Future Model for Pediatric ICU (PICU) Patient Room: Optimize Care Delivery in Terms of Staff Efficiency By Design

Yuqian Lu (Cornell University)

Work environment in hospitals are burdened with inefficiencies that stem from the physical space design, especially for care deliverers who provide cares to the vulnerable pediatric population (Pati, Harvey & Thurston, 2012; Zimring et al., 2013). These inefficiencies translate to serious patients’ health consequences, such as higher Hospital-acquired infections (HAIs) rates and longer length of stays (Zimring et al., 2013). Thus, the study identifies the desired physical environment, amenities and spaces in a pediatric patient room to support a safe and speedy care delivery. The study has two aims: 1) improve efficiency for care delivery by design (e.g. minimize steps Registered Nurses (RNs) take in delivering care); 2) minimize the risk of HAIs (e.g. reduce contact transmissions). To achieve that, the study identified the RNs care delivery workflow in the Pediatric Intensive Care Units (PICU) patient room, listed high touch surfaces , and proposed a desired workflow and diverse interior design accommodations according to Lean and evidence-based research. This novel study presented a new visual environmental evaluation tool and demonstrated its application in measuring the person-environment interaction with the intend to create safe and efficient pediatric care environments. To be more specific, a 40 hours observation was conducted in the New York Presbyterian Hospital PICU patient room to record work steps, walking paths, activities, and high touch surfaces. Additionally, open-ended interview was conducted with the nurses to understand their daily activities and work experiences in the patient room. Overall, the findings outlined key findings and design proposals on improving efficiency by design via rethinking room layout, arrangement and amenities and enhancing infection prevention by minimizing opportunities for transfer via touch. This study will inform the future design for pediatric intensive care units.