ICU DESIGN AND CONFIGURATION
Prince Charles Hospital’s ICU of the Future Project
Harm Hollander, a practising Australian architect who has driven the design and procurement teams of major hospital projects around Australia and internationally, Oystein Tronstad, Physiotherapy clinical lead at The Prince Charles Hospital, Brisbane, and an experienced ICU clinician and researcher, and architect and clinical planner, Angelo Pagano, describe a research project undertaken at the Brisbane hospital which has looked to improve ICU bed bay environments through a variety of measures – from mitigating unwanted noise and incorporating distractive ceiling panels, to enhancing indoor air quality. The scheme was the subject of a post-occupancy evaluation.
Traditionally, the luxury of using a blank canvas is not linked to the usual, actual available site, especially when considering retrofit solutions. Many innovative design nominations, since at least the 1990s, tend to assume a new open floor area, free of the physical constraints that hinder implementation of blue-sky ideas, often also within existing departmental boundaries.1
New and
unconstrained planning tends to lead to larger bed pods and additional auxiliary adjacent spatial requisites. The latter approach may be suitable for greenfield developments, but does not address: n the opportunity to enhance existing global ICU stock, which generally consists of smaller bed bays with finite real estate inside existing hospitals;
n disadvantages of area growth, including aggregating walking distances, stretched visual accessibility, department area, and accruing engineering plant, and
n non-first-world countries being unable to afford the growth of floor area,A
building stock to allow the creep to area growth. A prototype bed module.
Brisbane project’s lofty aims The ICU of the Future Project at The Prince Charles Hospital (TPCH), Brisbane, Australia had lofty aims.B However, the applied solution required a design within the tight constraints of an existing pair of old-style internal, windowless, and curtained bed bays. Consequently, the success of the design was ultimately evaluated against whether this compact design was replicable across many global contexts – limited by the local settings of existing departmental boundaries. This article reports on the
The remedy The Critical Care Research Group, in conjunction with the wider project team,D
using a co-design approach,6 Solutions included reduced utilised
information gained from interviews with patients and their family members to develop a list of patient-centred issues and subsequent solutions for incorporating into the model for the ICU of the Future.7
equipment noise (especially alarms); re-directing alerts away from the patients; active noise masking; acoustic linings; dynamic lighting to maintain circadian rhythms; distractive ceiling panels; sound attenuated barriers mitigating adjacent noises; reduced clinical aesthetic; light masking for controlling intrusion from adjacent spaces (including night light intrusion); simulated windows with scenes of nature; enhanced indoor air quality and monitoring, and improved abilities for patients to engage with family, friends, and the outside world. All are solutions aimed at promoting a quiet, peaceful, and connected environment to facilitate rather than inhibit healing, and avoid an otherwise chaotic and stressful place for the patients. Further design responses were then focused on value, compactness, ambience, and balance against other criteria, such as infection control measures. The designated research site consisted of a pair of existing, semi-open, adjoining bed
56 Health Estate Journal May 2025 nor the replacement of redundant
outcomes of this research model, which was implemented at TPCH in December 2022 as a part of the operational ICU department.C
The two upgraded bedspaces have
been operating as part of the live department for more than two years since its launch, allowing the implemented solutions to be further tested by a review of the adjustments to operation by the clinical staff of the unit. Every year, over 20 million people are admitted to an ICU globally.2
While the survival rate continues to
improve, the quality of survival remains sub-optimal. As many as 70% of ICU patients will experience physical, cognitive, and/or psychological problems after their ICU admission.3
However, these problems do not only
affect the patients; up to 75% of family members will also experience psychological symptoms after the ICU admission.4
These problems may be short-term, but
commonly last for many years after hospital discharge.5 Therefore, the improved ICU survival rate has come with an increased burden for ICU survivors and their families.
The Common Good/Critical Care Research Group
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