5 Evidence-based Design Strategies For ICU Patient Rooms
Of all the patient care areas in an acute care hospital, the intensive care unit (ICU) patient room is the area most likely to see medically fragile patients on a consistent basis. The ICU is also home to an array of specialized equipment, complex technologies, and staff who are frequently faced with critical decisions that need to be made in a split-second and followed up with swift and efficient actions. In order to optimize staff efficiency, as well as promote quality care and patient safety, the ICU patient room has become the Swiss watch of patient rooms—where performance is in the sum of the parts.
Through a detailed literature review, The Center for Health Design’s research team looked at room layouts as well as design strategies for everything from lighting and patient handling to furniture selection and communication/monitoring equipment. Eighteen different features were reviewed, and below are a few of the key considerations identified for your next remodel or new build.
1. Overall room layout—Improve patient mobility and reduce the risk of falls by studying the clearances in the room to be sure there’s adequate space for movement of wheelchairs, medical equipment, and furniture. Investing the time up front to build a mock-up room can reduce the chances of injuries to patients and staff in the long run. Limiting obstructions and verifying the location of equipment with the clinical team prior to building can lead to improved efficiency in the delivery of care. Larger, single patient rooms have been connected to improved staff satisfaction; improved patient satisfaction; reduced patient stress, pain, anxiety, and delirium; and reduced noise. Adequate room size has also been linked to future-proofing a space by allowing the footprint to absorb additional functions, as needed, such as adding a second bed in case of emergencies.
2. Casework and storage—Including proper casework and storage has a direct link to reducing the risk of injury to patients and caregivers. Specify rounded corners on casework found in patient/caregiver pathways and provide adequate storage for patient-handling/movement devices when not in use. Include flexible but defined options for storage of common medical supplies like linens and medications close to the patient to decrease staff time fetching them. Increase efficiency as well as reduce the chance of medical errors by creating visual and tactile discrimination between medical supplies through the use of size, color, and texture. Specifying reconfigurable casework allows for change-readiness and can reduce long-term costs.
3. Lighting—Lighting plays a significant role in ICU patient spaces. Providing adequate night lighting located between the bed and bathroom can reduce the fall risk for patients. Adequate task lighting in the medication safety zone for medication prep and administration, visual confirmation of the correct patient by reading the armband, and computer order entry provides for safe delivery of care. Thoughtfully designed lighting is not only connected to efficient and safe care, it also provides for higher levels of patient satisfaction by allowing caregivers to check on patients and equipment during the night without interrupting sleep.
4. Sound-masking equipment—Noise in an ICU is a ubiquitous concern. Use of sound-masking equipment can lead to improved comfort; enhanced privacy; and reduced patient stress, pain, anxiety, and delirium. Research links the use of white noise to reduced disruptions from noise. Technologies available to filter out or mask external noise include the use of pillow speakers or simply providing patients access to music.
5. Layout of the family zone—Friends and family members are playing a larger role in patient care, so providing well-designed, thoughtful space for them has taken on even greater importance. Position family space in the line-of-sight of staff so they can be included in the conversation and select multifunction furniture configured to facilitate communication. Position furniture so that it doesn’t encroach on the patient/caregiver zone, allows family the ability to see and hear the TV without disturbing the patient, and allows family to reach out and touch the patient and provide bedside care. Also, be thoughtful about providing access to areas outside of the patient room, but nearby, for family breaks and private conversations.
This is the second installment in a series based on the findings from a set of grants from the ASID Foundation and the Donghia Foundation. More detailed information and graphic representations of these design concepts can be found on the Design Insights and Strategies tool on The Center’s website
Watch my blog for the next installment of this series, which will look at strategies for maternity care room design. The first installment, “Six Evidence-Based Design Strategies for Med/Surg Rooms,” can be found here.