Cross-Functional Hospital Rooms and Infection Control: New Ideas, New Challenges

Ever since the COVID pandemic, hospitals have become more adept at thinking outside the box, or rather, outside the patient room. For some hospitals, the pandemic meant converting waiting rooms into treatment rooms, while for others, it meant finding ways to access shared spaces without sharing germs. This experience, plus the added financial pressures faced by healthcare, is accelerating a trend for more cross-functional, multipurpose rooms in healthcare facilities. How will this trend intersect with infection control protocols? Let's try to foresee some potential benefits and risks.

In a healthcare setting, a cross-functional room (or multipurpose room) is a space that is adaptable to meet a variety of diagnostic or treatment needs. In some cases, uses vary depending on the patient and can be flexible on a moment-to-moment basis.  Flexible spaces are those that can be used multiple ways quickly, often with the same patient. In other cases, the infrastructure of a room is such that it can easily be retrofitted or refitted to adapt to changes that take place over weeks or months. Adaptable spaces are those that can be modified as needs change for the facility, but require construction and can be considered semi-permanent.

There are many potential benefits to this kind of design with change in mind. Patients prefer to stay in one area, and fewer movements around the facility and fewer hand-offs do lead to lower risks. If healthcare workers can move smoothly from one procedure to the next, then there is less downtime for staff and spaces and more procedures can be done during the same visit. Adaptable spaces can accommodate changes in community demographics, including health emergencies.

There are also logistical and financial obstacles that arise from multifunctional or cross-functional spaces. It can be expensive to stock rooms with more equipment and supplies to meet multiple specialties, especially at first. Innovative furniture like chairs that take vitals and beds that adjust to a huge range of settings are expensive and may require significant upkeep. Facilities also need to have a streamlined, real-time electronic records and scheduling software to help manage all the rooms, equipment, and specialists.

One of the most significant considerations for a facility implementing more multifunction spaces is infection control and prevention. When a space is used by many different departments, there can be a lack of "ownership" when it comes to cleaning and maintenance. If room use is maximized, that means there is less time to clean between patients. This restricted cleaning time will impact the contamination levels of every multifunction room, especially if rooms are used for blood sample collection, wound cleaning, and other procedures that would normally take place in specialized spaces. The contamination levels of these rooms would quickly reach dangerous levels, where transmission is likely.

One way to mitigate the buildup of contamination (bioburden) in a multifunction room is to make sure the rooms are furnished with biocidal surfaces on armrests, workstations, bedrails, and overbed tables. The more surfaces that have the ability to continuously and actively kill harmful bacteria without additional human intervention, the lower the contamination levels. Research shows that copper-infused EOScu, for example, can keep bioburden levels in the benign zone, where transmission is at its lowest risk, between sporadic cleanings, even after recontamination. With so many patients and staff coming in and out of a room, the use of biocidal surfaces is essential to keep bioburden levels at a safe level.

For some facilities, multifunction or cross-function rooms will be a logical next step to serving the community. It may be that urban locations, where space is at a premium, will begin to adopt this design objective. Rural areas, which need to accommodate a range of possible health conditions with reduced staff, might also see the benefit of this approach. For these, and any other situations requiring rooms be used by more people, more often, and for a range of procedures, the topic of infection control and prevention must be taken into consideration.