Two Decades (1993-2012) of Adult Intensive Care Unit Design: A Comparative Study of the Physical Design Features of the Best-Practice Examples

Abstract

In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best-practice example adult intensive care units (ICUs) [1]. These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical Care Nurses (AACCN), and the American Institute of Architects/Academy of Architecture for Health (AIA/AAH) for their efforts to promote the critical care unit environment through design. Since 2003 several more adult ICUs were also awarded by the same organizations for similar efforts. The present study includes these newer ICUs with those of the previous study to cover a period of two decades from 1993 to 2012.

Like the 2006 study, the present study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. Based on the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of HealthCare Facilities [2] of the Facility Guidelines Institute (FGI) and the 2012Guidelines for Intensive Care Unit Design [3] of the Society of Critical Care Medicine (SCCCM).

The study indicates that the award-winning ICUs of both the decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the awardwinning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the FGI Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both the decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical design of these award-winning ICUs may help design better ICUs.