Architecture Students Design Neonatal Intensive-Care Unit of the Future

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Amanda Cross, an architecture student in the Fay Jones School of Architecture, explains a proposal she and teammate, Krystina Tacchi, for design of a new neonatal intensive-care unit at Phoebe Putney Memorial Hospital in Albany, Ga.

Amanda Cross, an architecture student in the Fay Jones School of Architecture at the University of Arkansas, finished explaining why she and her partner, Krystina Tacchi, designed a neonatal intensive-care unit with a fan-like layout of patient alcoves and shared family spaces. Someone responded that the pod-like arrangement would provide families with a sense of privacy while allowing good visibility of infants by the nursing staff.

It was a typical comment that someone providing critique for a design class might offer to students, except that this comment came from Jeannine Ancatalado, interim nursing director of the neonatal intensive-care unit at a hospital some 600 miles away in Albany, Ga.

She and several shift supervisors from the unit, a nurse educator, and a fundraiser for the Children’s Miracle Network, the source of funding for this project, sat in on August presentations by University of Arkansas architecture students via video conference. This approach allowed presenters in Arkansas and staff members at Phoebe Putney Memorial Hospital to see each other, as well as the architectural drawings and models that were presented.

The four student design teams had their work cut out for them when they signed on to design a neonatal intensive-care unit. The professor of the summer studio, Tahar Messadi, asked them to concentrate on designs that would promote family-centered care in the neonatal intensive-care unit, while also taking circulation patterns, natural light, acoustical conditions and efficient use of space into consideration.

He also asked the teams to document the research that supported their designs, both from an extensive literature survey and from field interviews. There is increasing evidence that the physical design of such units and other health care environments affect health-related outcomes such as patient stress, sleep and even the transmission of infections. Applying research in the design process is part of a recent trend in architecture called evidence-based design.

John Fischer, vice president of Phoebe Putney Memorial Hospital, examines a scale model of one of the proposed designs.

Part of the students’ research included a trip to see Phoebe Putney Memorial Hospital’s current neonatal intensive-care unit, which reinforced what they had learned about how the physical environment may affect family stress, privacy, and the manner in which nurses care for their tiny patients.

“Before the studio class, most of the student’s had not heard of a ‘NICU’,” said Sheila Bosch, director of research for Gresham, Smith and Partners, a national architecture, engineering and interior design firm working with Phoebe Putney Memorial Hospital. “Upon seeing the faces of fragile infants, some of whom were fighting for their very lives, I believe it really hit home with the students that their work as designers is more than form and function – it can significantly alter the experience of those for whom they design.”

The class also toured recently opened neonatal intensive-care units at Willow Creek Women’s Hospital in Johnson, Ark., and the University of Arkansas for Medical Sciences in Little Rock.

Each of the design teams approached aspects of the neonatal intensive-care unit differently: the first team provided a good separation of public traffic from the nursing and custodial traffic; the second team used a more traditional layout of rooms but gained efficiency in use of space; the third team created open-air gardens to allow parents or siblings a space to step away from the stress; and the fourth team created a design that allowed open-bay rooms to be turned into private rooms if the market trends that direction.

“I was incredibly impressed at the level of sophistication of the presentations,” said John Fischer, vice president of Phoebe Putney Memorial Hospital, sponsor of this project. “Every group has come up with creative solutions. Nothing is perfect at this stage, but they’ve all found practical solutions.”

The other student teams included Brandon Fryxwell and Mary Bost; Isaac Cortes and Humberto Mayoral; and Hilary Johnson and Janiva Henry. At the mid-point of the design process, Fischer decided he so liked what he had seen so far that he made a decision to be in Fayetteville for the final design critiques. Steve Klein and Bob Gower, senior architects with Gresham, Smith and partners; Andy DeYoung from Crafton, Tull and Sparks; and Dr. Bo Lin, director of the Willow Creek neonatal intensive-care unit, also joined the presentations at the School of Architecture to review the students’ work.

Gower described the designs as very “enabling architecture,” the sort that allows “staff to do their jobs without being in the way.”

Fischer perceived not only the architecture to be enabling but also the process: “this project has really engaged the nursing staff at a level we don’t always get to provide.”

Bringing student designers into the process allowed unforeseen questions and unexpected answers to percolate through the design process, even if some of the questions traveled 600 miles to get answered.