The threat of climate change isn't just impacting the planet's temperature. Warmer conditions also create more severe weather events that are catching cities flatfooted. In addition to putting people at risk, these weather disasters also made it difficult or impossible to access the vital services — including hospitals — that they need in challenging times. 

How can the addition of resilient design techniques for hospitals ensure these issues don't happen again?


Why Resilience is Critical During Climate Change

In 2017, Hurricanes Harvey and Irma struck the Gulf Coast. Harvey dumped so much rain on Houston that the city was covered in multiple feet of water, while Irma knocked out power to parts of Florida for weeks. 

The Houston area is home to roughly 120 hospitals, 20 of which had to close entirely due to the flooding. The East Houston Regional Medical Center ended up staying closed permanently, with no plans ever to reopen or continue seeing patients. 

This is just one example of climate change’s impact on cities worldwide. The West Coast of the United States is experiencing some of the worst droughts and wildfires in recent history. Australia spent the early months of 2020 on fire. The Midwest sees more severe weather events, including in-land hurricane-like storms called derechos. 

Floods are devastating parts of the world that usually don't see more than a few inches of rain a year. These disasters make it more difficult for hospitals to do their job and see the patients in their care.


Resilient Design Techniques for Hospitals

Hospitals need to look into resilient design techniques, but what does it mean to make a structure genuinely safe? It depends on the needs of the building and the kind of disasters it is likely to experience. A hospital in Florida may be designed to withstand hurricanes with their high winds and storm surge but wouldn't survive an earthquake. 

In general, though, the best rule of thumb to follow is to prepare for anything. Floods can render the entire bottom floor of a building unusable, both during the flood and after the waters have receded. It isn't always possible to prevent floods, but hospitals can relocate essential services to upper floors. Lower floors can be designed with measures to mitigate water damage to reduce the time it takes to return to operations. 

Winds are another threat, mainly because most of these structures are not aerodynamic. Tall rectangular buildings can only withstand so much before they start to buckle or windows break. Designing facades to reroute high winds rather than taking the brunt of the impact can help them weather the storm.

Buildings in earthquake-prone areas are already designed to withstand these shakes to a certain degree. Incorporating that sort of kinetic absorption and redirection could help these structures withstand storms.

Of course, nearly all healthcare facilities will benefit from retroactive HVAC improvements, even if building designers cannot start from scratch. Building ventilation, energy-efficient windows and other upgrades can have a positive impact on everything from airflow to weather resistance, supporting patients and staff even in inclement weather.


Resilience Requires Pre-Planning

Severe weather isn't the only thing that's hurt hospitals and their ability to care for patients. The COVID-19 pandemic might be a once-in-a-lifetime occurrence, but for the most part, the health care system was not prepared for the virus or its impact on everyday life. 

Hospital beds filled up fast, and even now, variant surges are leaving some cities scrambling to find enough beds to hold patients and enough medical professionals to care for them. Resilience means being prepared for and able to handle a massive influx of patients, whether because of a global pandemic or a mass casualty event closer to home. 

This can be challenging, as cost limitations and risk analysis can point to money being better spent elsewhere. However, with government support and industry demand, it’s likely disaster preparation will be a larger consideration for hospital design.

How can building designers contribute to this type of resilience? Working on plans for emergency departments that can isolate rooms, spaces that can be flexibly turned into high-capacity rooms, and entryways that allow for better screening procedures can all make a difference in a worst-case scenario.


Resilient Design Is Critical for Hospitals

Current hospital designs have served well for the duration of their life span. Still, when those designs were approved, the architects and engineers couldn't have foreseen the impact climate change would have on weather patterns and natural disasters. 

With that in mind, the focus for new structures needs to be resiliency. Existing hospitals need to consider retrofits or remodels that can make them better able to face whatever is to come.