Design and Workflow in Single-Family NICU Rooms: Examining Flow Disruptions in Infant Care

Abstract

Neonatal intensive care units (NICUs) are uniquely complex settings, where families and clinicians navigate workflows shaped by sophisticated medical technology and safety risks surrounding fragile infants. To enhance developmental care, many NICUs have transitioned toward the Single-Family Room (SFR) design model, treating patients in private rooms. Compared to open bay layouts, SFRs have shown increased infection control and family participation in care. Despite these benefits, relatively little is known about how SFR design characteristics introduce safety risks to infant care, especially considering the increased family involvement in care tasks such as Kangaroo care and infant feeding. These tasks can be cognitively and physically demanding, especially for families, and carry substantial risk of infection, traumatic injury and medical errors. While design may potentially minimize flow disruptions and risks in healthcare tasks, evidence is scarce from the built environment perspective, especially in the NICU. We conducted a study to identify how specific SFR features such as room size, layout, and equipment/furniture design can influence disruptions in the flow of infant care tasks jointly performed by families and staff. Using an exploratory approach, we conducted two online focus groups and a case study involving field observations and interviews, thematically analysing the data. Findings revealed 11 types of design-related flow disruptions in the SFR, categorized as high and low risk. Flow disruptions were linked to SFR layout, storage and surface organization, infant bed clearances, cord management, and furniture/equipment design. Findings also revealed physical mechanisms involved in these flow disruptions, laying foundation for future research.

Keywords: Healthcare Design, Built Environment, Neonatal Intensive Care Unit (NICU), Safety, Single-family Room, Flow Disruptions

DOI: 10.54941/ahfe1007479