Time for Healthcare Reform: Part 1, It begins with Design and Construction

Oklahoma City Murrah Building

“We shape our buildings thereafter they shape us”                   - Winston Churchill

“There is not a person on the committee that intentionally tried to keep any efforts to add language for 'hardening’ our health care buildings out of the guidelines” – American Institute of Architects Spokeperson

The Federal Healthcare design and construction sector, following the lead of all other Federal sector construction, has built significant vulnerability mitigation into the design of their facilities. This has been in response to known hazards and threats directed at the continental landmass, including domestic and international terrorism, natural disasters and evolving infectious diseases (pandemic). To do otherwise would leave a trusting public unprotected.

Unfortunately, the non-federal hospital and healthcare sector has marched to a different drummer. The opportunities lost to build more robust structures which have the dual benefits of workplace protection from both mounting natural and manmade threats are incalculable. Designing structures which protect against known Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) events also protect against Pandemic flu and more frequent and powerful natural disasters.

Shock and Awe, A review of the 2006 American Institute of Architecture (AIA) Guidance for the Design and Construction of Healthcare Facilities.

Context of Known Threats: The 1st Twin Towers Bombing, The Oklahoma City Murrah Building Bombing, The 9/11 attack on The Twin Towers, FBI Notification of major Urban Medical Centers that they had been identified as the next target for Terrorism in weeks following 9/11, Serial intrusions into hospitals across the nation by groups using false ID from JCAHO and Homeland Security, Purchase and theft of Ambulances by buyers not in the business…

The 2006 AIA Guidance for the Design and Construction of Healthcare Facilities (Bible for The Non-Federal Healthcare Sector) reflected a pre-9/11 environment written for the halcyon days of the peace dividend. Lengthy conversations with review contributors from Federal Healthcare Agencies, Academic Architectural Experts, Distinguished Elder Architectural Statesmen, Healthcare Professional Organizations, State and Territorial officials, produced more heat than light. We came away in disbelief that 125 committee members reviewed the contents of a pivotal healthcare guidance document without surfacing the issue of protecting Healthcare facilities against hostile outsiders. We could not find any evidence that the publication had been vetted or reviewed by the Department of Homeland Security and took little comfort in the fact that our comments would be considered in the 2010 revision. We leave you with a not so reassuring spokesman’s statement, “There is not a person on the committee that intentionally tried to keep any efforts to add language for “hardening’ our health care buildings out of the guidelines”.

You decide!!! Jim