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Healthcare Design for Pandemic Resilience: A Systems Thinking Approach
Seyedehnastaran Hashemi1,2, Debajyoti Pati2
1School of Architecture, University of Nevada, Las Vegas, NV, USA.
HERD
|July 16, 2026
Summary
The COVID-19 pandemic highlighted how physical environments impact healthcare systems. Understanding these environmental factors is crucial for building resilient healthcare infrastructure for future health crises.
Area of Science:
- Healthcare Management
- Public Health
- Health Systems Engineering
Background:
- The COVID-19 pandemic presented significant operational challenges to global healthcare systems, including surge capacity and infection control.
- Physical environments within healthcare settings critically influenced the ability to manage these pandemic-related challenges.
Purpose of the Study:
- To identify environmental factors that either supported or hindered healthcare work systems during the COVID-19 pandemic.
- To inform strategies for strengthening healthcare system resilience in response to future pandemics.
Main Methods:
- A systematic literature search was conducted across major databases (CINAHL, MEDLINE, PubMed, ScienceDirect) and supplemented with handsearching.
- Forty-two English-language, peer-reviewed studies focusing on physical healthcare environments during COVID-19 were included.
- Findings were deductively coded using the Systems Engineering Initiative for Patient Safety (SEIPS) model, focusing on environmental influences.
Main Results:
- Six major operational challenges were identified: surge capacity, infection control, error risks, care model adaptation, financial losses, and psychological impacts.
- Environmental factors were found to act as barriers, solutions, or facilitators to healthcare work systems.
- Specific environmental influences on various components of the healthcare work system during the pandemic were documented.
Conclusions:
- The Systems Engineering Initiative for Patient Safety (SEIPS) framework offers a valuable tool for pandemic response planning.
- Design strategies informed by this framework can enhance resilience, flexibility, and safety in healthcare systems facing health crises.
- Proactive planning utilizing environmental insights is essential for future pandemic preparedness.
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