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Healthcare Facilities

Evidence-based Design Interventions: Medical-Surgical Nursing Unit, Medical Offices and Neonatal Intensive Care Unit
Thursday, July 30, 2009

Concluding our series of evidence-based design interventions within specific areas of healthcare facilities, this blog identifies problems and provides design solutions for enhancing patient and staff outcomes in Medical-Surgical Nursing Units, Medical Offices and Neonatal Intensive Care Units.

Medical-Surgical Nursing Units

Better design within Medical-Surgical Nursing Units will result in decreased caregiver stress and increased time a caregiver spends at a patient's bedside.

  • Standardized, acuity-adaptable rooms, a design tactic adopted from the aeronautical industry, have shown to significantly reduce human error in care. In this design, each patient room is set up exactly the same which minimizing potential mistakes such as administering improper gas, because the gases are located in different locations in each room.
  • Decentralized nursing stations increase caregiver visibility and access to patient rooms. Utilizing this design is results in improved communications and reduces staff fatigue and stress from having to walk distances to patient rooms.
  • Noise reduction design and materials on patient units result in speech intelligibility and reduced staff and patient stress. During the design process, architects should conduct a noise audit to determine sources and then identify design strategies that will reduce or remove noise.

Medical Offices


Creating a better environment through design should lead to increased patient and family satisfaction, improved provider-to-patient communication and enhanced organization efficiency.

  • Improved access to the medical office by addressing proximity issues such as convenient parking and providing a clear way-finding system within the facility will increase patient and family perception and reduce stress.
  • Attractive waiting areas are directly correlated with reduced patient anxiety, higher perceptions of quality care and shorter perceived waiting times.
  • Patient access to technologies provides additional ways to improve communications between patients and providers.
  • Spatial organization of the exam room and orientation as well as the sense of connection experienced by the patient.
  • Decentralized nurse stations, information kiosks and implementing electronic medical records will reduce patient-wait times.

Neonatal Intensive Care Unit


The National Association of Children's Hospitals and Related Institutions identified loud noise, high light levels and infectious pathogens as environmental factors negatively affecting NICU patients.

  • Infants exposed to excessive noise levels in the NICU have been shown to have poor auditory system development, poor auditory attention and increased stress. Sound-absorbing ceiling tiles, flooring and wall panels along with privacy curtains will significantly drive down access noise levels.
  • Visual development and physiological outcomes among preterm infants is directly related to their sensitivity to light exposure. Cycled lighting and focused light over incubators will help improve sleep and developmental outcomes.
  • Single family rooms within the NICU provide a controlled and safe environment for the infant and privacy for the family. Each infant receives appropriate lighting, sound and level of care. In addition, single family rooms are associated with fewer nosocomial infections. Several studies on staff perception and performance in an open bay versus private room model suggest staff perceive that the private room model improved the quality of the physical environmental conditions, interaction with infants' families and overall patient care.

 

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