Keeping Healthcare Workers Safe During a Pandemic: Evaluating Doffing Area Design for Safer Removal of Personal Protective Equipment.

Objective: This study proposes a user-centered methodology to quantify the design affordances of doffing spaces, focusing on the safety and efficiency of healthcare workers (HCWs).

Background: Doffing personal protective equipment (PPE) poses a significant challenge for healthcare workers (HCWs) due to the high risk of self-contamination. The physical design of the doffing area plays an important role in ensuring safety during this process. However, there currently are no established spatial metrics for assessing the design of doffing spaces.

Methods: Four doffing areas in two Biocontainment Units (BCUs) were evaluated using Functional Scenario (FS) analysis method. FSs, representing the spatial needs of key users (HCW and Trained Observer-TO) were developed based on observations, literature, and discussions with staff. For each FS, we defined quantifiable metrics for visualizing the user's needs and evaluating doffing area design performance.

Results: We defined 11 FSs (seven for HCWs and four for TOs) and 19 associated spatial metrics. FSs for the HCW focused on the prevention of self- and cross-contamination, as well as facilitating visibility, efficiency, and situational and process awareness. The FSs for the TO center on preventing self-contamination, promoting visibility and process awareness, and safe waste management.

Conclusions: The FS approach allowed for the quantification of doffing area affordances and evaluation of how they impact HCW performance, emphasizing design aspects that enhance safety and efficiency. The presented metrics and study findings are expected to inform the future design of spaces where doffing occurs and provide new guidance for improved doffing safety.