How flexible infrastructure can help

Hospital infrastructure isn’t static. It undergoes constant alteration and improvement to ensure it remains fit for purpose in a changing world. 

And our world has changed immensely since COVID-19 hit, creating some infrastructure challenges for hospitals. 

Here, we explore the role of infrastructure in patient care and offer ways to rethink healthcare infrastructure and service delivery in light of the pandemic.

Infrastructure means more than bricks and mortar

According to Professor Linda Luxon of the UK’s Royal College of Physicians, infrastructure is the key to healthcare improvement. Writing in 2015, she noted that,

Infrastructure includes the built environment and supporting elements: equipment, access, information technology, systems and processes, sustainability initiatives and staff. 

Overall these interwoven facets should enable patients to move seamlessly, with their privacy and dignity maintained at all times, from initial referral through local hospitals to specialist tertiary centres and discharge to appropriate care (home, care home, or community hospital with intermediate care), whatever the age, disorder or social circumstances of the patient.

How well does your hospital infrastructure achieve that goal, especially in light of COVID-19’s ongoing impact?

Healthcare infrastructure needs in a COVID-normal world

While restrictions have been lifted, COVID-19 is still very much here and continues to reshape healthcare delivery.

It’s 120 years since an infectious disease was Australia’s leading cause of death but some experts are warning that could happen this year. By July 2022, the virus was the third leading cause of death, beaten only by heart disease and dementia. The winter wave may have peaked but another wave is likely by December

That means COVID-19 continues to have implications for your infrastructure needs. 

Jayesh Kapitan, National Director, Hospitals at RSM Australia, recommends taking a step back and properly considering how the pandemic has changed what you need from hospital infrastructure.

There’s been a fundamental change. Before the pandemic, infrastructure often meant bringing large numbers of patients and clinicians together in the hospital building. 

Fast forward to where we are now. Do you have the infrastructure to provide virtual services by video with due regard for patient privacy? How easy is it to isolate wards, make sure staff don’t move from one part of the building to another and segregate patients in the emergency department before they spread the infection to each other? What about your ventilation system – is it an infection risk? 

Hospitals were never designed for this. There are lots of infrastructure challenges due to the pandemic so we have to rethink how we deliver healthcare. 

Rethinking healthcare delivery

  • Video consultations with appropriate privacy

Kapitan notes that there’s a strong link between digital infrastructure and physical infrastructure. Video telehealth, for example, is a digital service that requires the physical provision of a private consulting room or office to protect a patient’s privacy. 

Many hospitals are not yet making full use of video telehealth as a mode of service delivery yet it is an ideal way to ease pressure on the hospital system and support patients while minimising COVID-19 risk. 

The Victorian Virtual Emergency Department, for example, can see 600 patients a day through video telehealth. Of the 28,000 patients treated from October 2020-July 2022, 71% had been able to avoid the need for an emergency department (ED) presentation after receiving medical advice and instructions via video.

  • Improve patient flow with data analytics

Patient flow throughout the hospital can be severely disrupted by poor access to data. If the digital infrastructure is poor, clinicians can’t see patient results or available ward beds that might enable a patient to move out of the ED. As Kapitan says, 

Real-time data enables better clinical care, improves patient flow and helps predict demand, meaning you can plan ahead. Artificial intelligence systems can help to guide clinical decisions, saving time on research by showing what percentage of similar patients improved with which treatments – a great help to exhausted and overworked clinicians. 

  • Addressing staffing challenges

Governments are fond of announcing large pots of new money to hire more doctors or nurses – but such people don’t currently exist and it will take years to train sufficient numbers of new staff. 

In the meantime, hospitals could: 

  • Expand the role of non-clinical staff so that nurses and doctors can focus on clinical aspects of care
  • Create new roles for a wider range of registered healthcare professionals who could play a valuable role on clinical teams
  • Tempt back qualified staff with creative offers such as part-time clinical roles and work-from-home telehealth options 
  • Provide incentives for older staff to delay retirement
  • Enable staff who are isolating with COVID-19 to provide telehealth services from home, relieving some pressure on staff who remain onsite. 

Better infrastructure may also help recruit staff by providing a modern, fit-for-purpose working environment. 

  • Rural and regional services

Nearly a third of Australians live in rural and remote areas. Geography creates unique challenges for healthcare, often leading to poorer health outcomes. Regional and rural hospitals may also struggle to attract staff who may feel there are better opportunities in the city. 

Mobile infrastructure could offer a way for a hospital or health service to create a surgical outreach program. A fully staffed mobile or modular operating room could be a valuable interim solution for a rural or regional hospital, tackling cataract surgery, hip replacements or colonoscopies for 6 months before moving on to the next region. 

  • Infection-controlled ED entry

Patients attending hospital for planned outpatient appointments or elective surgery can be screened for COVID-19 in advance. But, by its very nature, patients turn up at the Emergency Department without advance planning. If all patients mingle in the same waiting area, there’s a high risk of COVID spreading between them. 

A mobile or modular facility attached to the ED would allow COVID-19 patients, including those who test positive on arrival, to be isolated in a negative pressure area away from other patients.

Mobile and modular healthcare facilities

According to Jayesh Kapitan, 

Mobile and modular facilities are a wonderful mechanism that can be used for business continuity with applications in metro, regional and rural areas  

Such facilities can be created as a bespoke solution to a hospital’s particular needs. They can be installed in a matter of weeks, feature ventilation systems suited to the pandemic and can be used for almost any purpose other than heavy robotic surgery (endoscopy suites, cardiac surgeries and delivery rooms to name just a few).

If you’d like to learn how mobile and modular facilities could help to ease your infrastructure challenges, please contact Q-bital Healthcare Solutions.