Healthcare Design - November 2017 - 92

In Focus

92

NOVEMBER 2017

Common areas at East
Tennessee Children's Hospital in Knoxville, Tenn.,
allow families to spend
quality time together while
remaining close to the
neonatal patient.

EVOLUTION OF NICU CARE

In the 1970s, NICUs were typically designed in pods, with four to six beds
per pod and four pods per 32- to 36-bed floor. These departments maintained a staffing ratio of one nurse to two to four patients and one physician to eight to 20 patients. The closed pod setup was inefficient for patient
care, though-especially from a staffing perspective-because the addition
of one infant beyond the capacity of the pod meant another pod had to be
opened with additional staff. Twenty years later, the next generation of the
NICU used a pinwheel configuration with individual patient spaces in each
segment of the pinwheel, a spatial organization that provided more privacy
but resulted in a noisy, crowded environment. However, mothers in need of
companionship and support during a stressful time found the closeness to
other mothers reassuring, and the sound of the open NICU was thought to
provide a level of stimulation that's helpful to the neonates.
More recently, healthcare organizations' emphasis on reducing infection
rates and readmissions and improving quality and safety scores has pushed
the adoption of private-room NICUs, similar to other pediatric ICU layouts. Research studies, such as "18-Month Follow-up of Infants Cared for
in a Single-Family Room Neonatal Intensive Care Unit" published in Journal of Pediatrics in 2016, supports Lakshminrusimha's observation that the
model improves babies' length of stay and growth, breastfeeding, and parent satisfaction. Single patient rooms also greatly enhance patient privacy

HCDMAGAZINE.COM

DENISE RETALLACK, COURTESY OF SHEPLEY BULFINCH

I

N H O S P I T A L S across the country, neonatal intensive care units
(NICUs) are evolving from compact,
multipatient-room environments
to expansive, all-private-room settings. "The consensus among neonatologists is that the move to a
private-room NICU provides better
outcomes: decreased length of stay, improved
breastfeeding, and increased parent satisfaction and mother-baby bonding," says Dr. Satyan
Lakshminrusimha, chief of neonatology at John
R. Oishei Children's Hospital in Buffalo, N.Y.
This fundamental shift in care has implications
for NICU design, size, staffing, and operational
efficiency. However, there's an increased concern that despite the benefits noted, this new
approach brings its own challenges, including
new parents feeling physically and emotionally
isolated while caring for their babies, requiring
healthcare designers to identify solutions that
balance competing needs.

2/10


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Table of Contents for the Digital Edition of Healthcare Design - November 2017

Healthcare Design - November 2017
Contents
Editorial
From the Publisher
Show Talk
Photo Tour
Photo Tour
Maine Stage
Preserving an Icon
Magic Moment
Time to Shine
All Together Now
Operations Delivering a New Experience
Engineering Lessons From Rwanda
Product Spotlight Outdoor Furniture
The Center
Aia-Aah
Project Watch
Product Gallery
Face Time
Healthcare Design - November 2017 - Healthcare Design - November 2017
Healthcare Design - November 2017 - Cover2
Healthcare Design - November 2017 - 1
Healthcare Design - November 2017 - 2
Healthcare Design - November 2017 - Contents
Healthcare Design - November 2017 - 4
Healthcare Design - November 2017 - 5
Healthcare Design - November 2017 - 6
Healthcare Design - November 2017 - 7
Healthcare Design - November 2017 - 8
Healthcare Design - November 2017 - Editorial
Healthcare Design - November 2017 - 10
Healthcare Design - November 2017 - 11
Healthcare Design - November 2017 - 12
Healthcare Design - November 2017 - From the Publisher
Healthcare Design - November 2017 - Show Talk
Healthcare Design - November 2017 - 15
Healthcare Design - November 2017 - Photo Tour
Healthcare Design - November 2017 - 17
Healthcare Design - November 2017 - 18
Healthcare Design - November 2017 - 19
Healthcare Design - November 2017 - 20
Healthcare Design - November 2017 - 21
Healthcare Design - November 2017 - 22
Healthcare Design - November 2017 - 23
Healthcare Design - November 2017 - 24
Healthcare Design - November 2017 - 25
Healthcare Design - November 2017 - Photo Tour
Healthcare Design - November 2017 - 27
Healthcare Design - November 2017 - 28
Healthcare Design - November 2017 - 29
Healthcare Design - November 2017 - 30
Healthcare Design - November 2017 - 31
Healthcare Design - November 2017 - 32
Healthcare Design - November 2017 - Maine Stage
Healthcare Design - November 2017 - 34
Healthcare Design - November 2017 - 35
Healthcare Design - November 2017 - 36
Healthcare Design - November 2017 - 37
Healthcare Design - November 2017 - Preserving an Icon
Healthcare Design - November 2017 - 39
Healthcare Design - November 2017 - 40
Healthcare Design - November 2017 - 41
Healthcare Design - November 2017 - Magic Moment
Healthcare Design - November 2017 - 43
Healthcare Design - November 2017 - 44
Healthcare Design - November 2017 - 45
Healthcare Design - November 2017 - 46
Healthcare Design - November 2017 - 47
Healthcare Design - November 2017 - 48
Healthcare Design - November 2017 - 49
Healthcare Design - November 2017 - 50
Healthcare Design - November 2017 - 51
Healthcare Design - November 2017 - 52
Healthcare Design - November 2017 - 53
Healthcare Design - November 2017 - 54
Healthcare Design - November 2017 - 55
Healthcare Design - November 2017 - Time to Shine
Healthcare Design - November 2017 - 57
Healthcare Design - November 2017 - 58
Healthcare Design - November 2017 - 59
Healthcare Design - November 2017 - 60
Healthcare Design - November 2017 - 61
Healthcare Design - November 2017 - 62
Healthcare Design - November 2017 - 63
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Healthcare Design - November 2017 - 69
Healthcare Design - November 2017 - 70
Healthcare Design - November 2017 - 71
Healthcare Design - November 2017 - 72
Healthcare Design - November 2017 - 73
Healthcare Design - November 2017 - All Together Now
Healthcare Design - November 2017 - 75
Healthcare Design - November 2017 - 76
Healthcare Design - November 2017 - 77
Healthcare Design - November 2017 - 78
Healthcare Design - November 2017 - 79
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Healthcare Design - November 2017 - 86
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Healthcare Design - November 2017 - 88
Healthcare Design - November 2017 - 89
Healthcare Design - November 2017 - 90
Healthcare Design - November 2017 - Operations Delivering a New Experience
Healthcare Design - November 2017 - 92
Healthcare Design - November 2017 - 93
Healthcare Design - November 2017 - 94
Healthcare Design - November 2017 - 95
Healthcare Design - November 2017 - 96
Healthcare Design - November 2017 - 97
Healthcare Design - November 2017 - 98
Healthcare Design - November 2017 - 99
Healthcare Design - November 2017 - Engineering Lessons From Rwanda
Healthcare Design - November 2017 - 101
Healthcare Design - November 2017 - 102
Healthcare Design - November 2017 - 103
Healthcare Design - November 2017 - 104
Healthcare Design - November 2017 - 105
Healthcare Design - November 2017 - Product Spotlight Outdoor Furniture
Healthcare Design - November 2017 - 107
Healthcare Design - November 2017 - The Center
Healthcare Design - November 2017 - 109
Healthcare Design - November 2017 - 110
Healthcare Design - November 2017 - Aia-Aah
Healthcare Design - November 2017 - 112
Healthcare Design - November 2017 - 113
Healthcare Design - November 2017 - 114
Healthcare Design - November 2017 - 115
Healthcare Design - November 2017 - 116
Healthcare Design - November 2017 - Project Watch
Healthcare Design - November 2017 - 118
Healthcare Design - November 2017 - 119
Healthcare Design - November 2017 - 120
Healthcare Design - November 2017 - 121
Healthcare Design - November 2017 - 122
Healthcare Design - November 2017 - 123
Healthcare Design - November 2017 - 124
Healthcare Design - November 2017 - 125
Healthcare Design - November 2017 - 126
Healthcare Design - November 2017 - Product Gallery
Healthcare Design - November 2017 - 128
Healthcare Design - November 2017 - 129
Healthcare Design - November 2017 - 130
Healthcare Design - November 2017 - 131
Healthcare Design - November 2017 - 132
Healthcare Design - November 2017 - 133
Healthcare Design - November 2017 - 134
Healthcare Design - November 2017 - 135
Healthcare Design - November 2017 - Face Time
Healthcare Design - November 2017 - Cover3
Healthcare Design - November 2017 - Cover4
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