Emergency Department Environmental Responses to COVID-19 Pandemic: A Qualitative Study

Area of Science:

• Healthcare Management
• Public Health
• Environmental Design

Background:

• Emergency departments (EDs) underwent significant environmental modifications during the COVID-19 pandemic.
• The decision-making processes and effectiveness of these modifications were not well-studied.

Purpose of the Study:

• To document and evaluate physical environment strategies used by EDs during the COVID-19 pandemic.
• To develop recommendations for managing future public health crises.

Main Methods:

• In-depth qualitative case study utilizing semistructured interviews with 11 ED professionals.
• Qualitative content analysis of interview data, supplemented by design documents and photographic evidence.
• Focus on environmental responses within a large urban ED in the U.S.

Main Results:

• Key strategies included physical barriers, air filtration, airflow control, and alternative care spaces.
• Physical separation of patients was most effective, followed by air quality control.
• Challenges involved rapid changes with limited information and resources.

Conclusions:

• The physical environment is crucial for ED pandemic response and crisis preparedness.
• Recommendations include flexible building design (e.g., negative pressure, adaptable ventilation) and bottom-up decision-making.
• Hospitals should prioritize ventilation, security, and staff ergonomics in ED pandemic planning.