COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals

COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals


  • Stefano Capolongo Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy
  • Marco Gola Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy
  • Andrea Brambilla Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy
  • Alessandro Morganti Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy
  • Erica Isa Mosca Politecnico di Milano, Department of Architecture, Built environment and Construction engineering (DABC), Design and Health LAB, Italy
  • Paul Barach Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, United States of America; Jefferson College of Population Health, Philadelphia, PA, United States of America; Sigmund Freud University, Wien, Austria


COVID19, Hospital, Healthcare facilities, Built Environment, flexibility, resilience, evidence based design, user centerdness, digital innovation, patient safety


Background and aim: The COVID-19 pandemic has upended the global healthcare systems. The surge in infections and sick critically ill patients has tested the resilience of healthcare infrastructures and facilities forcing organizations to quickly adapt and embrace emergency solutions. The paper proposes a decalogue of design strategies applicable both to new hospitals and to the refurbishment of existing hospitals. Methods: The authors conducted observations at hospitals, during public health webinars and through experts working groups from March to May 2020. Results: In this commentary, the authors present a list of strategies for creating critical care surge capacity and exploring design strategies for healthcare design for resilient hospital facilities. The strategies are organized into two tiers: I) design and II) operations. The (I) Design phase strategies are: 1) Strategic Site Location; 2) Typology Configuration; 3) Flexibility; 4) Functional program; 5) User-centerdness. The (II) Operation phase strategies are: 6) Healthcare network on the territory; 7) Patient safety; 8) HVAC and indoor air quality; 9) Innovative finishing materials and furniture; 10) Healthcare digital innovation. Conclusions: Hospitals, health care systems, and institutions urgently need to assess their resources, identify potential bottlenecks, and create strategies for increasing critical care surge capacity. The COVID-19 pandemic disrupted healthcare operations and accelerated the processes of innovation and transformation. The design and operational strategies can enable the achievement of resilient hospital facilities. Further multidisciplinary researches is needed  to validate the strategies empirically.


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How to Cite

Capolongo S, Gola M, Brambilla A, Morganti A, Mosca EI, Barach P. COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals. Acta Biomed [Internet]. 2020 Jul. 20 [cited 2024 Jul. 18];91(9-S):50-6. Available from: