Highly specialized venues equipped in a very short time

3 June, 2020

MODULAR HOSPITALS

Los hospitales de campaña tienen como objetivo poner a disposición del sistema de salud camas con insumos médicos suficientes para poder atender la gran demanda de pacientes que necesitan atención especializada, dado el escenario de la pandemia que estamos atravesando. By: Romina Jaramillo di Lenardo

Modular hospitals mainly meet two basic conditions, explains Pablo Pulgar, architect and academic from the Department of Construction Sciences Utem: “The first is the speed with which an emergency is responded to by enabling highly specialized and equipped facilities in a very short time. term, with technological solutions adjusted to the situation. The second is that they can be located in places that must only meet some minor conditions, for example, complex temporary works, soil improvements or large earthworks are not involved, generally close to permanent service centers of varying complexity, decongesting the situation. inside these large hospital complexes”, emphasizes Pulgar. Given the current context of the COVID-19 pandemic, the high speed of spread of the virus given its conditions of permanence on different surfaces and in closed spaces without ventilation, make this prefabricated solution allow patients to be sectored and isolated more easily at different levels. of the disease, protect personnel in the health area and patients who must attend public and private care centers for other reasons.

A challenge for the country

Regarding the installation time of this type of enclosure, Francisco Lagos, academic of Civil Construction of the U. Mayor, states that it will depend on the square meters that are required to be installed. And that goes hand in hand with studying well how many beds are required to be made available to the health system. “For example, for the Sótero del Río modular hospital, which has an area of approximately 1,500 m2, its fitting out was in a range of time execution between 60 consecutive days, which gives us a performance of 25m2 per day, which which is a very beneficial result for the country. It should be noted that the Minsal enables five modular hospitals throughout Chile, which began their work in the fortnight of March, and there are some that are already ready to receive patients with COVID-19. This is quite a challenge for our country”, emphasizes the professor of the U. Mayor.

international cases

There are different success stories worldwide in this type of infrastructure. “The most surprising and recent is the emergency hospital set up by the Chinese government in Wuhan, the epicenter and origin of the pandemic, where 1,000 beds were set up in 10 days. In April Russia carried out a similar work in 15 days”, says the architect Pablo Pulgar.

Trend in field hospitals:
An efficient solution to respond to various emergencies

Chile is a seismic country. Perhaps for this reason, modular or field hospitals are not something new. However, under the COVID-19 crisis they have become more relevant. By: Jorge Aliaga Sandovala

An architectural trend that stands out is modular construction. In the case of emergencies, modular or field hospitals have been implemented that come from the military world, and that allow having the ideal infrastructure for hospital care. Among its main advantages is the possibility of offering a quick solution to the high demand in the healthcare network, especially in critical times, such as a natural disaster or the current COVID-19 pandemic. It is also reusable, adaptable and flexible, it can be disassembled and reused or relocated for other later uses. Likewise, modular hospitals can be thought of from their origin as a definitive or transitory modular solution. They have the necessary technology to withstand inclement weather, such as strong wind, snow or torrential rain. Also, they have a lower cost compared to other alternatives and allow them to be used in less time, since a hospital construction involves long-standing processes and stages. In our country there are several companies that offer highly advanced solutions ranging from construction, assembly, engineering and design, logistics, operation, maintenance, among others. Depending on the company, they can have a varied infrastructure, capacity and furniture, such as bathrooms, access ramps, service boxes, connection to electricity and drinking water, etc.

Primary and intermediate care

According to Consuelo Menéndez Gac, architect, specialist in hospital infrastructure and president of Hospital Infrastructure, there are many types of modular hospitals. “It is a type of clean construction and quick assembly. It can be used in extreme areas to lead multidisciplinary groups and bring health to people in remote areas, it can be used as primary health and intermediate care”, explains the also past president of the Chilean Association of Architecture and Hospital Specialties A.G. (AARQHOS).

“With the appearance of COVID-19, we have been able to verify the speed provided by modular sanitary construction. According to prominent epidemiologist Zhong Nanshan, opening additional hospital spaces has been crucial in reducing infections. The lack of rooms has forced COVID-19 patients to return home, something extremely dangerous, so having additional hospital beds has become a vitally important need”, explains Cristián Goldberg, Rental & Home manager. of Tecno Fast, a company specialized in the field.

He adds that these centers can be delivered in the form of sale or temporary rental, with different options of equipment and finishes. “All our buildings comply with current Chilean construction regulations, with the advantage of speed, quality, efficiency and sustainability,” he details.

Some of the solutions that Tecno Fast offers are, from a complete hospital (Transient Hospital of Salvador in Santiago) with care rooms, laboratory, morgue, psychiatric care, ophthalmology, among others. In addition, solutions that include emergency rooms, ICU, ICU, X-ray rooms, etc.

Currently, the Government has announced the implementation of various field hospitals to face the health crisis, generated as a result of the Coronavirus. Undoubtedly, modular hospitals are a good alternative to deal with emergencies and epidemics, offering timely care, considering that in the face of crises, where people’s lives and health are at stake, the most valuable thing is time.

Materials and structure
What characteristics do modular constructions have?

One of the main elements that the installation of a modular or similar hospital must consider is the adaptation to the spaces according to the needs and use that will be given to it. By: Nicole Venegas Reveco

As a result of the health emergency, various construction projects for modular hospitals and auxiliary modules began to emerge and be carried out, the purpose of which is to prevent health services from becoming congested and people can be treated before entering the hospital itself, the which may be more likely to be infected.

Alastair Aguilera, an academic from the Faculty of Architecture and Urbanism of the University of Chile, was one of the members of the team that carried out the technical registration of the Campaña Hospital installation at the Dr. Sótero del Río Hospital, which will eventually serve to move it to another area quickly and efficiently. The expert also coordinated the so-called Zone Zero project, related to the construction of auxiliary modules in hospital facilities.

The FAU academic affirms that one of the greatest requirements for this type of facility is that “it be flexible for the requirements that just now change every day.”

This is how the versatility of the module will depend on what is required in that space. “I believe that the minimum dimension should be the stretcher and it will also obviously depend on the type of complexity. A pavilion requires much more space, because it has many more tools, than a consultation or a quick service box”, says Aguilera.

Construction materials

In the case of the Zona Cero project – a shed that contemplates approximately five meters wide by 20 long – the auxiliary modules were destined as a segregation space for patients with respiratory pathologies. This space includes a waiting area, an area for registering and classifying the patient’s pathology, a waiting area for taking vital signs, and a care and referral area that will be determined according to the patient’s severity classification.

The project – whose first prototype should be built on June 15 – uses a prefabricated system that includes one piece, which allows adaptation to the size of the hospital complex.

Regarding the construction materials, the FAU academic affirms that, in the case of this particular project, “washable, sanitizable steel is being used, which has high resistance to chemicals and pressure washers in sanitization processes with chlorine. or ozone. They are prepainted steel plates, the ones that are working today”. In addition, the projects they work on include “galvanized steel and expanded polyethylene, which is a panel that can have different thicknesses depending on the area and environmental requirements, but which allows quick assembly and easy assembly,” he adds.

Another of the characteristics that a project of these characteristics must have are security measures, such as ventilation, resistance to rain, the possibility of varying thermal insulation, according to geographical requirements, and universal accessibility.