Planning an ICU: What You Should Know Post-COVID

Planning an ICU: What You Should Know Post-COVID

The need for adaptable and forward-thinking intensive care units (ICUs) has never been more evident. The COVID-19 pandemic forced hospitals to rethink their ICU infrastructure, prompting a shift towards a holistic design approach.  

The ICU planning process begins with a deep analysis of the hospital campus, extending all the way to the placement of a simple light switch in a patient’s room.  

Following these five major tenets of planning a post-COVID ICU will put any hospital system on a path towards providing an efficient and welcoming intensive care unit. 

Advisors quote iconThe process of planning a successful ICU begins by guiding the hospital owner through early visioning sessions.”

Early Visioning and Critical Success Factors

The process of planning a successful ICU begins by guiding the hospital owner through early visioning sessions. During these sessions, Critical Success Factors (CSFs) are established, and an Operational Team is formed with regular touchpoints to ensure a cohesive approach to the project. These CSFs serve as the bedrock of the planning and early design process and include considerations like the standardization of room types for improved patient outcomes and staff ease of use. 

ICU diagram showing decentralized nurse work areas with integrated patient monitoring technology and view windows to patient rooms for observation

An ICU diagram showing decentralized nurse work areas and a large family zone for care-giver overnight stays.

Expanding Beyond Patient Rooms

It’s essential to recognize that a well-designed ICU extends beyond patient rooms. For Frontline staff moving in a hurry, removing guesswork is key. Medication rooms, nourishment alcoves, clean supply rooms, and equipment rooms all benefit from proper planning and a standardized approach. This consistency streamlines logistics, aiding both the staff responsible for stocking these spaces and those who rely on them in high-pressure situations.

Other Critical Success Factors for ICUs

There are other critical patient and staff considerations that should be addressed early in the process.  

  1. Creating Flexible Units: Preparing for future pandemics or surges necessitates considering larger rooms for double occupancy, additional infrastructure for negative air floors, and adequate provisions for personal protective equipment (PPE).
  2. Family and Visitor Satisfaction: Larger spaces and more amenities in waiting areas can enhance the overall experience for families and visitors—which has a direct impact on a patient’s wellbeing. 
  3. Staff Satisfaction: Creating an optimal staff work environment is vital. Providing spacious work areas, respite zones, and improved amenities for staff can boost morale and overall job satisfaction. Something as simple as ensuring staff can see the outdoors can have huge benefits. The professionals that staff an ICU have a stressful job, so it’s important that the design of an intensive care unit accounts for their safety, physical and mental health. 

Evaluating Existing Conditions and Case Studies 

To design an effective ICU, it’s crucial to evaluate existing conditions and review relevant case studies. Existing facilities offer insights into what works and what doesn’t. Successful systems and practices should be implemented, while shortcomings must be documented and addressed. 

Reviewing ICU Logistics

Logistics can be organized into two broad categories, what is going in and what is coming out.  

Incoming: Evaluate logistics for incoming supplies, linen, medications, patient meals, staff, and medical equipment to streamline processes. 

Outgoing: Ensure efficient systems for handling soiled linen, biohazard waste, and trash. 

Learning from Case Studies

Learning from recently opened facilities can provide valuable perspectives on the planning process and implementation. Case studies reveal the successes and failures of previous designs, helping planners make informed decisions. However, these comparisons must always be weighed along with the specific feedback collected in the visioning sessions. 

Operationalizing Priorities

Patient safety and better outcomes are paramount when planning a new ICU. The Operational Team must meticulously map patient transfers to minimize them when possible. Always consider the relationships between the ICU, Emergency Department, Imaging, and Surgery, aiming for expedited, smooth, and safe transfers.

Enhancing the Visitor Experience

Patient satisfaction surveys can provide valuable insight into visitor experience factors and should not be overlooked. Factors such as ease of parking, wayfinding and signage, on-unit and off-unit amenities, noise control, lighting, and access to PPE contribute to a positive ICU visitation experience.  

CaroMont Gastonia Critical Care Tower designed by McMillan Pazdan Smith Architecture

Patient rooms feature a large family zone for caregiver overnight stays and adequate clearance around the bed for long-range flexibility.

ICU Mock-ups and Testing

 Creating both virtual and full-size mock-ups provide opportunities to evaluate elements and spaces for ease of use, durability, noise levels, and overall quality. It allows for the testing of various configurations for areas including documentation stations, staff work areas, footwall layouts, and lighting systems. A thorough evaluation process determines the optimal layout and components of each space.  

Involving Frontline Hospital Staff

Frontline staff, along with the Operational Team, should have the opportunity to review, comment, and provide feedback during the evaluation phase. Their input is invaluable for refining the design to meet the practical needs of every user. 

Paying Attention to the Details 

ICU efficiency and success lie in the details. Acknowledge the significance of seemingly small aspects that collectively enhance the patient experience and streamline operations. 

  • Floor Markings: Implement floor markings to help gauge the distance patients walk. 
  • Circadian Rhythm Lighting: Utilize lighting control systems to align patient room lighting with circadian rhythms. 
  • Family Accommodations: Provide space for families at the ICU patient’s bedside. 
  • Patient Control: Allow patients to control visibility into their rooms with integral louvers and motorized shades. 
  • Reducing Noise: Install white noise at patient doors to reduce corridor noise. 
  • Digital Signage: Implement digital signage at patient doors to eliminate paper and temporary signage. 
  • PPE Cabinets: Integrate PPE cabinets into the architecture. 
  • Dialysis Facilities: Consider including dialysis boxes on headwalls for convenience. 

Much more collaboration and planning go into the planning and design of an excellent ICU — especially in a post-COVID environment. Having an experienced team that is committed to taking a holistic approach that encompasses every aspect, from early visioning and standardization to meticulous attention to detail will benefit any hospital system.  

By beginning with these major tenets, healthcare facilities can provide ICUs that prioritize patient care, staff well-being, and visitor satisfaction, while ensuring adaptability in the face of evolving healthcare challenges.

If you need a trusted partner to help you plan a successful ICU for your hospital, schedule a discovery call with our Advisors team today. 

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