The new Neonatal ICU at John Muir Medical Center's Walnut Creek Campus builds for the future of medicine and allows newborn intensive care to be a family affair. The department director did extensive research on innovative care concepts, particularly the issues of noise, infection control, and parent-infant bonding. The staff and design team visited facilities to see and discuss various patient room configurations. A Clinical Nurse Specialist worked closely with the design team to produce an environment almost entirely free of dioxins, phthalates, and mercury and halogenated fire retardants.

The most critically ill infants will receive care in a central suite, planned to allow nurses sight lines into the individual rooms. The lighting in this suite is adjustable and can be controlled to reflect diurnal light levels. The outer ring of patient rooms includes pods of four rooms each clustered around a clinical workstation. The placement of interconnecting doors between the pods allows all staff to support one another.

Project category: Project in progress (June 2010)

Chief administrator: Jane Willemsen, President & Chief Administrative Officer, (925) 947-5348

Firm: Ratcliff, (510) 899-6425

Design team: Christopher P. Ratcliff, AIA, Principal-in-Charge; Thomas Patterson, AIA, Project Manager; Linda Mahle, AIA, Project Planner; Bill C. Wong, AIA, Project Architect; Heather Kilday, Architect; Lynn Drover, CID, IIDA, Interior Designer

Illustration: Mariati Paham

Total building area (sq. ft.): 11,500

Construction cost/sq. ft.: $650

Total construction cost (excluding land): $7,475,000

Every patient room includes reading and task lights for parents and staff, exam lights, and soft ambient lighting that allows parents and staff to function quietly without disturbing the infant. In various locations throughout the unit, single rooms have been separated by sliding glass partitions to allow infants from a multiple birth to be close to their parents and to one another. Physiologic monitors at each bedside will have split-screen capability, allowing nurses to maintain visual contact with vital signs of all their patients.

There will be a number of decentralized work areas throughout the unit, with a variety of lighting intensities to support the circadian rhythms of the staff—increasingly important for evening and night shifts. Most clinical workstations, the neonatologist's office, and even the quiet, spacious staff lounge have views to the outside, providing a connection to nature and the outside world.

A rooftop garden outside the unit is accessible by parents, family visitors, and staff. It has been planned for either quiet contemplation or a bit of exercise. The unit's family lounge gives parents, siblings, and visitors a much-needed place of their own in which to rest, socialize and, through Internet access, stay connected to family, friends, and work. Additional amenities for parents include a room in which they can spend the night; a separate shower room is available to all parents.