Intensive care units (ICUs) often have high levels of associated stress for patients and staff. Typical hospital sounds such as beeping equipment, noisy supply carts, and loud conversations, combined with visually cluttered patient rooms, strange scents, and bright fluorescent lights can cause sensory overload and trigger physiological reactions for everyone who experiences the space. A research study on sleep in the ICU, published in the Journal of Intensive Care Medicine in 2016, suggests that prolonged sensory stress can impact the body’s ability to heal and may prolong hospital stays.
Beyond its impact on patients, the ICU environment can also adversely affect nurses and staff, who can become overwhelmed by the constant combination of surrounding sights, sounds, and smells. Without a space within the facility to adequately decompress, medical staff can experience burnout and compassion fatigue.
When Gresham Smith began designing Tallahassee Memorial Hospital’s (TMH) M.T. Mustian Center in Tallahassee, Florida—a new critical care tower to replace the hospital’s decades-old ICU—the project team not only focused on increasing capacity and integrating new technology, but also on challenging the status quo in critical care design using evidence-based design. The goal was to create an ICU environment that supports improved outcomes by decreasing sensory stress, not only by concealing staff work areas using but also by minimizing noise levels, maximizing visibility, and increasing natural light throughout the space.
Research Question
How does the built environment positively impact outcomes to help reduce sensory stress for patients, families and staff?
Prior to the new tower opening, data gathered from patients, families, and staff on the former ICU identified three types of environmental stressors within the space: sound, overall distractions, and room layout. After the M.T. Mustian Center opened, Gresham Smith’s Research & Insights team partnered with TMH to conduct a research-focused post-occupancy evaluation to compare the campus’ former ICU with the new environment to better understand how the design strategies incorporated in the new ICU impacted sensory stress on patients and medical staff. The data supported that the ICU’s architectural elements, including acoustically rated glass around nurses’ stations, internal corridors for noisy back-of-house support activities, and decentralized work niches for patient monitoring and administrative tasks, successfully mitigate sounds and overall distractions.
Summary of Findings
- Patients, families and staff reported reduced stress levels and increased satisfaction with the built environment
- Overall acoustic levels were lower, and new patient rooms measured 3 to 5 decibels lower than old rooms
- New decentralized nurse stations enabled staff to block out unwanted sounds and focus more closely on their patients
- New, elongated ICU floors had good visibility and walkability, lowering stress levels
- Medical staff communication improved, as improved acoustics led to nurses using phones rather than shouting across the space
- Nurse turnover rates decreased slightly across all floors
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