Lessons from the first wave of COVID-19 in Italy: A collection of design strategies to face pandemic situations in healthcare facilities





COVID-19, healthcare facilities, design for health, design guidelines, infection control, human-centered


Objectives: This study aims to provide metadesign indications for the improvement of healthcare facilities, emphasizing the role of spatial design in the management of epidemic health emergencies.

Study design: A parallel mixed-method study including literature reviews, survey creation, and survey distribution was performed.

Methods: Data were collected between August and October 2020 capturing information related to the first wave of the COVID-19 pandemic, utilizing a review of existing literature, a comparison of existing hospital planning guidelines and assessment tools, and distribution of a survey to analyze design changes within selected Italian hospitals.

Results: Among the changes identified, the most frequently identified included the conversion of space into intensive care units, space expansion, and the usage of wayfinding strategies for the reduction of cross-contamination risks. There was limited attention given to solutions with a human-centered approach, and those that addressed physical and psychological well-being of all users, including healthcare staff. The solutions were collected and systematized into a list of metadesign guidelines.

Conclusions: The resulting indications represent a starting point for developing design solutions to aid healthcare facilities in facing future epidemics.


Author Biographies

Andrea Brambilla, PhD

Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy

Erica Brusamolin, MSc

Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy

Alexander Achille Johnson, BS

Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy; Columbia University Vagelos College of Physicians and Surgeons, New York, New York

Francesco Scullica, PhD

Department of Design, Politecnico di Milano, Milan, Italy

Stefano Capolongo, PhD

Department of Architecture, Built Environment, and Construction Engineering (DABC), Design and Health Lab, Politecnico di Milano, Milan, Italy


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How to Cite

Brambilla, PhD, A., E. Brusamolin, MSc, A. A. Johnson, BS, F. Scullica, PhD, and S. Capolongo, PhD. “Lessons from the First Wave of COVID-19 in Italy: A Collection of Design Strategies to Face Pandemic Situations in Healthcare Facilities”. American Journal of Disaster Medicine, vol. 17, no. 3, Sept. 2022, pp. 227-44, doi:10.5055/ajdm.2022.0437.