Access, observation, and efficiency drive design of revived Neurological Intensive Care Unit
[Winfield, IL] – In the intensive care unit (ICU), every moment counts. That’s why when Northwestern Medicine Central DuPage Hospital (CDH) set out to renovate its Neurological ICU, it wanted to create the most efficient setting possible. CDH also wanted to go beyond the typical ICU and bring its staff and patients a more welcoming, less clinical setting.
Today, in the completely renewed and more spacious third floor Neuro ICU, doctors and nurses rely on everything from ceiling-mounted medical booms in patient rooms to caregiver alcoves in corridors to serve patients with maximum efficiency. Visitors know something is special about the revived ICU the moment they experience the soft lighting and warm wood tones.
The 11,000-square-foot renovation, designed by Legat Architects and built by Bulley & Andrews, expands corridors and converts 16 patient rooms to 12 larger rooms. Caregivers have better views of and access to patients. Robert G. Burkhardt & Associates led MEP/FP engineering, while C.E. Anderson & Associates led structural engineering.
The project also includes an expanded family lounge, conference room, staff lounge and locker room, pharmacy, EEG room (i.e., 24-7 patient monitor room), offices, and support/storage space.
Access on All Four Sides
Like many hospitals’ patient rooms, beds in CDH’s previous Neuro ICU were tethered to the headwall, which supplied cable and hose connections. Therefore, doctors and nurses could only work on three sides of the patient.
Now, caregivers have 360-degree access to the centralized beds. That’s partly because the rooms are larger, and partly because of the two medical booms suspended from the ceiling in every room. Clinicians can easily move these pivoting vertical columns to plug into medical gases, data, and other services. Caregivers are no longer constrained by cables, cords, or even the wall behind the headboard.
Layers of Observation
Due to the critical nature of the ICU, CDH and Legat focused on keeping as many caregiver eyes on the patients as possible. The design responds with several layers of observation.
It starts with the main caregiver station, which has a direct line of sight to all 12 patient rooms. At the center of the station, doctors and nurses can sit on stools or stand and work at 36-inch-high tables, while also observing the patient. Desks around the station’s perimeter are at the standard 29-inch height so seated caregivers can see into the rooms. Large-screen monitors around the station are mounted higher up to keep views open to patient rooms.
“Caregivers throughout the ICU have unobstructed views into patient rooms,” said Legat’s Derek Dunn. “Large windows enable them to see into the room without opening the door and disturbing the patient.”
The increased room depth allowed for installation of caregiver alcoves just outside each patient room. Doctors and nurses use these stations to do charting without disrupting patients, plus it adds another layer of observation. CDH staff suggested a second window be added to each alcove. This enables staff to see the room directly in front of the alcove, as well the room to its side. Thus, every room can be viewed from two separate caregiver alcoves.
The design team also wanted to prevent caregiver alcove chairs from rolling into the corridor and impinging on the eight foot required clearance. Legat’s Steve Blye, associate director of healthcare, carried over an innovation he helped create (while with another firm) for the CDH bed tower addition—beneath the nursing alcove desks, fixed retracting chairs connect to an arm. Seating is two per arm so two caregivers can sit side-by-side. It keeps the corridor clear, plus caregivers never have to go looking for a chair!
A Clean, Comfortable Place
When it comes to ICUs, a sanitary environment is critical, especially with the threat of nosocomial (i.e., hospital-acquired) infections. The CDH ICU was designed to eliminate such threats. For instance, all room doors and windows have “integral blinds” encased between two pieces of glass so no infectious particulates will stick to the blinds. Caregivers use thumbwheels to operate the blinds from inside and outside the room.
Because of its neurological focus, the renewed ICU is extra sensitive to patient comfort . . . starting with 100% LED lighting. Corridors have indirect lighting so that when patients are transported, they don’t experience the harsh glare of the more typical down lights. The same ambient lighting can be achieved in patient rooms. Overhead direct down lights are only on during procedures or cleaning. Additionally, virtually all lighting is dimmable—caregivers can set it at any level that suits their needs.
Patients have “pillow speakers” that give them control of reading lights and shades. The devices also have controls for the TV, nurse call, and bed settings.
The Legat team took extra steps to reduce the intimidation factor. Caregiver stations are quartz stone and durable plastic laminate that looks like wood—real wood veneer chips easily—appears throughout the space. Most notable is the sweeping wood-toned elliptical ceiling cove that tops the central caregiver station. Footlights coves below the main caregiver station create more visual drama, but also work well late at night when other lights are dimmed.
The design of the CDH Neuro ICU also conceals equipment wherever possible.
“As you look around, you see that, for most part, anything ‘clinical’ or ‘medical’ is out of sight,” said Blye. “This strategy, along with the materials, the layout, and the lighting, helps reduce the stress that is inherent in the ICU experience.”
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