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The Business Case for Building Better Neonatal Intensive Care Units

Originally Published:
Journal of Perinatology
Key Point Summary
Key Concepts/Context
There is increasing evidence that the physical environment of the Neonatal Intensive Care Unit (NICU) has a tangible effect on the vulnerable infants who spend the first crucial weeks or months of their life there. While many aspects of NICU design have been evaluated, none is more notable than the single-family room (SFR) concept because of its many potential benefits, possible hazards, and its increased cost of construction. Data is now available to allow us to establish a cost-benefit analysis of SFR design in the NICU by assessing its impact on operating costs.
This paper reviews the cost implications of SFR design and compares those to its quantifiable benefits.
This paper uses literature review and cost-benefit analysis methods to assess the relationship between design features and capital costs. The authors also enumerate non-quantifiable benefits and hazards of SFR design and describe additional desirable, evidence-based design aspects for those who are considering new NICU construction or major renovation.
Design Implications
There may be valid reasons for not placing some babies in an SFR NICU room, but financial barriers are not among them. Therefore, SFRs are considered to be a reasonable option for those considering the construction or renovation of NICUs.
The incremental cost of constructing a NICU with mostly single-family rooms rather than placing all beds in a multiple-bed room design may be recouped after the first year of operation, with substantial operating savings each year thereafter. 
Insufficient evidence is available to draw additional inferences. If additional observed benefits were quantifiable, the savings from SFR design could be much greater.
Design Category
Acoustic Environment|Lighting (artificial and natural)|Room configuration and layout|Unit configuration and layout
Outcome Category
Error related outcomes|Patient / resident health outcomes|Patient / resident satisfaction and comfort|Staff satisfaction|Visibility
Environmental Condition Category
Lighting|Patient Satisfaction and Comfort|Physical proximity/density|Sound|Visibility
Primary Author
Shepley, M., Smith, J.A., Sadler, B.L. & White, R.D.