National Hospital Organization Kyushu Medical Center
[Event Report] 9/13 Web Symposium “Infectious Disease Response City: What Will the Future Look Like?”
Preparing for the Next Pandemic What are cities and medical/nursing care facilities that are resilient to emergencies?
National Hospital Organization Kyushu Medical Center (Location: 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Director: Shigeki Morita,
hereinafter referred to as “the center”) held a web symposium on September 13, 2022. Infectious disease response city: What will the future look like?” was held.
The symposium was a place to discuss the “future of urban planning” from multiple perspectives, not limited to “infectious disease control”, with officials from Fukuoka City Hall and Naito
Architectural Office. I will send you that report.
What is the web symposium “Infectious disease response city: What does the future look like?”
・Date and time: September 13, 2022 (Tuesday) 17:30- (online format) ・ Target audience: Staff involved in future planning of medical and nursing care facilities, administrative staff involved in pandemics and disasters
The pandemic exit strategy for the new coronavirus has reached the stage of discussion, and preparations for the next pandemic that summarizes the responses so far are required. As we explore
medium-term responses, we will deepen discussions from the perspective of construction and urban planning on what kind of medical and nursing care facilities should be resilient to pandemics and disasters, and what kind of urban development is required in emergencies. The purpose was to
Opening remarks Soichiro Takashima (Mayor of Fukuoka City)
1. The future of medical facilities and nursing care/welfare facilities 1. How were temporary medical facilities constructed and functioned? Chiharu Okada (Deputy Director, National Hospital Organization Headquarters)
2. How should hospitals be designed in the near future? Masaki Fujita (Deputy Director, Fukuoka University Hospital)
3. What kind of support is required for nursing care and welfare facilities? Yuki Kinugasa (Director, Health and Medical Care Department, Health Insurance and Medical Care Bureau, Fukuoka City) 2. How to create facilities and towns that are resistant to infection and disasters?
4. What is important for designing medical and nursing care
facilities? Kunio Kawasaki (Naito Architectural Office Tokyo Headquarters Planning Department)
3. Infectious disease response city concept
5. Aiming for an international city that is resistant to infectious diseases Hiroyuki Yoshida (Fukuoka City Economy, Tourism and Culture Bureau Director)
4. General discussion Discussants: Speaker and Yasuko Arase (Deputy Mayor of Fukuoka City)
Closing remarks Shigeki Morita (director of the center)
◆ Background of the symposium
A web symposium on the new coronavirus hosted by the Kyushu Medical Center. The first is “Update on the response to the new coronavirus in the Fukuoka area (https://infection.hosp.go.jp/event/event6.html)” to share the response status of each medical site, and the second is G – “How to connect G-MIS and on-site coordination function?” This time, the 3rd time, we co-sponsored with Fukuoka City to discuss future hospital construction and city planning with the theme of “Infectious disease response city: What is the future?” This is a symposium that comprehensively develops from on-site experiences to discussions on the future in response to the pandemic.
The reason why the theme of the 3rd conference was to focus on urban planning is that it is important to coordinate medical functions and urban functions in order to respond to a pandemic such as COVID19. For example, it is necessary to physically transport a seriously ill person to a medical facility, and it is important to shorten the time. Based on the fact that not only the design of individual hospitals but also the total design of the city as a whole is necessary, we planned a place to discuss urban planning and medical care with experts who have various perspectives.
◆ Contents of the symposium
1. How were temporary medical facilities constructed and functioned? (Chiharu Okada, Deputy Director, National Hospital Organization Headquarters)
From March 10, 2022, the National Hospital Organization Tokyo Hospital has started operating a temporary facility specializing in corona. [Image 2
Drawings of the actual facility
▼Advantages of temporary facilities
Hardware: Easy zoning for negative pressure, positive pressure, etc. Intangible aspects: There is no turnover of doctors and nurses, which tends to occur in specialized hospital facilities.
▼ Disadvantages of temporary facilities
Hardware aspect: The maintenance period is unclear, but since it is a temporary building, it will need to be repaired repeatedly even after construction. Equipment problems also occurred.
Intangible aspect: It is extremely difficult to maintain a certain level of function of dispatched doctors and nurses for a long period of time. (Limited to half a year)
Temporary medical facilities are useful for disaster response in the short term. However, in the long term, it is still essential to prepare a normal medical response system. For that reason, is the “short term” that can be endured half a year? 1 year? Based on this, further discussion is necessary in the future.
2. How should hospitals be designed in the near future? (Fukuoka University Hospital Deputy Director Masaki Fujita)
At Fukuoka University Hospital, during this pandemic, the existing ward was converted to a corona-specialized ward. However, since it is an emergency response, it is difficult to set zoning and
negative/positive pressure. In response to this situation, we are proceeding with the design of the new hospital, which was planned even before the corona crisis, with consideration of pandemic response. (Scheduled to open in spring 2024)
In addition to the layout of the entire ward, each ward has at least two negative pressure rooms (direct access from a dedicated elevator) for normal times, the floor is designed on the premise that the respiratory medicine department will be converted to a specialized ward in the event of a pandemic.
3. What kind of support is required for nursing care and welfare facilities? (Yuki Kinugasa, Manager, Health and Medical Care Department, Health Insurance and Medical Care Bureau, Fukuoka City) In the 7th wave, out of a total of 200 clusters at high-risk facilities (medical institutions, facilities for the elderly, facilities for the disabled) in Fukuoka City, 127 cases occurred at facilities for the elderly, accounting for more than half. Elderly people are at high risk of serious infections, including influenza, so there is an urgent need to strengthen measures at nursing homes. [Image 5
In response to this pandemic, the problems and necessary points for responding to infectious diseases have been clarified (see above). However, since nursing homes are nothing more than “places for living,” it is necessary to discuss the balance with the functions required during normal times.
4. What is important for designing medical and nursing care
facilities? (Kunio Kawasaki, Planning Department, Naito Architectural Office, Tokyo Head Office)
In response to this pandemic, 24 temporary wards have been set up across the country, as well as a large recuperation center in Osaka. [Image 7
Mr. Kawasaki has actually been involved in the construction of multiple projects, and comparing each facility, the following stages are necessary for the construction of an infectious disease ward. ▼ How facilities should be prepared for the next infectious disease Clarify the infectious diseases targeted by the hospital
Clarify the scope of the target hospital (prevention of hospital infection, acceptance of suspected patients, response to confirmed patients by symptoms, etc.)
Zoning (clearly demarcated zones and one-way traffic lines for medical personnel and goods)
create gradual airflow
Preparing for a gradual increase in the number of infected patients Plan based on the summary table of infectious disease countermeasures (measures for each infection route such as contact infection and droplet infection)
In preparation for the next pandemic, Mr. Kawasaki made the following proposals regarding infectious disease wards.
Design so that it can be handled permanently rather than temporarily (because even temporary construction takes a considerable amount of time and money, and there are limits to functions)
Securing financial resources such as subsidies
In normal times, it should be possible to use it freely (not covered by insurance, but for emergency storage, student training, temporary relocation during hospital renovations, etc.)
5. Aiming for an international city that is resistant to infectious diseases (Fukuoka City Economy, Tourism and Culture Bureau Director Hiroyuki Yoshida)
In thinking about measures against corona, the balance with economic activity has always been discussed. In order to achieve both of these goals, Fukuoka City has come up with the concept of an “infectious disease response city.”
In Fukuoka City, several rebuilding projects are underway for aging buildings in the center (Tenjin Big Bang, Hakata Connected), and the value of offices will be redefined in the future. While the spread of online has progressed due to the corona vortex, the value of people gathering has been re-recognized. From this perspective, it is necessary to create a more attractive office environment, and infectious disease control is one of them. Taking advantage of deregulation under Fukuoka’s special zone system, the city’s unique incentives of adding floor area ratios to construction plans that utilize ventilation capacity above the standard value and technologies that can be operated without contact will help prevent infectious diseases. We are taking countermeasures.
General discussion (speaker and Deputy Mayor of Fukuoka City Yasuko Arase) In response to this pandemic, Director Morita presented the
requirements for medical and nursing care facilities in an emergency (see below).
▼Requirements for medical and nursing care facilities in future emergencies (infections and disasters)
Increase persistence (medical facilities)
Design considering infection zoning (medical and nursing care facilities) Understanding the principle of “do not enter, spread, and destroy” (especially in nursing homes)
Securing a holding area (medical facilities)
・Emergency clinic, hospital lobby, parking lot, adjacent open space Hardware and software for treating clusters at your own facility (nursing facility)
Measures to promote efficient allocation of medical facilities and division of roles in city planning (infectious disease response city) In response, Mr. Arase explained Fukuoka City’s initiatives related to nursing homes.
First of all, in order to prevent entry in 3., we are distributing antigen test kits and masks to all elderly facilities in Fukuoka City. Next, we are building a system in cooperation with the Fukuoka City Medical Association in order to prepare the recuperation environment for 5. Because medical care cannot be provided at facilities for the elderly, and it is currently not possible to provide end-of-life care for patients with infectious diseases, they have no choice but to be transported to emergency hospitals when they develop symptoms. However, there are many people who are hospitalized in each facility, and the treatment period tends to be long, so it is easy for emergency hospitals to become tight. Therefore, we are adjusting the system to promptly transfer or return to the facility at the appropriate time. In addition, discussions are underway, including with medical personnel, on how to provide medical care in facilities for the elderly, which are “living spaces” in the future.
From the 6th wave to the 7th wave, the number of elderly hospitalized from nursing homes increased and hospitals were overwhelmed. Furthermore, when so many patients visit at the same time, it is important to secure a physical area as in 4., which functions as a buffer in addition to the system. Generally, it is handled in the lobby, etc., but in response to a pandemic such as this time, the use of parking lots and the design of open spaces (parks, etc.) in the vicinity should also be considered (can be used as a heliport in an emergency). . There was a discussion on the need to respond on a city planning scale, including measures to organically connect existing medical facilities and placement of medical facilities in 6. [Image 13
In addition to this, the discussion progressed with questions and answers from the speakers, such as the management policy and personnel system for emergencies, and the balance between building elements and management for hospitals that can respond to infectious diseases in the future.
Even after the coronavirus converges, it is not possible to predict what kind of situation will occur, not limited to infectious diseases. Responding to such situations requires flexibility in urban design and facility planning. The pandemic has made it clear that emergency situations cannot be handled without some degree of redundancy. In addition to pursuing efficiency, the future challenge is how to ensure that redundancy. To that end, it will be important to continue to have opportunities to deepen discussions by incorporating a great deal of knowledge and on-site experience.
National Hospital Organization Headquarters Deputy Director
Responsible for setting up and maintaining temporary facilities at the National Hospital Organization Tokyo Hospital. Sharing practical experience in planning and operating temporary facilities during the spread of infection.
Fukuoka University Hospital Vice Chairman
Experienced the rebuilding of Fukuoka University Hospital during the corona crisis (currently under construction). Lecture on the design of a large hospital based on infectious disease control.
Director, Department of Health and Medical Care, Health and Medical Care Bureau, Fukuoka City
Jurisdiction and guidance for infections and clusters in nursing homes. He has a deep knowledge of not only medical care but also nursing care.
Naito Architectural Office Tokyo Headquarters Planning Department He has a wealth of experience in architectural planning for COVID-19, including multiple experiences in the construction of medical facilities, especially temporary medical facilities.
Fukuoka City Economy, Tourism and Culture Bureau Director
Involved in multiple redevelopment projects in the center of Fukuoka City. We are promoting urban planning aimed at balancing pandemic countermeasures and economic activities.
Deputy Mayor of Fukuoka City
After graduating from medical school, served as director of the Health and Welfare Bureau in Fukuoka City. He has cross-cutting knowledge of municipal administration, medical care, and insurance welfare. [Center Overview]
Name: National Hospital Organization Kyushu Medical Center
Director: Shigeki Morita
Location: 1-8-1 Jigyohama, Chuo-ku, Fukuoka City
Established: July 1994
Functions: medical care, research, training
Number of beds: 702 beds (650 general beds, 50 psychiatric beds, 2 infectious disease beds)
Number of employees: 1,353
Phone number: 092-852-0700 (representative) HP: http://www.kyumed.jp/index.html Details about this release: