An isolation ward’s architectural blueprint for prompt infectious disease prevention

Abstract

Background

The community epidemic prevention in the post COVID-19 requires the prevention to respond quickly to changes in the epidemic and immediately initiate on-site isolation. A system for rapid prevention and control of infectious diseases is built systematically, forming a comprehensive epidemic prevention method, and to achieve the application of the system by proposing a new architecture scheme (isolation wards).

Methods

The paper starts from the theoretical framework of epidemic prevention across preventive medicine, architecture, and mechanical engineering. Through interviews with medical staff in healthcare institutions and preventive medicine experts in public health institutions, the Grounded theory is used to deeply analyze the composition system and key factors.

Results

The architectural blueprint is composed of community epidemic prevention as the core, consisting of physical realization & supply system, preventive medicine system, and spatial & functional system. The study identified eight major influencing factors related to the isolation and epidemic prevention system, including the application scenarios and management considerations of isolation wards within communities, the relationship between isolation wards and surrounding community environments and facilities, as well as key aspects of manufacturing and implementation technologies for isolation wards. The small foldable isolation ward will serve as the core material carrier of the prevention system, mainly composed of three key elements: support structure, use unit, and equipment support.

Conclusions

The realization criteria, multi-unit combinations, application scenarios and distribution models of isolation wards are also explored. The proposed plan of interdisciplinary collaboration significantly boosts the overall performance of the isolation program and overcomes challenges that community epidemic prevention and control face.

Clinical trial number

Not applicable.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-14999-w.

Introduction

During infectious disease outbreaks, social distancing alone is often insufficient to interrupt transmission. For highly contagious and rapidly spreading infectious diseases, physical isolation measures are required [1, 2]. In the face of the continuing threat posed by newly emerging and sudden infectious diseases, infectious disease prevention and control has evolved from a purely public health and medical issue into an interdisciplinary challenge that also requires the integration of architectural engineering technology [3, 4]. A key challenge is improving the ability of buildings to support both routine and emergency use, thereby enabling the immediate and efficient implementation of physical isolation measures during emergencies. In particular, improving the ability of community healthcare buildings to support both routine and emergency use, such as community hospitals and healthcare service centers, is critically important because these facilities serve as the frontline infrastructure for grassroots epidemic prevention and control [5].

Community healthcare buildings constitute the first line of defense in infectious disease prevention and control [6, 7]. However, such facilities commonly suffer from problems including limited functional diversity, rigid spatial layouts, and outdated hardware infrastructure, making them insufficient to meet the operational demands of effectively controlling disease transmission during outbreaks and epidemics. In some cases, these limitations may even increase the risk of cross-infection [8]. Constrained by limited spatial resources as well as insufficient human, material, and financial investment, traditional approaches such as renovation and expansion are often characterized by long construction periods and high costs, making them unsuitable for rapidly strengthening grassroots epidemic prevention and control capacity [9]. Therefore, this study focuses on how to enhance the flexibility and resilience of existing community healthcare buildings for infectious disease prevention and control through dual-purpose spatial and functional design strategies, without altering the main building structure.

During the COVID-19 pandemic, three major approaches were commonly used for epidemic isolation: temporary centralized hospitals, conversion of existing buildings, and large-scale movement restrictions. Temporary hospitals can rapidly increase isolation capacity, but patient transfer and material transport may increase infection risks [10, 11]. Converted buildings can provide additional isolation space in a short time, but most lack appropriate ventilation and infection-control systems [12, 13]. Large-scale movement restrictions can reduce transmission, but prolonged restrictions may significantly affect daily life and community operation [14, 15]. These limitations highlight the need for more flexible and rapidly deployable isolation solutions at the community scale.

Existing studies on isolation wards have mainly focused on hospital-based environments [16], particularly ventilation control [17], negative-pressure systems [18], ward layout optimization [19], modular construction [20], and prefabricated building technologies [21]. These studies have improved the efficiency and safety of medical isolation facilities. However, relatively limited attention has been paid to rapidly deployable isolation systems suitable for community-based epidemic prevention scenarios. In particular, there remains a lack of integrated architectural solutions that combine rapid deployment, infection control, adaptability, and user comfort within small-scale community settings.

To address the problems and practical needs associated with community-based infectious disease prevention and control, this study aims to propose a novel architectural design solution for isolation rooms suitable for community settings. Conventional isolation solutions are often developed solely from the perspective of architecture or medicine, while overlooking the potential contributions of other disciplines. In contrast, this study integrates knowledge and technologies from preventive medicine, architecture, and mechanical engineering to support the development of a new isolation system. The proposed interdisciplinary collaborative approach significantly improves the overall performance of the isolation solution by addressing issues such as delayed isolation response, insufficient epidemic prevention effectiveness, and the neglect of user comfort in community-based epidemic control. At the same time, the proposed isolation solution incorporates greater structural flexibility from an engineering perspective and enhanced functional diversity from an architectural perspective, enabling it to flexibly respond to different epidemic severity levels and changing environmental conditions while balancing routine and emergency use requirements.

Building an integrated theoretical system across preventive medicine, architecture, and mechanical engineering

An integrated theoretical system combining preventive medicine, architecture, and mechanical engineering has been developed to provide comprehensive guidance for the design and implementation of the isolation and epidemic prevention system [22, 23]. First, preventive medicine provides the basis for the scientific methodology of the system, ensuring that the designed program can specifically block transmission and thus effectively reducing the risk of viruses further spreading. Second, architecture underpins the physical foundation and structural framework for the entire system. It guides the spatial and functional layout of the facility, ensures clear division of functional areas and efficient collaboration, and simultaneously takes into account the appropriateness of the living environment to create a comfortable and safe isolation environment for patients. Finally, mechanical engineering supports the connection of the isolation and epidemic prevention facilities, and ensures the stable operation of the ventilation system, disinfection equipment, and safety protection devices in the isolation ward, thus providing a more pleasant experience for patients.

• Preventive medicine: Providing communities with facilities for the rapid prevention and control of infectious diseases and methods for curbing the spread of infectious diseases.

In the development and design process of the isolation and epidemic prevention system, preventive medicine provides an important theoretical basis and scientific method for physical space layout and functional organization. From a microscopic point of view, the isolation and epidemic prevention system based on the principles of preventive medicine is able to isolate suspected and confirmed cases in a timely and effective manner, thus significantly lowering the risk of spread. From a mesoscopic perspective, the community is at the bottom of the health service network and disease control network. The isolation system with the community as the basic scope of the spatial combination establishes links with hospitals and public health organizations at all levels of the urban health service system. This layout enables the isolation system to rapidly respond to outbreaks and effectively contain the spread of the virus in the wider community. From a macroscopic perspective, the design and use of the isolation and epidemic prevention system reflect the advanced concepts of preventive medicine in the allocation of medical resources, health services, and social health maintenance [24].

• Architecture: Providing a pleasant environment for people’s (patients’) disease control and daily activities.

Architecture is concerned with the functional design, spatial layout, structural design, and environmental adaptability of isolation and epidemic prevention systems [25]. In terms of functional design, it is necessary to ensure that the isolation system can meet the specific needs of medical isolation and temporary accommodation, and takes into account its portability and ability to be rapidly deployed to cope with various emergencies. When it comes to spatial layout, the architectural design optimizes the internal space to the maximum extent possible, ensuring that each functional area is both independent and closely connected. Structural design is the core of architectural design, which through the structural logic design, selection of load-bearing components and design of component connections, ensures that the isolation system maintains the stability and security of the structure, providing users with safe and reliable protection. As for environmental adaptability, the architectural design needs to give full consideration to the needs of the isolation and epidemic prevention system in different scenarios, such as ventilation, lighting, heat preservation, heat insulation, etc. in order to ensure that it can provide a comfortable and safe environment.

• Mechanical engineering: Ensuring the proper functioning of the isolation and epidemic prevention system and comfort of users.

Stemming from architectural design, mechanical design enhances not only the functionality and comfort of isolation wards, but also their safety and stability [26]. First, precise mechanical structure design enables isolation facilities to unfold and fold rapidly to adapt to different scenarios and space requirements. The flexibility and convenience are a major advantage of the isolation and epidemic prevention system over traditional medical isolation wards. Second, mechanical design plays a significant role in the internal layout and efficiency of the isolation system. Additionally, the mechanical design of the water supply and drainage system needs to take the water supply, wastewater discharge, and leakage prevention into consideration to ensure that the isolation system is hygienic and environmentally friendly [27]. Apart from that, mechanical design also involves the structural strength and stability of the isolation facilities. Practical mechanical structure designs can ensure that isolation facilities are not easily damaged during the unfolding and folding process, and can withstand a certain degree of external pressure and impact during use.

Materials and methods

Research methods - interview research based on grounded theory

This paper conducted interview research based on the grounded theory, first to understand the current situation, methods, and technology of infectious disease prevention and control, and second to understand the pain points of healthcare workers and preventive medicine specialists in the prevention and control of infectious diseases. This will clarify the needs of the relevant workers for the new isolation ward and the basis for its application in communities. The interview research produced first-hand data for this paper, which not only helps to clarify the feasibility of the architectural design of small portable isolation wards, but also helps to ensure the authenticity and reliability [28].

Grounded theory can closely link empirical research and theory construction, and provides a set of methods and steps for generalizing and constructing theories from primary data [29, 30]. Researchers can develop concepts and construct theories by analyzing and generalizing empirical data through systematic analysis [31]. For this paper, grounded theory will offer specific strategies and procedures for analyzing data and information, which will facilitate identifying the needs and basic application of the new isolation system by analyzing the textual data and information collected from the interview research (see Fig. 1).

Fig. 1.

Research process based on grounded theory

Interviewees

Interviewees for this study were healthcare workers in healthcare service organizations and preventive medicine specialists in specialized public health organizations. Among them, healthcare workers included those from tertiary hospitals (i.e., hospitals that provide healthcare services across regions, provinces, cities, and even nationwide), secondary hospitals (i.e., local hospitals that provide healthcare services to multiple communities), and healthcare workers from primary healthcare service organizations (i.e., primary healthcare service organizations).

The interview process strictly adhered to the principles of voluntary participation and theoretical saturation. These principles governed all aspects of participant recruitment and the interview process, without exception. The principle of voluntariness means that the interviewees were aware of the situation, purpose, and significance of this study, and volunteered to be interviewed for this study [32]. The theory saturation principle means that for the purpose of this study, a certain number of interviewees were selected, and the information value derived from these interviewees has reached the saturation point at which “new theories” can be obtained [33]. In general, the sample size of interviews that can satisfy the principle of theory saturation is usually between 20 and 30 people [34]. Participants were recruited through purposive sampling based on existing institutional collaborations, targeting healthcare workers and preventive medicine specialists with infectious disease control experience. Snowball sampling was subsequently used to expand the sample, and data collection continued until theoretical saturation. Eligible participants must possess at least extensive relevant work experience, be affiliated with designated medical or public health institutions, and possess frontline or community epidemic management practice; those unable to provide adequate expression or interview time, or who declined transcription and exclusive research use of data, were excluded (Table 1). Considering that healthcare workers in healthcare service organizations have a deeper intuitive understanding of community epidemic prevention in terms of means, technology, space, building functions, and diagnostic and treatment equipment, a higher proportion of the interviewees were healthcare workers in those organizations. In addition, to ensure the objectivity of the interview results, the number of healthcare workers from secondary and tertiary hospitals and those from primary healthcare service organizations were evenly selected.

Table 1.

Participant inclusion and exclusion criteria

Category	Criteria
Inclusion	① ≥3 years of work experience in infectious disease prevention and control
	② Healthcare workers from secondary/tertiary general hospitals, community-level primary healthcare institutions, or preventive medicine specialists from professional public health institutions (e.g., Centers for Disease Control and Prevention)
	③ Practical experience in frontline infectious disease prevention and control, or in community-based epidemic management
Exclusion	① Inability to adequately understand the interview content or to clearly express personal practical experience and viewpoints
	② Inability to ensure sufficient interview time
	③ Refusal to permit transcription of the interview content, or refusal to allow the data to be used exclusively for this academic research

Based on the above recruitment process and subsequent coding analysis, a total of 26 participants were ultimately included in this study. All participants were from China, specifically from Hangzhou, Shaoxing, and Lishui in Zhejiang Province. Among them, 10 were healthcare workers from secondary or tertiary hospitals, 9 were healthcare workers from primary healthcare institutions, and 7 were preventive medicine specialists from professional public health institutions (see Table 2). These participants collectively represented the major stakeholders within the hierarchical infectious disease prevention and treatment system. Participants were recruited exclusively from China because China accumulated extensive experience in infectious disease prevention and control during the COVID-19 pandemic. Healthcare professionals in China have accumulated extensive practical experience in emergency treatment, epidemiological investigation and tracing, and preventive management, which provides a relevant practical context for this study for the design and application of the proposed isolation ward. Zhejiang Province was selected because it was one of China’s national pilot provinces for hierarchical diagnosis and treatment reform, and its three-tier system for infectious disease prevention and control is leading nationwide, allowing the study to include perspectives from different levels of the healthcare system. This context provides representative scenarios and favorable conditions for exploring the design and application of the proposed isolation ward.

Table 2.

Sources and attributes of interviewees

Basic Information		Percentage
Gender	Male	46.2%
	Female	53.8%
Workplace	Second - and third-class hospitals	38.5%
	Primary healthcare service institutions	38.5%
	Disease prevention and control centers	23%
Occupation	Doctor	65.5%
	Nurse	23%
	Manager	11.5%
Professional expertise	Infectious diseases department	46.2%
	General practice	23%
	Preventive medicine	19.2%
	Disaster medicine	3.9%
	Other	7.7%
Experience in COVID-19 control	Participated in emergency rescue	42.3%
	Only involved in daily prevention and control	57.7%

Content of the interview

With the help of interview research, this study intends to find out whether small portable isolation wards are needed for infectious disease prevention and control, whether they meet the needs of healthcare workers, and whether there is an application basis for small portable isolation wards to be used in communities. The main purpose of the interviews was to accurately and objectively obtain primary qualitative data for the study. And the content of the interviews has potential structural layers to explore the interviewees’ knowledge and opinion on the small portable isolation wards even further, including the subjective understanding and feelings of the interviewees. Therefore, the semi-structured interview method was selected for this study, which fits better with the purpose and content of the interviews in this study.

To ensure consistency in data collection, both interviewers received prior training in qualitative research methods and semi-structured interviewing. The interview team consisted of two researchers. Prior to the formal interviews, both researchers underwent standardized training in three areas: research methodology, interview techniques, and research ethics. In addition, they conducted three pilot interviews. The pilot interview data were used solely to refine the interview guide and standardize questioning and probing strategies across interviewers and were not included in the final formal analysis. During the formal interviews, both researchers were present throughout the entire process, with one researcher leading the interview and the other responsible for process documentation, which helped ensure consistency across interviews and reduce interviewer bias.

All interviews were conducted between June and December 2021. To minimize environmental interference, interviews were primarily conducted in locations familiar to the participants, such as their offices or reception rooms. Each interview lasted approximately 1–4 h. With informed consent obtained in advance, the vast majority of interviews were audio-recorded in full, and the recordings were subsequently transcribed verbatim into text by the research team. For the small number of interviews in which participants declined audio recording, a dual-note-taking approach was adopted as an alternative: one researcher conducted the interview and recorded key points, while the other focused on documenting participants’ original statements. The two researchers then jointly reviewed and integrated the records into detailed interview notes within 24 h after the interview. To ensure the authenticity and completeness of the data, the relevant textual information was returned to the corresponding participants for member checking after data organization had been completed. Participants were asked to verify the accuracy of the content and make any necessary corrections. The finalized materials were subsequently used as the original data for coding and analysis.

By studying literature and documents on preventive medicine (including community prevention and control), epidemiology, and hospital isolation wards, and by incorporating the opinions of doctors, nurses, preventive medicine specialists, and other personnel, the interviewer developed an initial version of the interview outline [35, 36]. The interviewer then conducted pre-interviews with three interviewees (the same group of interviewees as for the formal interviews) based on this outline. During the pre-interviews, the interviewer found that the interview outline was closely related to this study in general, but the interview outline was incomplete in two aspects: measures to prevent infectious diseases and measures to isolate infectious agents. Therefore, the interviewer added related questions accordingly. Finally, through discussions with doctors, nurses, and preventive medicine specialists, the interviewer finalized the official version of the interview outline (Table 3). The details of the interview and research on the demand for small portable isolation wards can be found in Appendix I.

Table 3.

List of interview outlines

No.	Questions
1	Are small portable isolation wards a need for infectious disease prevention and control?
2	Are small portable isolation wards needed for healthcare workers during outbreaks or epidemics of infectious diseases?
3	Can small portable isolation wards be used for home isolation?
4	Are small portable isolation wards suitable for use in communities?
5	What features do you think are needed in a small portable isolation ward?
6	What do you think can be used as a basis for the design of a small portable isolation ward?
7	In what ways do you think a small portable isolation ward could be relevant to healthcare services?
8	What role do you think the small portable isolation ward can play?
9	In what ways do you think small portable isolation wards are associated with community health service centers?
10	In what ways do you think the use of small portable isolation wards needs to be supported (e.g. policy, concepts, technology, space, etc.)?

Data processing

The coding process was jointly conducted by the two researchers who had previously conducted the interviews. Microsoft Excel was used to assist with coding management. Prior to formal coding, the two researchers discussed and standardized the coding criteria and operational procedures. Subsequently, both researchers independently coded the interview transcripts and regularly held coding discussion meetings to compare results. Any inconsistencies were resolved by returning to the original interview transcripts and reaching a consensus through discussion, which helped reduce potential subjective bias during coding. The coding of the data based on the grounded theory is divided into three steps, namely Open Coding, Axial Coding, and Selective Coding [37]. After the coding of the data is completed, the theoretical model constructed from the coding needs to be tested for theoretical saturation.

1. Open coding

First, the author selected two-thirds of the original research data for open coding, which refers to the text processing method of refining and synthesizing a large amount of original research data stage by stage, and correctly reflecting the content of the original research data using more abstract and generalized phrases, vocabulary, concepts, etc. The purpose of open coding is to identify phenomena, define and discover the concepts that encompass part of or the entire picture.

To ensure semantic integrity and thorough analysis, the coding was performed in a sentence-by-sentence manner. Depending on the degree of data refinement, the author categorized the open coding into three types, namely Concept Labeling, Initial Concepts, and Core Concepts. To find the Concept Labeling, Initial Concepts, and Core Concepts that best reflect the research situation, the author kept examining the original research data. Finally, the author abstracted 36 initial concepts and 16 core concepts from the original research data. Since the core concepts are more refined and abstract than the initial concepts, the core concepts will be the focus to support the subsequent data analysis.

• (2)Axial coding

The main task of axial coding is to categorize, compare, and summarize the “core concepts” in the open coding, and then derive “Categories.” Instead of linking the initial concepts and core concepts to construct a comprehensive theoretical framework, the main task of axial coding is to develop the core concepts into more refined, abstract, and generalized categories. By analyzing the original research data, the author finally abstracted eight categories based on the core concepts.

• (3)Selective coding

Selective coding refers to the identification of “Core Categories,” which are concepts that provide an overarching view of the overall situation. Identifying core categories requires systematic consideration of their links with other concepts and categories, establishment of relationships between them, and completion of category conceptualization that have not yet been fully developed in the axial coding. Through repeated reading of the interview data and repeated analysis of the open and selective coding, the author finally identified four Core Categories, namely Community Epidemic Prevention System (CEPCS), Physical Realization and Supply System (PRSS), Preventive Medicine System (PMS), and Spatial and Functional System of Medical Buildings (SFSMB) (see Table 4).

Table 4.

Content identified through coding

Open coding (labeling: level 1)	Open coding (initial concepts: level 2)	Open coding (core concepts: level 3)	Axial coding (categories: level 4)	Selective coding (core categories: level 5)
Y11; Y15…	Isolation wards for the temporary isolation of infectious agents	Different use scenarios of isolation wards in communities	Use scenarios and management points of isolation wards in communities	CEPCS
Y16;Y19…	Isolation wards suitable for the home isolation of infectious agents
Y23;Y47…	Isolation wards should be easy to manage by healthcare workers	Rationality of isolation ward management
Y20;Y49…	Isolation wards should be easily accessible for the referral of infectious agents
Y62;Z19.	Isolation wards need to be located near major roads	Accessibility of isolation ward layout	Linkage of the isolation ward to the community and its surrounding environment and facilities
Y9;Y24…	Isolation wards should be located close to health facilities
Y8;Y51…	Isolation ward layout should consider the reasonable use of the community and its surrounding environment and facilities	Rationality of isolation ward layout
Y30;Y33…	Isolation wards should be located a reasonable distance from the residential area
Y46;Y67…	Manufacturing cost controls of isolation wards	Economy of manufacturing of isolation wards	Key points of manufacturing and realization technology of isolation wards	PRSS
41;Y59…	Cost controls for installing facilities in isolation wards
Y10; Y28…	Economy needs to be considered for the realization technology of isolation wards	Rationality of isolation ward realization technology
Y13;Y32…	Feasibility needs to be considered for the realization technology of isolation wards
Y27;Y35….	Reliability needs to be considered for the realization technology of isolation wards
Y12;Y25…	Streamlined transportation for isolation wards	Convenience of transportation and storage of isolation wards	Supply characteristics of isolation wards
Y18;Y37.	Easy storage of isolation wards
Y29;Y56…	Isolation wards facilitate stratified treatment	Linkage of isolation wards to the tertiary care system
Y21;Y57…	Isolation wards provide a flexible method of isolation
Y34;Y50…	Isolation wards help improve the epidemic prevention ability of healthcare organizations
Y22;Y40…	Isolation wards allow for quick and convenient isolation of individual infectious agents	Isolation wards can help realize preventive strategies among high-risk groups	Isolation wards help realize primary prevention	PMS
Y17;Y52…	Isolation wards enable preventive interventions that target individual disease-causing risk factors
Y89;Y93…	Isolation wards enable quick and convenient isolation of multiple infectious agents	Isolation wards contribute to the realization of a whole-population prevention strategy
Y68;Y73…	Isolation wards help cut off the spread of disease-causing risk factors
Y72;Y77…	Isolation wards eliminate harmful exposure to the environment and objects
Y6l; Y83….	Isolation wards ensure early isolation and observation of infectious agents	The isolation ward supports the implementation of the “three early measures” (Early detection, early diagnosis, and early treatment)	Isolation wards help realize secondary and tertiary prevention
Y36;Y66….	Isolation wards ensure early diagnosis and treatment of infectious agents
Y38;Y76…	Isolation wards ensure short-term diagnosis and treatment of infectious agents	Isolation wards can support clinical diagnosis and treatment of infectious agents
Y82;Y90-	Isolation wards can serve as auxiliary facilities for the diagnosis and treatment of infectious agents
Y3l; Y65…	Isolation wards can provide flexibility and mobility in isolation
Y64;Y78….	Isolation wards provide epidemic-prevention back-up space for medical buildings	Isolation wards can enhance the flexibility and mobility of setting up epidemic prevention spaces in medical buildings	Isolation wards can expand and improve epidemic prevention spaces of medical buildings	SFSMB
Y85;Y98…	Isolation wards are suitable for medical buildings with tight spaces and a shortage of wards
Y8l; Y97.	Isolation wards can be installed in conjunction with nursing spaces such as wards in medical buildings	Isolation wards can support the upgrading and renovation of epidemic prevention spaces in medical buildings
Y45;Y84…	Isolation wards can be installed in conjunction with aisles and other ancillary spaces in medical buildings
Y1;Y2…	Isolation wards help realize epidemic prevention renovation in general wards	Isolation wards can support the renovation of epidemic prevention functions in medical buildings	Isolation wards can enhance the epidemic prevention functions of medical buildings
Y58;Y60…	Isolation wards are suitable for medical buildings where functional flow lines are difficult to modify
Y43;Y44…	Isolation wards are required to have daily living functions such as offices and rest rooms	Isolation ward functions need to be diversified and compound
Y14;Y26	Isolation wards need to provide medical service functions
Y14;Y55	Isolation wards need to have functions such as disinfection, ventilation, waste discharge, etc.

• (4)Theoretical saturation test

The theoretical saturation test was independently conducted by the two aforementioned coders, using one-third of the original interview data that had not been previously coded. The test results showed that the categories summarized in this data analysis were already relatively complete. Neither new concepts and categories appeared nor new connections were formed between different categories, which indicates that the theoretical model constructed in the previous analysis reached theoretical saturation.

Trustworthiness and scientific rigor of the interview analysis

This study followed the trustworthiness framework proposed by Lincoln and Guba together with standard grounded theory procedures, to establish a quality control framework that ensured the trustworthiness and scientific rigor of the research findings [38]. Credibility was established through strict inclusion/exclusion criteria, a representative sample of 26 key stakeholders, pilot interviews, verbatim transcription, member checking, and consistency between interviewers and coders. Dependability was supported through standardized researcher training, jointly developed coding protocols, and independent dual coding with full process documentation. Confirmability was ensured by resolving coding disagreements through transcript re-examination and consensus, and by reserving one-third of the data for theoretical saturation testing, which confirmed that no new concepts emerged. Transferability was addressed by clearly delineating the research context and participant characteristics, thereby defining the scope of applicability to similar healthcare settings.

Results

Component systems and influencing factors of isolation wards

Through interview research on the demands and application of isolation wards, this paper has classified the component systems of isolation wards in detail (see Fig. 2). Through iterative open, axial, and selective coding along with constant comparison, the four core categories were grounded in participants’ accounts. Specifically, Community Epidemic Prevention and Control System (CEPCS) captured community-level spatial and isolation dilemmas; Physical Realization and Supply System (PRSS) reflected production and supply chain practicality; Preventive Medicine System (PMS) consolidated multi-level prevention functions; and Spatial and Functional System of Medical Buildings (SFSMB) addressed the rigidity–flexibility tension in primary healthcare facilities. Table 5 details how each category emerged from raw data through initial concepts to its final conceptualization.

Fig. 2.

System framework of small portable isolation wards

Table 5.

Emergence of the four core categories from interview

Core category	Raw data concerns (Participants’ accounts)	Initial concepts (Open coding)	Formation logic (Axial/Selective coding)
CEPCS	Lack of epidemic prevention spaces(Y11); cross-infection risks(Y15); inadequate home isolation(Y16)	Different usage scenarios of isolation wards in communities	Need for a flexible, embeddable nodal network to strengthen community epidemic resilience
PRSS	Controlled production costs (Y41,Y46); technical feasibility (Y10, Y13, Y27); rapid deployability (Y12, Y21, Y18)	Economy of isolation ward manufacturing	Need to balance production feasibility with integration into existing medical and emergency supply systems
PMS	Rapid isolation (Y22, Y40, Y89); transmission interruption (Y17, Y68, Y72, Y73); early treatment (Y36, Y38, Y61)	High-risk and population-level prevention strategies	Isolation ward supporting the implementation of the three-level prevention strategy
SFSMB	Insufficient space (Y85, Y98); difficult functional modifications (Y1, Y2, Y45, Y81); spatial rigidity vs. flexible epidemic needs(Y45,Y81,Y14,Y43)	Enhanced spatial flexibility; functional integration	Plug-and-play prefabricated isolation module providing spatial/functional resilience without large-scale renovation

Among them, the CEPCS is the core component of the overall system framework for isolation wards, which embodies the application scenario and characteristics of isolation wards in the epidemic prevention system in the post-epidemic era. In practice, small portable isolation wards can be deployed in a timely manner to serve as isolation and treatment space for the community. The PRSS are associated with the isolation wards, reflecting the key points of manufacturing and realization technology, as well as the supply characteristics of isolation ward materials. The effective operation of this system ensures that the isolation ward can be quickly and efficiently deployed on the front line of epidemic prevention. The PMS is relevant to the context in which the isolation wards are used, whose philosophy is present in every aspect of the isolation ward design. This comprehensive medical consideration enables isolation wards to effectively prevent the spread of disease and protect the health of healthcare workers and the public in actual application. The SFSMB are linked to the design features of the isolation ward, showcasing the design principles of the small portable isolation ward. The four systems mentioned above incorporate the concept of this paper into the whole process from theory construction to conceptual design of the small portable isolation ward from different perspectives, which contributes to the integration of theory and design.

There are eight influencing factors in the isolation and epidemic prevention system: (I) the key points of use scenario and management of isolation wards in communities; (II) the linkage of the isolation ward to the community and its surrounding environment and facilities; (III) the key points of manufacturing and realization technology of the isolation wards; (IV) the supply characteristics of the isolation wards; (V) the isolation wards help realize primary prevention; (VI) the isolation wards help realize secondary and tertiary prevention; (VII) the isolation wards can expand and improve the epidemic prevention space of medical buildings, and (VIII) the isolation wards can enhance the epidemic prevention function of medical buildings. The relationship among the influencing factors is shown in Fig. 3.

Fig. 3.

Concept map of influencing factors of the isolation ward system

Scheme of small portable isolation wards

In the course of the natural history of disease, small portable isolation wards play a preventive role, mainly in the pre-morbid and early stages of the onset of infectious diseases (see Fig. 4).

Fig. 4.

Main stages of the preventive role of small portable isolation wards

The small portable isolation ward is mainly composed of key elements such as support structure, use unit, and equipment support.

1. The support structure is the core force system of the small portable isolation ward, which ensures the stability of the overall structure of the isolation ward [39]. The isolation ward is subjected to a variety of sources of force, including self-weight, external loads (e.g., live loads, wind loads, etc.), deformation (e.g., deformation caused by temperature changes, contraction of structural materials, etc.), and environmental effects (e.g., sunlight, temperature, humidity, etc.), etc. As isolation wards provide a safe space for people (patients) to move around, their support structures need to have a load-bearing capacity comparable to that of a conventional building to cope with various loads. Under non-extreme conditions, the support structure must not produce excessive deformation or cracks, nor overturning or instability; although the enclosure structure does not bear vertical loads, it still needs to shelter from wind and rain, and remain stable. Given that, for the support structure, this scheme selects self-locking gas springs or bamboo-type electric lifting bars as the basic structural form, and its working principle can be referred to Fig. 5a. As for the enclosure structure, this scheme selects hinges as the basic component, and its working principle is shown in Fig. 5b.

2. The use unit refers to the different functional areas within the isolation ward, providing space for the basic living, medical quarantine, and clinical diagnosis and treatment of isolated patients. According to the functional difference of space, an isolation ward use unit can be divided into two parts: the living unit element and bath unit element [40]. The former represents the space for activities such as resting, quarantine, and treatment, which meets the basic living needs of the isolated and the medical observation needs of the healthcare workers. The latter includes a space for activities such as cleaning and washing, which serves as supporting facilities of the living unit. According to the specific function and site characteristics analysis, the two elements of the unit can be linked through a variety of combinations (see Fig. 6) to achieve effectiveness. To accommodate the collapsibility of small portable isolation wards, various facilities (e.g., furniture, bathroom accessories, medical facilities, etc.) within the two unit elements need to be integrated with the portable structure of the isolation ward as a whole. This ensures that the internal facilities can be retained and flexibly adapted in the event of a change in the structure of the portable isolation ward.

3. Equipment support mainly consists of the HVAC system and the water supply and drainage system, which provide sterilization and disinfection functions for the isolation ward. The HVAC system adopts an upper-supply and lower-side exhaust airflow strategy to maintain directional airflow from the clean zone to the contaminated zone. A negative-pressure gradient (e.g., − 5 Pa) is maintained by keeping the exhaust airflow slightly higher than the supply airflow, thereby preventing reverse diffusion of contaminated air and improving airflow control in compact spaces. The supply air system uses a three-stage filtration process consisting of pre-filtration, medium-efficiency filtration, and HEPA filtration, while the exhaust air system adopts pre-filtration and ultraviolet disinfection. In both single-unit and multi-unit configurations, pressure differentials between clean, buffer, and contaminated zones are used to reduce airflow recirculation and prevent cross-contamination. Antibacterial and anti-mold interior wall materials are further applied to reduce infection risks. In addition, the water supply and drainage system provides clean domestic water and performs harmless treatment of wastewater and excreta through collection, filtration, disinfection, and chemical inactivation before safe discharge.

Fig. 5.

Schematic diagram of the support structure and enclosure structure of small portable isolation wards

Fig. 6.

Illustration of the ways in which the living unit and bath unit are combined

Based on the theory of preventive medicine and combined with mechanical ventilation and sewage treatment, this construction scheme of isolation ward has formulated a technical approach to air disinfection (see Fig. 7a), sewage disinfection (see Fig. 7b), and excreta disinfection (see Fig. 7c). Since the relevant disinfection equipment and other equipment such as power supply facilities, piping and water tanks are arranged in the same unit, the layout of the equipment needs to be designed. The division is set up in accordance with the principles of purification and pollution zoning and non-interference, with air purification and disinfection facilities arranged in the uppermost space of the unit, followed in descending order by power supply facilities, water tanks (for daily life), sewage disinfection facilities, excreta disinfection facilities, etc.

Fig. 7.

Schematic diagram of the technical approach to disinfection of equipment support units

Discussions

Combination of multiple isolation wards

The combination of multiple isolation wards is a comprehensive solution covering both parts and the whole, which updates and optimizes a single isolation ward in terms of structure, function, and performance [41]. Based on structuralism in architecture, this paper focuses on the overall function of multiple isolation wards, and the constraints and dependencies between single buildings with discipline as the prerequisite [42]. Multiple isolation ward combination: First, multiple isolation wards form diversified planes and spatial forms to meet the needs of different scenarios. Second, the combination will significantly improve the ward’s isolation functionality and effectiveness. Third, these combined isolation wards will forge an effective link with the existing buildings on the site in terms of prevention and control of infectious diseases and other functions to supplement and extend the functions of existing buildings.

A single isolation ward, which has followed the productization concept, becomes a standardized module and the basis from which a variety of combinations are formed with the same module, module parameter adjustments, and the reconnections of the module with different functional units (see Fig. 8). According to its different assembly modes, it can be divided into two forms, namely horizontal assembly and vertical assembly. For the former, it is necessary to focus on the following aspects: a). Determination of the technical means applicable to the horizontal connections of multiple single wards (e.g. pure dry horizontal connection of two isolation wards through the coordination of bolts and nuts) and avoidance of on-site wet construction, etc. to shorten the construction cycle and reduce labor costs. b). Diversification of use unit and equipment support unit combinations given the specific needs (such as the centralized isolation of the community), along with the characteristics of the site. c). Appropriate extensions of infectious disease prevention and control technology for different units to adapt to the variations in combinations. As for vertical assembly, attention should be paid to: a). Determination of the technical methods applicable to the vertical connection of multiple single wards (e.g., precise alignment of vertical components through devices). b). Addition of stairs and walkways, and determination of the method to combine and connect the passages with the isolation wards.

Fig. 8.

Diagram of combination modes of multiple isolation wards

Application scenarios and distribution models of isolation and epidemic prevention facilities

The application scenarios of small portable isolation wards mainly include community-level and secondary and tertiary hospitals. Among them, the type is mainly applied in communities, especially community healthcare service organizations, such as community hospitals and community health service centers [43]. In addition, community centralized isolation and home use are also important application scenarios.

In extreme cases of infectious disease outbreaks and epidemics, quality medical resources in cities are overwhelmed, leaving a localized surge of patients in its wake, which in turn gives rise to challenges in diagnosis and treatment, a shortage of medical supplies, and cross-infection [44]. Considering that, wards are designed to best utilize existing resources and in line with the principle that infectious diseases should not be treated in a decentralized manner.

The distribution model and its working principles are illustrated in Fig. 9. Overall, the model offers a form that integrates community medical and health resources in terms of the physical space of communities, which emphasizes the primary status of communities in the prevention and control of infectious diseases, and highlights the pivotal role of community health service centers in this regard. It is conducive to the decentralization of medical and health resources to the primary level [45]. In terms of material resource utilization, the entire distribution model focuses on combining facilities like community health service centers, buildings such as gymnasiums, hotels, school dormitories, etc., and environmental resources such as urban open spaces and green spaces. When it comes to morphological structure, although the entire distribution model tends to be flat, the distribution of isolation wards is embodied in centralized groups, forming a layout “with a center in localized areas while decentralized overall”. It presents both “main body” and “center,” and is also associated with the layout characteristics of gymnasiums and other buildings.

Fig. 9.

Diagram of distribution model of isolation wards and its principles

Furthermore, the proposed small foldable isolation ward may be particularly suitable for resource-limited settings frequently affected by quarantine infectious diseases such as viral hemorrhagic fevers. Its modular design reduces per-unit production costs through large-scale manufacturing, while its lightweight, foldable nature lowers storage and transportation costs, easing local supply chain barriers. The integrated air filtration and negative pressure system meets infection control requirements for highly contagious diseases, and the assembly and deployment require no specialized construction teams or large equipment, helping to overcome infrastructure and personnel shortages. The ward can be flexibly configured to rapidly expand epidemic prevention space in primary healthcare institutions, thus serving as an effective emergency reserve for rapid outbreak response.

To better position the proposed isolation ward within existing research and practice, as well as to highlight its innovative features, this study compares the isolation ward with modular medical units, temporary medical facilities, and deployable isolation facilities (see Table 6).

Table 6.

Comparison and innovation of isolation ward with existing approaches

Type	Definition	Relationship with Existing Technological Approaches	Innovative Features of the Proposed Isolation Ward
Modular Medical Units	Medical units typically based on containers or prefabricated box structures, enabling rapid construction through off-site prefabrication and on-site assembly.	The proposed isolation ward adopts technologies such as standardized modular design, integrated equipment systems, multi-unit prefabricated assembly, and industrialized production, adapting modular medical technologies to community-level epidemic prevention settings.	The proposed isolation ward is designed for micro-scale community settings, shifting the module function from “diagnosis and treatment” to “isolation and early intervention.” It adopts foldable technology, enabling potential use inside residential units, and supports flexible combinations of living units, sanitary units, and equipment units.
Temporary Medical Facilities	Non-permanent medical facilities rapidly constructed or adapted to provide short-term emergency medical and isolation services.	The proposed isolation ward adopts technologies such as light weight design, adaptive reuse of existing spaces, and dismantling and reuse strategies, extending emergency medical concepts to community-based settings.	The isolation ward features a high degree of equipment integration and can operate independently of external building infrastructure. It also avoids conflicts with the original functions of existing buildings and does not require major structural, spatial, or pipeline modifications.
Deployable Isolation Facilities	Prefabricated modules that can be rapidly transported and flexibly deployed, and that independently provide isolation and epidemic prevention functions.	The proposed isolation ward retains characteristics such as multi-scenario adaptability, deployment flexibility, and ease of transportation, representing an extension of deployable isolation technologies into micro-scale scenarios such as communities and households.	The proposed isolation ward adopts a rigid foldable structure that balances convenience, durability, and structural stability. It also integrates multiple functions including physical isolation, observation and monitoring, treatment of mild cases, and basic living support.

Conclusion

The rapid isolation plan is centered on the CEPCS and consists of the PRSS, PMS, and SFSMB. The main influencing factors of this plan are: (I) the key points of use scenario and management of isolation wards in communities; (II) the linkage of the isolation ward to the community and its surrounding environment and facilities; (III) the key points of manufacturing and realization technology of the isolation wards; (IV) the supply characteristics of the isolation wards; (V) the isolation wards help realize primary prevention; (VI) the isolation wards help realize secondary and tertiary prevention; (VII) the isolation wards can expand and improve the epidemic prevention space of medical buildings, and (VIII) the isolation wards can enhance the epidemic prevention function of medical buildings.

This paper proposes a modular and standardized construction method for small portable isolation wards. This kind of structure will be used as the core material carrier of the isolation and epidemic prevention system. Compared with the fixed traditional building structure, the portable structure applied to the small isolation ward displays notable advantages in terms of space utilization, construction efficiency, cost controls, and flexible management. In this scheme, the small portable isolation ward is clearly defined as a miniature building with product characteristics, primarily consisting of key elements such as the support structure, use units, and equipment support. It integrates the product attribute of physical isolation functions and social attributes of habitat creation. The isolation ward is mainly designed for patients with mild symptoms of infectious diseases (especially respiratory infectious diseases), but it can also be compatible with others in need of isolation, such as suspected cases, and carriers of pathogens and contacts.

This study has several limitations related to its qualitative interview design. Some interview questions (e.g., Questions 1 and 2) were oriented toward confirming the practicality of the small foldable isolation ward, rather than fully and openly exploring its potential limitations, constraints, or alternative solutions. This confirmatory tendency may have influenced participants’ responses. As a result, opposing views and potential limitations may not have been explored in sufficient depth. Although the study sought to obtain comprehensive information through pilot interviews, open-ended follow-up questions, and encouragement for participants to freely express their views during the formal interviews, this tendency in the interview guide remains a limitation of the study. Future studies could explore this issue further by adopting more open-ended interview questions.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

CEPCS

Community Epidemic Prevention and Control System

PRSS

Physical Realization and Supply System

PMS

Preventive Medicine System

SFSMB

Spatial and Functional System of Medical Buildings

Author contributions

B. Z. and X. X. designed research; H.L. and X.B. performed research; H.L. contributed new reagents/analytic tools; X.B. and L. Z. analyzed data; and B. Z. and X. X. wrote the paper.

Funding

Funding for this study was provided by the National Natural Science Foundation of China General Program (Grant No. 52378019), the Chinese Ministry of Education Humanities and Social Sciences General Project (Grant No. 24YJC760190), and the Fundamental Research Funds for the Central Universities of Huazhong University of Science and Technology (Major Liberal Arts & Interdisciplinary Research Project, Grant No. 2024WKZDJC008).

Data availability

The relevant data involved in this study are from the questionnaire survey conducted by the research team. Due to the fact that the original data involves the personal information of the interviewees, it cannot be fully disclosed at the request of some interviewees. Thus, the authors do not have permission to share data. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Zhejiang Shuren University (No. CJ2021001). The procedures used in this study adhere to the tenets of the Declaration of Helsinki. During the survey, authors have confirmed through the prompt at the beginning of the questionnaire that informed consent was obtained from all participants and/or their legal guardians.

Consent for publication

All authors have approved the final version of the manuscript for publication. We confirm that the work described has not been published previously, is not under consideration for publication elsewhere, and all authors have read and agreed to the submission.

Competing interests

The authors declare no competing interests.