By Douglas King, Contributing Writer

Over the last decade, the fast pace of technological advancement, the growth of co-located research labs and the expansion of medical centers in large urban cores have created high demand for vertical healthcare facilities. The COVID-19 pandemic also forever shifted the way healthcare facilities owners and executives think about infection control, patient isolation and emergency preparedness, paving the way for a new era of healthcare design and facility management. 

While this surge in high-rise hospital design is far from unexpected, it has been interesting to watch as healthcare facilities across the continent navigate the challenges and opportunities presented by expanding their reach into the sky. In the past, medical centers tended to grow horizontally. But when land is at a premium, healthcare facilities in major cities have found that using modern, high-rise hospital design tactics provide them with more space to grow and serve patients and make a real difference in their communities. 

Over the last decade, there also has been an expanded desire for research, education and clinical care services to be co-located under one roof. This bench-to-bed model in which research facilities are integrated with patient care areas has become a key driver of vertical hospital design, particularly within academic medical centers. Security is another emerging concern that can be addressed by high rise hospital design. 

For example, hospitals in São Paulo and Bangkok have found that vertical facilities are safer and more secure than horizontal medical facilities because it is much easier to limit traffic in and out of a building with one point of entry. 

Pandemic lessons 

The movement toward telemedicine and home care after the COVID-19 pandemic has pushed the medical industry toward vertical designs. Today, inpatient facilities are largely devoted to the sort of high-acuity, tech-heavy care unavailable outside of hospitals. 

Meanwhile, routine outpatient services that do not require a hospital setting are being increasingly decamped from the main hospital and into nearby facilities. This decentralization of care reinforces a hub-and-spoke model of service, which means more room is allocated to patients in need of acute care and on-site recovery while others can recover in the comfort of their own homes through virtual check-ins. 

Another large, post-pandemic lesson has been the importance of air filtration and pressure control in protecting patients and staff. During the onset of COVID-19, hospitals invested heavily in scalable air-handling systems that can adapt quickly when patient numbers surge. 

Throughout this chaotic international crisis, centrally located city hospitals such as Rush University Medical Center in Chicago had the importance of emergency planning underlined for them. While many other urban and high-rise hospitals had perhaps conceptualized scalable solutions prior to the pandemic, Rush officials had actually implemented scalable air-handling systems and intentionally created several areas in their ground-floor lobbies that could be easily reconfigured and converted into patient care units — two features that proved invaluable in 2020. 

While emergency-response planning became a higher priority during the pandemic years, the sense of urgency around preparing for future crises has faded. Fewer hospitals are making large-scale investments in emergency preparedness than even four years ago. Investing in the infrastructure necessary to make such transformations seamless and effective will be important for the success of future hospitals — many of which are exploring ways to make their spaces and air handling systems more flexible and resilient. 

Douglas King is emeritus vice president, healthcare, at PMA, a real estate project and development consulting firm.