What the Post-Pandemic Hospital Might Look Like

When the first crush of Covid-19 patients overran New York’s Mount Sinai Hospital in March 2020, Neel Shah witnessed the harrowing scenes virtually, following clinicians wearing head-mounted GoPro cameras as they made their hurried rounds. Shah, an obstetrician who heads the Delivery Decisions Initiative at Ariadne Labs in Boston, was shocked by what he saw. Despite the need to isolate infectious coronavirus patients from the rest of the hospital, doctors and staff frequently blew past the boundaries that were supposed to separate Covid patients from the rest of the hospital. They weren’t intending to spread infection; the isolation regime was simply incomplete, and incompletely understood.

Ariadne Labs, a center for health systems innovation affiliated with Boston’s Brigham and Women’s Hospital and Harvard’s Chan School of Public Health, was brought in to help Mount Sinai manage the pandemic’s terrifying first wave. Working with the nonprofit MASS Design Group, Shah and Ariadne worked to establish unmistakeable thresholds in Sinai’s Covid ward, with doors, bright warning graphics and places to don and doff personal protective equipment.

That experience provided an early demonstration of how an unprecedented infectious disease crisis would change how hospitals operate. But it was far from the last. Over the course of the past year, the pandemic exposed the weaknesses of a fractured U.S. health-care system, serving up horrifying scenes of frantic clinicians running among patient beds parked in hallways, families saying goodbye to loved ones via iPad, and refrigerator trucks stacked with bodies because funeral homes are full. “Covid has taken every inequity in society and thrown them into a pressure cooker,” says Shah.