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Dedicated Service Corridor in an Adult Cardiac ICU, A Medical Center in the North Central United States

September 2012
EDAC Advocate Firm Project
Cannon Design

CANNON DESIGN


 

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

  
EBD Goal 

To reduce noise and distractions in the patient care environment in the design of a new adult cardiac ICU.


Challenge

Shared corridors immediately adjacent to patient rooms are generally noisy due to a variety of activities, including service deliveries and pickups.  This phenomenon is thought to be detrimental to patient care by creating noise and negative distractions and environmental stress, which may contribute to medical errors and impact bedside caregiving. 
 

Solution

This project team hypothesized that adding a dedicated service corridor to a typical racetrack-style patient care unit would help to reduce noise and improve patient care by separating support staff traffic from patient care traffic.  Limited research has been done to investigate this design strategy and its impact on the sound levels in patient care environments and nursing performance.
 
A post occupancy evaluation compared the noise and staff performance in an ICU with a dedicated service corridor to those in the ICU’s previous environment, without the corridor.  The same groups of staff in the ICU were surveyed to investigate their pre- and post-move environmental comfort, stress, and satisfaction.  To collect baseline performance measures, the previous ICU was used as the control environment for the acoustical data collection and onsite observations. 
 
Statistical analyses showed that the perceived noise level was lower and staff reported less stress and more satisfaction in the new ICU.  Analyses of acoustical data confirmed that the new ICU was significantly quieter.  The average sound levels in the new unit range from 51 (night) to 53 (daytime) dBA, which were lower by 2-4 dBA than the control environment.
 
In the new unit, sound profile was largely characterized by the sounding of alarms.  In the control environment, observers did notice the HVAC noise more than in the new unit, which served as a constant background, disguising other noise.  Observations and acoustic readings added a valuable layer of data to this study, providing firsthand information of the actual activities in the corridors, not just those reported in the staff surveys.  The addition of the dedicated service corridor contributed to the reduction of noise and helped to improve nurse satisfaction and reduction of stress.