In a parking lot next to a hospital in an Atlanta suburb, dozens of modular critical care units—made in a factory and delivered by truck—are being installed to help add space as COVID-19 cases continue to grow.
The prefab system, called STAAT Mod (Strategic, Temporary, Acuity-Adaptable Treatment), has the same complex features as standard hospital rooms. But while traditional construction of an intensive care unit might take 12 to 24 months, this can be put in place in just a few weeks. “This goes together like a series of Legos or an erector set,” says Kurt Spiering, principal and healthcare market sector leader at HGA, the architecture firm behind the design. “That was really the challenge: How would you create something that’s repeatable and modular, but something that has infinite variations, so it could be adapted and assembled in any different arrangement?”
In March, as coronavirus lockdowns were beginning in the U.S., a construction firm called the Boldt Company reached out to HGA—which designs hospitals—and suggested partnering on prefab modules. The need kept getting clearer. “We started seeing tents go up,” says Kate Mullaney, national healthcare market strategist at HGA. “Everyone saw New York City put tents in Central Park, and people were pretty horrified—’Oh, my God, is that where I’m going to end up?’ We also knew that just wasn’t the level of clinical quality that critically ill patients need.” Some others were trying to retrofit shipping containers, but those designs didn’t meet the standard that the Centers for Disease Control and Prevention was recommending for COVID-19 patients, called airborne infection isolation rooms.
Hospitals, with complex requirements for air quality and clinical equipment, are not easy to build, and that’s especially true when all of the components have to fit on trucks. “We had to analyze what we do from our traditional, critical quality requirements in healthcare and how we do our process work, and then make that all fit inside a box,” says senior associate Kyle Weisman. As the design has evolved over the last several months, and the architects realized that hospitals would want to use the units beyond the COVID-19 emergency, more components are now integrated into the frame of the building, so it can meet standard code requirements and look as streamlined as possible.
The modular units—which were first tested in part by critical care nurses using virtual reality—come with two patient isolation rooms and bathrooms. Other units have room for healthcare workers to take on and off protective equipment, along with electrical distribution panels. Everything can be configured to meet the needs of a particular site; the system can be placed outside or within a larger building like a convention center. Two systems have been installed in cities in Maryland so far, with another in process in Baltimore. Spiering says some healthcare workers have told the architects that they’re an improvement over the current hospitals. “It’s older hospitals, and most of them are ‘under-bedded’ . . . These are better equal to or better than, in most cases, the clinical quality and the space that they’re working in now.”
In the hospital near Atlanta, called Northside Hospital Gwinnett, 71 isolation rooms are being put in place outside. “They had a big, open parking lot they can land these things in,” Weisman says. “And I would say that we have maximized, to the foot, that site of getting as many beds as possible on it.” The hospital, in an area where the population is quickly growing, needed to add capacity even without COVID-19. As coronavirus cases surged in the area in the summer, the team reached out to the architects, who worked on customizing a design. Fabrication took about a month, and modules began to be installed in September. The whole new “wing” of the hospital will be complete in December. (Hospital management did not respond to a request for an interview in time for this article.)
As cases surge elsewhere now, other hospitals could move quickly to install similar systems if needed. “Within three weeks, we can have them on the road,” says Spiering. “They take a week or so to get to the site. It takes another six weeks or so to actually install them when they show up to the site and get utilities there and become operational. In 8 to 10 weeks, we could have a 16-bed unit fully operational and ready to go.”