When Cardinal Glennon Children's Medical Center decided to build a new Neonatal Intensive Care Unit, patient care was the top priority. To make informed decisions for the design of their new 60-bed unit, a group of physicians and nurses toured other facilities, attended the Gravens conference, and consulted with physician experts. The group decided that private rooms offered the best model for care of their patients. NICU staff were surveyed before and after the move to learn about their experiences with this model. The hospital is currently collecting data to monitor results in terms of patient safety and outcomes, staff effectiveness, and family satisfaction.

In the new unit, staff concerns about lighting reduced from 68% to 11%; and concerns about noise decreased from 92% to 9%. Current research is analyzing decibel and light levels at the bedside before and after the move and their impact on sleep patterns and weight gain. 65% of staff believe that handwashing is better in the single patient room. This can affect infection rates and length of stay which are also being compared.

Cardinal Glennon needed to make the transition from their existing ward unit without increasing their staffing ratio. Cardinal Glennon's Hours Per Patient Day (HPPD) were benchmarked against other NICUs in their peer group, and simulations were created to determine optimum pod size to maintain staffing. Measurements from before and after the move have demonstrated no increase in HPPD.

Nurses were concerned about feeling isolated in the new unit where a centralized nurse station would be replaced with distributed alcoves. To ease this transition, two nurses were part of the design team which visited and held learning sessions with peer hospitals in Minnesota and Iowa . An "On the Move" team of 12 staff members developed policies and designed work flow for the unit.

To create visual connection and maximize patient safety, windows and glass doors allow views into each room. Visibility of the patient's monitor from the charting desk was tested with a full-scale room mockup. Research was done to determine the most effective methods of electronic communication. Staff satisfaction has demonstrated increases in direct proportion to the improved level of care that is being provided.

The hospital's land-locked urban site required the use of every square foot to accommodate 60 beds. Existing NICU plans from across the country were studied to determine the optimal amount of support space and learn about family amenities. The Parent Support Group, composed of former NICU families, was included in the design process to assure that families would feel comfortable in the new unit. This group was surveyed for interior finish preferences, gave input in the design of the waiting room and family lounge, and toured the patient room mock-up to provide feedback about its design. Each patient room includes a sleepover sofa, kangaroo chair, and locker for family belongings. A curtain between the baby and family allows staff to observe patients without disturbing parents. The impact of these decisions on family comfort, as well as the family's time at the bedside, knowledge of their child's caregivers, and family satisfaction, are also being studied.

As a member of SSM Health Care, the first health care organization to receive the Malcolm Baldrige National Quality Award, Cardinal Glennon recognizes the importance of measurement to ensure exceptional results. In the year since NICU's completion, data analysis has been an important component of the unit's success and measurement will continue to drive improvement initiatives throughout the department.