Thursday, January 16, 2014

Focus on Family – A New Model for NICU Design

Submitted by Tim Eastwood (Toronto, ON)

A family zone helps keep families
comfortable while in the NICU 
In November, I was proud to accept the first place award in the 2013 Patient & Family Centered NICU Design Competition. Sponsored by the Institute for Patient-Centered Design, the competition honoured Stantec Architecture for our design work with the Hospital for Sick Children in Toronto.

Our team members, myself, Jane Wigle, Zoee Johnson and Essam Basta, were excited by the opportunity to enter this competition. Together, we could further examine the ideas of family-centered design outside the constraints of existing building space or of a budget.

Where to begin?

Typical neo-natal intensive care unit (NICU) designs have very little space for parents. What space is
provided is often just a virtual space to one side of the patient’s bed, which is shared with other clinical space. But we believe that parents should become primary caregivers in the NICU. With this in mind, our team designed a space that would focus on the family.

Floor plan of a family-based NICU
The transition from being a patient during birth to becoming a visitor during a child’s NICU stay is a stressful path for parents. We wanted to design a space that would ease this transition. To do this, we had to move beyond the technical requirements of an NICU room. These requirements, for equipment and clinical space around the bassinette, for example, are fairly easy to determine, but they often limit the design of these types of projects. Achieving quality of space is a more elusive goal.

Our design provides maximum support and privacy for the family to encourage close connections and bonding between the NICU patient and family. We included a significant “family” zone – an area featuring large windows that would allow family to sleep, relax, eat, work, store personal items or bathe in privacy.

When the sliding doors open, this family zone integrates into the patient zone, which includes a recliner chair – an ideal spot for parents to sit and bond with their baby. When the sliding doors close, the family enjoys a private area of retreat.

A clear space on all sides of the patient area can accommodate family as well as nursing staff and, at times, a multidisciplinary team of caregivers. Essential equipment, charting space and overhead, adjustable exam lighting are located at the perimeter of the clear floor space.

Tim Eastwood
A full-width sliding glass door connects the room to the communication corridor of the NICU while also providing noise control. Meanwhile, locating a supply storage cabinet between the room and the corridor helps to reduce disturbances in the room when supplies are stocked.

Overall, our team endeavored to achieve a balance between environmental control for the optimal benefit of the patient, with support and privacy for family members.

We hope that this family-centered design will be an exemplar. We want it to push the discussion – in our office, with our client and within the industry – about what is possible for and what should drive NICU design.

Tim Eastwood is a senior associate and healthcare architect.

1 comment:

  1. Hi Tim, congratulations to you and your colleagues on this work and recognition. Our first child spent a week in NICU in 1997 at Edmonton's University of Alberta Hospital, where at that time there existed a similar progressive facility in the form of a separate parents' room -- basically a small hotel room with a double bed, hospital-type bathroom. Though it was remote from the clinical space and there was only one for a NICU with perhaps 16 patient beds, it was a godsend to us as our child struggled to live. Later, we made a donation in Lauren's memory to help re-build the parent room when the unit moved within the hospital. I'm not sure if the room exists any more (sadly) due to the continuing re-jigging of hospital space (and competition for other space uses). But I'd commend you on advancing this idea of parent / family spaces for NICUs, where the rapid transition from joy to huge stress and potentially-devastating loss warrants extra investment of space and money in a modern hospital design. Best wishes for your continued success and efforts. -- Dean Cooper (Transportation, Edmonton)