Healthcare Architecture In Post-COVID Pakistan: A Multi-stakeholder Perspectives On Resilient And Patient Centered Hospital Design

Abstract

The COVID-19 pandemic showed that Pakistan's health care infrastructure was already facing challenges, such as chronic overcrowding, lack of isolation beds, lack of ventilation, and the almost complete absence of architects in emergency response planning. Though the relationship of the built environment with patient's outcome has been well documented in international literature, however, the lived experience of healthcare professionals and architects has not been explored in Pakistan in post pandemic era. The study is based on in-depth, semi-structured interviews with three key informants, who represent the three different aspects of hospital planning, namely, design, clinical and administrative, senior government architect with more than 20 years of experience designing public-sector hospitals, an infectious disease specialist and a pediatrician, and a hospital administrator at a large tertiary care facility. The interviews were coded and analyzed using constructivist grounded theory methodology, which uncovered themes of infrastructural challenges, infection control, patient centered design, sustainability and interdisciplinary teamwork. Results indicate that Pakistan's hospitals are mostly reactive rather than proactive in design approach and that flexible and convertible space, natural lighting and ventilation, and architect-clinician collaboration are the most pressing problems that need to be addressed. The study attempts to present a contextualized approach for resilient patient centric healthcare architecture, inspired by the World Health Organization (WHO) guidelines and grounded in the resource, cultural and policy settings of Pakistan. The results have implications for architects, administrators of healthcare facilities, and policymakers who wish to design hospital facilities that will be future-proofed for subsequent public health crises.