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Children’s Hospital Southeastern United States

September 2011
EDAC Advocate Firm Project


Firm's role on the project:  Planning, Programming, Architecture, Design, Interiors 

EBD Goal

In order to better serve the needs of the community, a children’s hospital recently renovated and expanded 10,000 square feet of the facility’s neonatal intensives care unit (NICU). The expansion added 23 private single-family rooms (SFRs) to bring the level III tertiary care NICU to 64 beds total. The family-focused program at this case study site was designed to improve safety and quality to meet the specific needs of patients, their families, and staff.


A growing body of research evidence demonstrates that environmental conditions affect the well-being of patients, family members, and staff. For many years the NICU setting has consisted of open-bay, multi-bed environments, but in recent years there has been an increase in the design and construction of single-family rooms (SFRs) to provide more family-centered care. An individual room allows each infant to receive levels of stimuli appropriate for its developmental needs and affords privacy to family members. Yet there are also disadvantages to implementing the SFR model, such as increased costs and potentially increased isolation of staff members. Hospital decision-makers often wrestle with whether or not to implement the SFR model when designing or redesigning a NICU, and there are not enough studies documenting the advantages or disadvantages of the SFR design approach.


The project team started by developing a hypothesis that staff members working in the combination NICU (open bays and single family rooms) will perceive their work environment as being more positive than the pre-renovated, open bay only NICU. We also hypothesized that staff members would perceive the combination unit to be superior in terms of quality and safety for infants and their family members when compared to the open-bay only unit.
A pre-move and post-move survey was developed and administered to the nursing staff by the NICU director. The post-move survey had a lower response rate than the pre-move survey (25% versus 55%). The findings demonstrate that the staff members now perceive their work environment to be more positive (e.g., job stress, morale at work, staff privacy) than in the open-bay, pre-renovated unit. Also, staff members perceived that the new, combination NICU is better in terms of safety and quality for infants and their families (e.g., privacy, noise levels and lighting). The next step is to submit a manuscript to a peer-reviewed journal for publication.