title: Evidence-based design in an intensive care unit: end-user perceptions.
abstract: BACKGROUND
  The objective of this study was to describe end-user impressions and experiences in a new intensive care unit built using evidence-based design.
  
  
  METHODS
  This qualitative study was comprised of early (2-3 months after opening) and late (12-15 months after opening) phase individual interviews with end-users (healthcare providers, support staff, and patient family members) of the newly constructed Foothills Medical Centre intensive care unit in Calgary, Canada. The study unit was the recipient of the Society of Critical Care Medicine Design Citation award in 2012.
  
  
  RESULTS
  We conducted interviews with thirty-nine ICU end-users, twenty-four in the early phase and fifteen in the late phase. We identified four themes (eleven sub-themes): atmosphere (abundant natural light and low noise levels), physical spaces (single occupancy rooms, rooms clustered into clinical pods, medication rooms, and tradeoffs of larger spaces), family participation in care (family support areas and social networks), and equipment (usability, storage, and providers connectivity). Abundant natural light was the design feature most frequently associated with a pleasant atmosphere. Participants emphasized the tradeoffs of size and space, and reported that the benefits of additional space (e.g., fewer interruptions due to less noise) out-weighed the disadvantages (e.g., greater distances between patients, families and providers). End-users advised that local patient care policies (e.g., number of visitors allowed at a time) and staffing needed to be updated to reflect the characteristics of the new facility design.
  
  
  CONCLUSIONS
  End-users identified design elements for creating a pleasant atmosphere, attention to the tradeoffs of space and size, designing family support areas to encourage family participation in care, and updating patient care policies and staffing to reflect the new physical space as important aspects to consider when building intensive care units. Evidence-based design may optimize ICU structure for patients, patient families and providers.
authors.affiliation: Department of Community Health Sciences, Institute for Public Health, University of Calgary, Calgary, Canada. mbellerferri@gmail.com.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Ferri
authors.affiliation: Division of Critical Care, University of Alberta, and Alberta Health Services, Edmonton, Canada. zygun@ualberta.ca.
authors.forename: David A
authors.initials: DA
authors.lastname: Zygun
authors.affiliation: Department of Community Health Sciences, Institute for Public Health, University of Calgary, Calgary, Canada. acharris@ucalgary.ca.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Harrison
authors.affiliation: Department of Community Health Sciences, Institute for Public Health, University of Calgary, Calgary, Canada. tstelfox@ucalgary.ca.|Department of Critical Care Medicine, University of Calgary, and Alberta Health Services, Calgary, Canada. tstelfox@ucalgary.ca.|Department of Medicine, University of Calgary, and Alberta Health Services, Calgary, Canada. tstelfox@ucalgary.ca.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
mesh_terms: D000328:Adult; D000416:Alberta; D001291:Attitude of Health Personnel; D003256:Community Participation; D000067013:Evidence-Based Facility Design / Q000592:standards*; D005190:Family / Q000523:psychology*; D005260:Female; D006749:Hospital Design and Construction / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008029:Lighting; D008297:Male; D008875:Middle Aged; D009622:Noise; D010362:Patients' Rooms / Q000592:standards; D010549:Personal Satisfaction; D012944:Social Support