A research team, comprising clinicians and consultants, was established to measure the effects of the new facility on staff, parents, babies and the environment. The research staff were gathering information and collecting data even before the old unit was demolished and briefing began on the new NICU, primarily to make a case for funding the new unit. This meant they were also well-placed to provide a very clear brief and were aware of all the issues the new NICU would need to address.
The team focussed on four areas of research:
- Building Data: sound and light and energy efficiency
- Parent wellbeing and behaviour
- Infant wellbeing
- Staff wellbeing and behaviour
The tools used for the evaluation were questionnaires, interviews, cot side diaries, baby movement detection, staff tracking and light meters.
The baby movement detectors were small, self -contained wireless devices mounted on the babies’ nappies to measure breathing, restlessness and sleep patterns.
Nurses were located by wi-fi triangulation and tags. Their location information was recorded continuously throughout a 24-hour cycle and used to calculate time spent in clinical rooms, caring for babies, and in non- clinical rooms such as the nurses' station and in the coffee and milk rooms. Nurses were recorded anonymously and their locations could be viewed remotely online.
The outcome of the research shows that putting babies and their families at the heart of the design has had a significant impact on the health and wellbeing of the users.
The new unit is 8 decibels quieter than the old. It is far brighter, allowing natural daylight to penetrate the building while giving control to the care rooms and ability to dim lights during the evening. The building is more energy efficient, £50 per 100 cubic meters, compared with £80 per 100 cubic meters in the old unit.
The nurses spend on average nearly twice as much time in the clinical room looking after babies in the new unit as in the old one.
Parents reported that compared to the old unit:
- The new one feels much more spacious
- There is less interference from noise and light
- They feel more at home and less in the way
- They feel more comfortable breastfeeding
Testament to this is that 90% of babies in the new unit compared to only 64% of babies in the old unit go home breastfeeding.
The data shows that parents' anxiety levels decreased significantly with time spent in the new NICU, whereas anxiety levels increased for the parents during time spent in the old NICU. Parents now visit the new centre for an average of 30 minutes longer a day and have more positive and direct physical contact time with their babies, crucial for development and parent/baby bond.
Critically the new unit allows babies to get 20% more sleep, so desperately required for growth and development, giving them a greater chance of survival.
Design for healthcare is often driven by the technical needs of medicine. If a healthcare facility works well for clinicians the general assumption is that it will therefore meet the needs of the patients too. The emotional wellbeing of the staff, patients and families is less well-considered. Our research at the RUH serves to support the theory that accounting for the needs of the patients when planning a new healthcare building can have a positive effect on the quality of care and the mental and physical wellbeing of the building users.
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