INTENSIVE CARE FACILITIES
VR technology informed Finnish ICU design
Tiina Yli-Karhu, Design co-ordinator at the Hospital District of South Ostrobothnia, and PhD candidate at the University of Tampere, describes in detail the process – which included the application of ‘virtual reality’ technology – used to design a new intensive care unit (ICU) at the Seinäjoki Central Hospital in Finland, the country’s first 100 per cent single-bedded such facility.
The process of designing the new intensive care unit (ICU) at the Seinäjoki Central Hospital commenced with a pre- occupancy evaluation and research study to identify best practice and design models. It was clear from the outset that it made sense to move to single patient bedrooms, to harness evidence-based design, and to exploit all the suitable potential technological innovations. Although single patient rooms provide a number of advantages, there were many issues to be addressed, particularly around visibility, audibility, and assistance.
The EVICURES project
The aim of EVICURES project (2014-2016) was to develop a new ‘user-friendly’ design model of intensive and intermediate care unit (ICU) to improve the quality of care and the care environment, and to impact positively on the wellbeing of both patients and staff. The model was firmly based around the participation of the staff in designing the new ICU, drawing both on the data collated from the research, and the expertise and experience of those involved. To support the work, a multidisciplinary project group was put together comprising hospital managers, staff, patients, and their families, as well as representatives from other hospital districts, research institutes, and commercial companies. The evidence- based design (EBD) approach was familiar to the staff, having already been used on other building projects at the Seinäjoki Central Hospital. As a result, the project – entailing the design of Finland’s first all- single-room ICU – saw evidence-based design extensively harnessed.
This article, entitled ‘Designing the ICU for the future - Seinäjoki Central Hospital, Finland’, first appeared in the December 2018 issue of Healthcare Facilities, the magazine of the Institute of Healthcare Engineering Australia (IHEA). HEJ thanks the author, the magazine’s publisher, Adbourne Publishing, and the IHEA, for allowing its reproduction, in slightly edited form, here.
Figure 1: A multi-professional group using a CAVE ‘virtual design’ model.
Designing a new ICU facility entails considering multiple options. Firstly, there are existing guidelines and recommendations for the design of such facilities to consider, while it is equally important to take into account both the culture of the hospital and current clinical practice. While it is important – in any new design – to harness the optimal qualities of existing premises and clinical practice, one must also be open to new approaches to design and workflow, and to using new technology. With the number of patients in intensive and intermediate care predicted to increase by up to 20-25 per cent over the next few decades, due to an ageing demographic and innovations in medical care, any new healthcare premises also need to offer sufficient space for expansion, to be adaptable to new uses, and to meet ever more stringent hygiene criteria over the longer term.
Multiple methods
The EVICURES project utilised multiple methods to facilitate staff participation in the design process. These enabled the staff to contribute their knowledge and expertise and make them feel that their contribution was as valuable as that of the designers. The design process entailed the use of co-design harnessing a ‘CAVE’ automatic virtual environment (CAVE – ‘an immersive virtual reality environment where projectors are directed to between three and six of the walls of a room-sized cube’), here undertaken in three phases. In all, 47 multi-professional groups – each comprising between four and six people – took part (Fig. 1).
In each phase the architect introduced a virtual model of the patient rooms (intensive and intermediate) with a bathroom and a nurse station. After participants had viewed them, lively discussions ensued on the spaces’ proposed design, and on how the nurses and other staff would work in the rooms, with each group able to propose changes. The use of VR technology made it easy for participants to voice their opinions, identify any shortcomings, and highlight their requirements. Following the completion of each phase the architect transferred the various elements and features to a new virtual model, ready for the next evaluation round. After the third phase a model of the rooms was ready to put forward for the actual architectural design, which in turn enabled construction to begin. In addition to allowing the gathering of substantial detail for the room models, the exercise saw significant
Figure 2: The glass windows and doors to patient rooms can be electronically changed from ‘clear’ to opaque to provide privacy.
February 2019 Health Estate Journal 29
©Samuel Hoisko
©Esa Nykänen
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