Reshaping healthcare design in Hong Kong

Thinking

Re-shaping healthcare design in Hong Kong post-COVID19

The recent COVID-19 pandemic has affected healthcare systems globally and Hong Kong was not spared. The devastating impact of COVID-19 has superseded that of SARS, and has brought to light that infectious disease outbreaks are becoming more frequent and life threatening. To overcome the current challenges and spur economic growth, the Hong Kong Government has spent billions of dollars to battle against COVID-19 and to stimulate the economy.

Pandemic aside, Hong Kong is also one of the cities in Asia where the population is expected to have a long-life expectancy. It is set to rise from 85 years in 2021 to 88 years in 2050. With a growing ageing population and a need to put in place a robust healthcare network, the Hong Kong Government has implemented a 10-year Hospital Development Plan. This plan includes additional rehabilitation centres, general infirmary services for elderly, new hospital developments and existing public hospital redevelopments/expansions.

In response to the pandemic outbreak and challenges brought about by a growing ageing population, I started to reimagine how the future healthcare design will look like from a building services perspective.

Nimble solutions, smart technologies and safety drive future healthcare design

Even before COVID-19, the Hong Kong healthcare sector has been facing multiple challenges. Besides Hong Kong’s ageing population, other challenges include overcrowded hospitals, overstretched healthcare workers, increasing medical costs and growing waiting lists for access to healthcare.

According to the Food and Health Bureau of the Hong Kong Government, the total health expenditure in Hong Kong rose at an average annual rate of 5.6 per cent in real terms between 1989/90 and 2018/19.

To address these challenges and to be more resilient, incorporating innovation and digitalisation in building services engineering design has become integral to healthcare design. There is also an expectation from patients, staff and visitors to experience smarter and safer healthcare facilities with greater flexibility and efficiency in a post COVID-19 world.

Increasing flexibility in the use of space in healthcare facilities can play an important role in being able to react to future crises more rapidly and easily. Being able to convert wards/areas easily to cater to different needs allows hospitals to plan for changes quickly and more effectively, without interrupting patients and other day-to-day operations. For example, switching between ICU and high-dependency units, negative pressure/isolation with general wards, and between common areas and out-patient clinics, when needed, is essential going forward.

Aurecon took this approach when assisting Monash Health in Australia to quickly design and build a temporary resuscitation unit using prefabricated models to treat and isolate COVID patients, during an existing major reconfiguration and expansion

The pandemic has accentuated the need for a touchless environment and even more so at healthcare facilities. Today, people are cautious about what they touch, who they interact with and the distance between them and others. They welcome touchless technologies that have been installed in different facilities (e.g. lifts, displays, kiosks, doors) and electrical appliances (e.g. lights, air-conditioners, televisions).

Digital services are also becoming part of the new normal to mitigate the spread of COVID-19 and to reduce the transmission risk of infectious diseases in the future. Different digital services, such as video medical consultations, patient monitoring and visiting as well as digital check-in/check-out systems, can reduce waiting time and unnecessary interactions.

Hong Kong has recently started to develop telehealth services which has been proven to be effective in other markets such as mainland China, Singapore, Europe, the US and Australia. Incorporating digital delivery into medical facilities requires planning for additional ICT infrastructure which then opens up other opportunities to explore digital capability to not just deliver services but also to monitor and optimise infrastructure across the lifecycle of the facility.

Nimble Solutions, Smart Technologies and Safety

Key considerations when developing resilient and sustainable healthcare facilities

Smart and innovative building services engineering design can contribute to the development of resilient and sustainable healthcare facilities in Hong Kong. Healthcare developments should consider the following in the designs:

  • Increase fresh air supply and exhaust ventilation. The design needs to enable fresh air to be supplied from outside and air change rates can be increased as much as possible to ensure the circulation of clean and quality air. The design also needs to be able to support the longer ventilation operation time. This approach is now preferred in healthcare facilities, especially in high-risk areas such as toilets, where ventilation should be made available 24/7 to prevent faecal-oral transmission. The design needs to ensure that the air recirculation is avoided, especially during pandemics, and air discharged from negative pressure/isolation wards to outside is properly and effectively filtered.
  • Effective air filtration system. Subject to the location and surroundings of the healthcare facility, an air filtration system is needed to remove different contaminants such as airborne particles, microorganisms and infectious air from the outside air.
  • Room-air cleaners. Room-air cleaners must have at least high-efficiency particulate air (HEPA) filter efficiency to remove particles from the air. Special UV cleaning equipment is also effective at killing bacteria and viruses.
  • Innovation and smart design integration. Integrating advanced technologies in the design is imperative to facilitate touchless environment and digital services development. IoT, ICT, AI and apps are powerful digital solutions to increase operational efficiency. More importantly, they effectively prevent the spread of infectious diseases by eliminating face-to-face interactions and treatments.

Resilient and sustainable healthcare facilities

Achieving return on investment

While designing the best healthcare facilities in Hong Kong to meet future needs, demands and circumstances, we need to carefully find an optimal balance between best practices, the investments made in terms of cost and time, the design service life and the users’ learning curves to sustain the sector’s development.

Operating hospitals with greater flexibility and efficiency mean longer time is required for the design process as there are many careful and comprehensive considerations. This is not to mention the time spent on coordination with project stakeholders and local authorities. It is also important to evaluate the service life expectancy of the design before making a sound and clever investment.

Ensuring all users (i.e. doctors, nurses, staff, patients and visitors) are familiar with the operation and usage of different smart facilities, electrical appliances and technologies is crucial yet challenging. Sufficient training and guidelines should be provided to the users and ensure that on-site technicians have access to real-time guidance and support to ensure smooth, risk-free and injury-free operation.

To cater to the future needs of the healthcare sector, engineers have an important contribution to make by leveraging their knowledge, experience and technical capabilities to deliver smart, innovative and sustainable design. This will equip our healthcare sector to be prepared and resilient for the new normal and for the challenges that may come.


About the author

Patrick Mok has more than 35 years’ building services consultancy experience, both in engineering design and management in Hong Kong and mainland China. He has extensive experience in a variety of developments and redevelopments in healthcare, industrial, commercial, hotel, institutional and residential sectors. In particular, he is specialised in design and build projects.

Patrick has participated in the development of over 20 hospitals, clinics and medical centres and redevelopments, where he was the project director or project manager responsible for leading the whole team to ensure quality solutions were delivered.

Patrick has also been involved in other complex large-scale developments including Hong Kong – Zhuhai – Macao Bridge Hong Kong Boundary Crossing Facilities, Hong Kong International Commerce Centre and Macau Grand Lisboa.

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