Global crises expose systemic weaknesses in medical infrastructure as evidenced by the COVID-19 pandemic, which rapidly overwhelmed the capacity to deliver medical services. To offset this, the Department of Defense provided a grant, challenging groups to imagine an overseas conflict that would bring 1,000 wounded service members back to the U.S. for 100 days straight. Davis Partnership Architects partnered with the University of Colorado School of Medicine team and National Disaster Medical Service to research how we could transform a nearby hotel into an extension of the hospital to handle this imagined surge.

Davis Partnership Architects had the opportunity to create multiple Alternate Care Facilities (ACF) during the COVID-19 pandemic including the Colorado Convention Center in Denver, Colorado and a tent-based solution for White Memorial Hospital in Los Angeles. Their experience was key in developing the concept for turning an existing hotel into a functional hospital. As part of this research, the team developed the Hotel2Hospital (H2H) Conversion Playbook, a comprehensive guide for architects, engineers, and hospital emergency management professionals to create patient-ready spaces in 2-4 weeks, functioning as an integral “wing” of an existing hospital. The playbook includes: criteria for the assessment and selection of suitable hotels, the process for selecting partner hotels, room conversion design for patients and ancillary support services, necessary clinical equipment, and the variances that could be required by authorities having jurisdiction. The Playbook also includes an approach to converting a partner hotel back to its original function and condition after the surge has passed.

After 18 months of research and Version 1 of the Playbook published, the team entered the “proof of concept” phase which involved construction at the Hyatt Regency Aurora-Denver hotel. The team partnered with GH Phipps Construction to build two intensive care units, a medical/surgical patient unit including care giver support spaces, a laboratory, imaging, and pharmacy spaces using the Playbook as a guide. The goal was to prove that the team could build and ramp up this ACF within 2-4 weeks. Once operational, the team conducted a series of day-in-the-life exercises with key partners, including UCHealth and the National Disaster Medical Service, to validate the Playbook’s functionality. The results were overwhelmingly positive.

Today, the hotel is back to its original condition, and the Playbook is available as a national resource. Version two is currently being finalized to document the lessons learned from the completed demonstration unit. Davis Partnership Architects has recently been selected to continue this critical work, by exploring the use of widely available mobile homes as another option to create alternate care facilities to be more proactive, than reactive if the need for future medical surge space is needed.

Photo by Shelli Foth, credit to “The Unfound Door”