Presbyterian Morgan Stanley Children's Hospital
Critical Care Research Study
PICU is a central and vital component in all comprehensive acute care
children’s hospitals. Changing physical models, specifically
private patient/family rooms are being planned for and designed to
address issues of family focused care, patient privacy, sound and
infection control. These emerging physical models, and the
communication and monitoring technologies which make them possible, are
also posing challenges and raising concerns of clinical staff members
at children’s hospitals worldwide. For these reasons Poltronieri Tang
& Associates has developed and sponsored a multi-year
research study of the PICU environment. Identifying which
factors aid or hinder patient safety and appropriately balance the
needs of families for increased involvement with that of effective
clinical care delivery are essential. The health, well-being, and
recovery of patients, make an understanding of these new PICU design
current evidence based design research study evaluates three separate
PICU’s all within the same academic children’s hospital. Each
unit has significantly different spatial and environmental
characteristics. The compares and contrasts the differing
configurations, their physical layouts, space allocations, and
functional relationships. The data collected quantifies the
correlations between these environmental factors and measurements of:
family and patient satisfaction; patient safety and outcomes; and staff
efficiency and satisfaction. The results of this research are
intended to guide and inform the detailed physical planning and design
of PICU environments worldwide. It will provide a detailed and
quantified understanding of the environmental design factors that have
an impact on the pediatric intensive care setting.
Unit typologies being studied include:
- A 12-bed
open bay unit, with cubicle curtain separation
- A 13-bed
unit with glass enclosed rooms, sliding front and side walls
14-bed unit with enclosed rooms, with sliding glass fronts,
side partitions, and decentralized room-side nursing stations
differing unit configurations, their physical layout, size, space
allocations, and functional relationships have been measured,
categorized, and assessed. Additional factors including
mechanical systems, acoustics, amount of daylight, etc. have also been
noted. Each unit is evaluated against measurements of patient/family
satisfaction, staff performance and satisfaction, as well patient
safety and outcomes.
Some questions central to the
families in private rooms spend more time at bedside?
families in private rooms perceive they are getting better care?
private room PICU models require additional staffing?
clinical care staff members spend more time at bed side in private room
self-extubation rates differ between unit designs?
infection rates differ between units?
acuity adjusted ALOS differ between units?
units are being measured and evaluated through numerous research
comprehensive physical inventory of all potentially relevant
observations of all three units 168 hour period.
These observation sessions are tracking
frequency and length of caregiver/ patient, caregiver/ family, family /
patient, and family/family interactions
years of patient and quality control data are being evaluated
patient outcomes, self extubation rates, infection rates, lengths of
medical errors, staffing patterns, etc.
designed family and staff feedback questionnaires are also being
availability of three
distinct PICU’s within one children’s hospital affords an incredibly
opportunity to evaluate how these distinctly different environments
quality of care. We are anxious and excited to share our findings with
broader PICU clinical care community in order to further refine our
and conclusions. This research study will
determine how specific PICU planning and
design details influence patient outcomes, as well as staff and family
satisfaction and set new benchmarks for the design of PICU’s.