Predesign and Postoccupancy Analysis of Staff Behavior in a Neonatal Intensive Care Unit

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Abstract
This research provides data on behavioral issues associated with the design of neonatal intensive care units (NICUs). Behavior was examined utilizing both predesign research (PDR) and postoccupancy evaluation (POE) techniques; data were collected prior to the remodeling of a NICU and after the remodeling was completed. Infants in the original unit were located in closed bays. Infant beds in the new unit were distributed in an open floor plan with 60% more area. Behavioral mapping, interview, and questionnaire methods were used to examine medical staff activity patterns and perceptions of the modified environment. One hundred twenty-four hours of predesign and postconstruction mapping data were gathered. The hypothesis that the total amount of time staff spent walking from activity to activity would be reduced was not supported, although when the data were weighted to reflect the impact of the size of the large unit, the ratio of time spent traveling to a total unit area was found to be less in the open-bay plan. Trends in the data supported the hypothesis that staff in the remodeled unit would spend more time with infants and families, but the results were not statistically significant. The number of transactions with families, however, did increase significantly. The hypothesis that activities involving supply storage would take less time did not receive support. The amount of time on a single supply transaction, however, did decrease significantly. Conclusions are drawn regarding the behavioral mapping technique used and the efficacy of combined PDR-POE research. Also discussed is the relation between design decisions and implementation of operational protocols in support of these decisions.