid + or suspected)
Minimise the amount of additional work required - e.g., moving materials and supplies
Physical space - minimize the distance of displacements
A stage can be skipped if needed
Build Surge into your Plan
Sample Surge Progression at a Glance
Be Prepared for High or Overwhelming Surge
So now you have a basic idea of how to set things up.
Now the other issue: You don’t know how many patients you will have, nor how fast they will come.
COVID infection has a clear potential to cause a huge surge in patients and to Overwhelm our capacity.
High or Overwhelming Load will be very difficult.
Planning Surge management beforehand will help.
You must be prepared that a Surge will overwhelm your transport capacities, that you will be treating patients locally, and that your resources will exhaust and patients will not survive.
You may have to ration or triage treatment.
You may have large Palliative Care Needs.
This is something you will not be accustomed to.
It will be psychologically and emotionally hard.
Presented below is a 3 stage condensed process of the diagram above for you to adjust your clinic layout. It's the same information presented in different format.
You will have to adjust the specifics based on your own physical layout and available resources.
Where to see Patients - A 3 Stage Process
Presented below is a 3 stage process for a sample facility. See the Next Section Facility Layout: Specifics to see an Actual Floorplan that corresponds with what is below.
Use this example to adjust your facility based on your own physical layout and available resources.