• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.4
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• pp.69-77
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• 2023

Purpose: During the COVID-19 pandemic, there have been many cases of converting regular hospital wards into temporary negative pressure isolation wards. The purpose of this study is to evaluate the minimum airflow differences that satisfies the pressure difference criteria(-2.5 Pa) according to airtightness of switching type wards, in preparation for utilization of aging regular wards as negative pressure isolation wards. Methods: Visual inspection and field measurements were conducted using blower door to evaluate airtightness of 5 hospital wards. CONTAM simulation was used to assess the airflow differences when pressure difference between the corridor and wards met the criteria at various levels of airtightness. Results: The ACH₅₀ of evaluated wards ranged from 19.3 to 50.1 h^-1 with an average of 37.0 h^-1, indicating more than four times leakier than other building types. The minimum airflow differences increased as the airtightness of the wards decreased and the size of the wards increased. Implications: When operating rapidly converted negative pressure isolation wards, understanding airtightness is crucial for determining the minimum airflow differences to maintain the pressure differences. The analysis of this study suggests that improving the airtightness of aging rooms is essential and the minimum airflow differences should be suggested considering both the airtightness and size of rooms.

• Journal of the Earthquake Engineering Society of Korea
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• v.26 no.3
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• pp.127-136
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• 2022

Recently, an unprecedented emerging infectious disease has rapidly spread, causing a global shortage of wards. Although various temporary beds have appeared, the supply of wards specializing in infectious diseases is required. Negative pressure isolation wards should maintain their function even after an earthquake. However, the current seismic design standards do not guarantee the negative pressure isolation wards' operational (OP) performance level. For this reason, some are not included in the design target even though they are non-structural elements that require seismic design. Also, the details of non-structural elements are usually determined during the construction phase. It is often necessary to complete the stability review and reinforcement design for non-structural elements within a short period. Against this background, enhanced performance objectives were set to guarantee the OP non-structural performance level, and a computerized tool was developed to quickly perform the seismic design of non-structural elements in the negative pressure isolation wards. This study created a spreadsheet-based computer tool that reflects the components, installation spacing, and design procedures of non-structural elements. Seismic performance review and design of the example non-structural elements were conducted using the computerized tool. The strength of some components was not sufficient, and it was reinforced. As a result, the time and effort required for strength evaluation, displacement evaluation, and reinforcement design were reduced through computerized tools.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.61-69
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• 2022

Purpose: In response to the rapid spread of COVID-19 in 2020, the government supported facilities and equipment through the 'Urgent Isolation Ward Expansion Project'. Design and remodeling of efficient negative pressure isolation facilities had to be done in a short period of time, and the performance gap between facilities was very large because the types of hospitals and wards of existing medical facilities were diverse. In order to secure the stability of isolation wards between medical facilities and reduce the facility gap, guidelines for planning isolation wards considering the diversity of each hospital should be appropriately presented. In consideration of these points, this study aims to provide basic data for future remodeling guidelines for each plan type of the negative pressure isolation ward first. Methods: We analyzed the plans before and after the change of 13 case hospitals that performed the urgent care bed expansion project for COVID-19 confirmed patients. Before the remodeling, the current status of the facility was analyzed according to the type of corridor, the location of the nursing station, and the location of the elevator. After remodeling, the flow of medical staff and patients, the flow of entry and exit of clean and contaminated items, and the space of negative pressure and non-negative pressure areas. Results: The ward type was divided into three types according to the corridor type and room arrangement: double loaded corridor type with two side wards, race track type with one side ward, and race track type with two side wards. Based on these three types, the standard floor plan type of the isolation ward was proposed in terms of the location of the elevator bank and Nurse station. Implications: When the existing general ward is converted into a negative pressure isolation ward, this study can be a basic data to present customized guidelines for each ward type.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.4
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• pp.29-35
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• 2023

Purpose: The 2015 Middle East Respiratory Syndrome (MERS) outbreak and the recent COVID-19 pandemic have highlighted the lack of negative pressure isolation rooms and the fragility of the healthcare system. The need for healthcare facility transformation for respiratory infectious diseases has become more prominent due to COVID-19, and the purpose of this study is to provide a foundation for the rapid, economical, and safe construction of negative pressure isolation wards. Methods: This study analyzes the current status of hospitals that have been converted to negative pressure isolation rooms, and provides architectural plans and examples to provide a reference for bedroom change. Research data of this study have been obtained by analyzing the drawings of negative pressure isolation wards of nationally designated inpatient treatment beds and urgent isolation beds. In addition, the relevant literature of urgent isolation beds has been analyzed to derive bedroom change type. Result: In this study, a total of 21 isolation bed conversion methods have been presented. Implications: In order to change efficiently from a general ward to an isolation ward, it is necessary to consider the actual hospital's infectious disease transmission patterns and facility conditions.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.89-97
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• 2022

Purpose: Because of the recent COVID-19 pandemic, there have been many cases of using portable negative pressure unit to convert general wards into temporary negative pressure isolation wards. The purpose of this study is to analyze the indoor environment of the switching type wards. Methods: Field measurements and experiments were conducted in a medical facility. Air volume, wind speed and pressure difference were measured in non-occupant state. Dispersion tests were performed with gas and particle matter. Results: The pressure difference between the wards and the corridor was higher than -2.5 Pa in normal situation. However, in the gas and particle dispersion tests, it was found that there were concerns about the spread through leakages in low-airtight walls or ceilings. In addition, it was confirmed that the pressure imbalance in ducts through the non-sealed diffusers could cause back flow during portable unit operation. Furthermore, when there was a pressure difference between adjacent wards planned to be at same pressure level, the possibility of the spread through the leakages was found. Implications: When using portable units for making switching type wards, it is necessary to create airtight space and seal the non-operation diffusers. In case of operating the air handling unit, T.A.B must be performed to adjust the duct balancing.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.3
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• pp.37-44
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• 2023

Purpose: To decrease cross-infection, it's essential to analyze the spatial composition of the 'PPE doffing area'. Instead of solely relying on manpower standards, we should focus on responding to infectious diseases within the context of space planning. By doing so, we can lower the risk for healthcare workers' infection and ensure a level of safety in various environmental changes or new manpower input situations. Methods: This analysis is conducted specifically for facilities with negative pressure isolation wards. Additionally, interview surveys to obtain feedback from healthcare workers and incorporate their expertise into the design of the 'PPE doffing area' have been carried. Results: In a PPE doffing area, the standard spaces include a PPE doffing room, a shower room, and a clothing room. Depending on the facility environment or the level of infectious diseases, a Decontamination room or Anteroom can be optionally added. Healthcare workers who remove their PPE in the PPE doffing room should avoid re-entering the Negative pressure room. The shower room is often underutilized. When planning for a future PPE doffing area, an aisle space or passageway must be included even if a shower room is planned. Implications: This study examined the space used by healthcare workers rather than patients, with a focus on infection prevention through architectural planning rather than individual efforts. However, the investigation was limited to facilities that have been converted from general wards to negative pressure isolation wards, so it cannot be generalized to all infectious disease facilities.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.1
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• pp.65-69
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• 2023

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.3
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• pp.17-28
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• 2023

Purpose: This study aims to provide basic data for the future construction plans of the Infectious Disease Hospitals by analyzing the area composition and required room ratios in the wards and ICU of currently under-construction infectious disease hospitals. Methods: 3 Methods have been used in this paper. 1) This study conducted a literature review on major considerations and related guidelines for hospitals specializing in infectious diseases using existing data. 2) Based on the objects and activities of the hospital space, zones and areas were set for each department according to infection control. 3) Based on the established zones and areas, basic plan drawings of three hospitals specializing in infectious diseases currently under construction were collected and architectural drawing analysis was performed. Results: 1) Infectious Diseases Hospital must have a spatial organization that can accommodate patient isolation, infection control, efficiency of medical service, and changes. 2) Zones for infection control are divided into negative pressure and non-negative pressure zones based on airborne precaution isolation. It is divided into clean and contaminated zone according to class of cleanliness by Aseptic technique. Areas are classified by objects (patients, healthcare workers, supplies) and activities (access, medical treatment, support), and a system for organizing space is established based on this. 3) By analyzing the area composition of each departmental area, each required room, and each required space in the wards and intensive care units, it provides basic data for the spatial organization for architectural planning of the infectious disease hospital. Implication: It can be used as basic data when planning related facilities by analyzing the characteristics of the space plan of the required room according to the relationship between activities, movement lines, and operation plans based on user behavior.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.51-60
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• 2022

Purpose: This study aims to analyze and supplement the standards related to healthcare facilities, negative pressure isolation wards, and emergency treatment facilities. In addition, through environmental investigations, analysis of emergency remodeling cases centered on the structural and HVAC characteristics of healthcare facilities is conducted. Methods: Domestic and foreign standards related to healthcare facilities were analyzed. Field investigations and architectural drawing analysis of general and emergency treatment facilities were conducted. Results: Healthcare facilities have different space classifications and air conditioning methods depending on the site situation. Emergency treatment facilities are classified into cases where the HVAC system is remodeled and portable negative pressure unit is installed, and some facilities did not meet the standards for differential pressure and air change rate. Implications: When developing emergency remodeling technology, remodeling and safety evaluation guidelines, it is considered possible to propose clearer guidelines for emergency remodeling treatment facilities for infectious diseases in Korea by referring to the results of this study.

• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.3
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• pp.45-56
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• 2016

Purpose: The MERS(Middle East Respiratory Syndrome) outbreaks in Korea highlighted dramatically the failings of traditional hospital environment for controlling or preventing infections among both patients and healthcare workers. MERS is transmitted by droplets that can be airborne over a limited area. The point should be emphasized that MERS in South Korea was predominantly a hospital-acquired (not a community-acquired) infection, because approximately 93% of MERS cases were resulted from exposure in hospital settings. This paper tries to suggest the design guidelines of negative pressured isolation ward for the sake of proper control of severe respiratory infectious diseases. Methods: Literature survey on the design guideline and regulations of airborne infection wards in Korea, Europe U.K. and CDC of U.S. have been carries out. 4 special infection wards in Hongkong, Germany, Japan and Korea have been surveyed in order to make the best use of the experiences related to facility design and operations. Results: Operating system influencing the facility design, space organizations of infectious ward including required space and zoning, and circulations of patients, staffs and materials are proposed. Implications: The results of this paper can be the basic data for the design of the airborne infection ward and relevant regulations. Afterwards in-depth study such as the development of space standards for the single bedroom, locker room and so on could be explored.