The success of the design will be evaluated in the autumn of 2019 via a post-occupancy evaluationconducted among staff

results indicated that, for a hospital of this size, unifying the facilities made logical and practical sense, because the staff’s wide-ranging expertise can be harnessed more efficiently, and both the quality of care and outcomes improved. The hospital’s intensive care unit, neurological intermediate care unit, coronary care unit, and gastro-surgical observation unit, were thus brought together to form one ‘united’ intensive and intermediate care unit. The interventional cardiac unit – equipped with six observation beds – was also accommodated within the plans. The second challenge was to

determine whether all the rooms should be single rooms, because the original space allocated was insufficient to allow this. Plans for a 100 per cent single room facility and for a set number of rooms were, however, maintained. The new ICU incorporates 24 single patient rooms for intensive and intermediate care. The 2,400 m2

facility, on two floors, was

formed via the refurbishment of an old ward with two extensions. The new ICU is on the same floor, with offices, meeting rooms, and a staff cafeteria one floor below.

Opaque glass To ensure good visibility, the walls between the patient rooms and the doors are glass. To maintain patient privacy the electric glass windows can be changed from clear to opaque ‘in seconds’ (Fig. 2), while the nurse stations provide good visibility to patient rooms. All the rooms feature a standardised design, while mobile cabinets accommodate the same medical equipment. Adequate space around the bed and ceiling supply system, conveniently positioned sinks and hand disinfection dispensers, and ceiling lifts, facilitate the work of staff (Fig. 3), while dialysis is available in all rooms. While it proved impossible to provide

natural light and windows in all the rooms, all feature dynamic lighting to support circadian rhythms, and nature-themed photos on the walls (Fig. 4). Special attention was paid to acoustics

in the new unit, and as a result they are rated as ‘excellent’. The ability to carefully


monitor and observe patients is key, and here the new unit supports staff in many ways. For example, the doors to patient rooms can be left partly open, while although staff cannot constantly be at the bedside, technological innovations such as alert systems transfer vital information, while alerts from the monitoring devices are automatically routed to staff smartphones. The display terminals of the smart control centre show the shift- leader the situation in all the patient rooms (Fig. 5), making managing the unit much simpler.

Layout was critical The ICU’s new layout was another critical factor; the design needed to minimise travel distances for nurses. The wards were divided in four modules, each with six beds, and with each module equipped with its own office and small supplies. Among the technological innovations

incorporated were no-touch operation patient room doors that can be opened fully or partly, or locked open, and the ability for staff to control and adjust the internal temperature. The unit also features the hospital’s first ‘smart’ (electronic) medicine cabinets (Fig. 6).

Advantages of the use of ‘VR’ Although the concept of designing all the spaces in the new unit using ‘virtual reality’ was discussed, only the patient rooms, nurses’ station, and bathrooms, were thus designed, due to time and cost restraints. Both the size and configuration of the rooms settled upon were key. The approaches harnessed in the EVICURES project supported staff involvement, and helped to prepare them for a significant change in working conditions. The use of co-design and ‘virtual models’ aided mutual understanding, and meant that all parties could express their views.

Figure 5. The display terminals of the smart control centre.

Conclusions The new intensive and intermediate care unit and the interventional cardiac unit became operational in April 2018. Prior to start-up staff received three months of practical training. All the medical equipment was new, the layout was three times bigger than the old premises, and the new patient data management system was installed at the same time. Overall the staff are happy with the new premises, with their pleasant indoor conditions, and because everything is new. The success of the design will be evaluated in the autumn of 2019 via a post-occupancy evaluation conducted among staff. At this point patient care statistics will also be carefully studied and compared. The Seinäjoki Central Hospital provides

care for 200,000 local inhabitants. The new ICU, with its six intensive care, and 18 intermediate care (including two isolation rooms) beds, offers the best available care in new premises, staffed by 10 doctors and 100 other staff. The unit will receive around 3,200 patients per year, although predictions suggest that this number may increase by up to 25 per cent.

Major reforms Finland’s biggest reform in health and social services to date will commence in 2021, with the preparations already under way all over Finland. The country will be divided into 12 emergency service units, with the Seinäjoki Central Hospital set to be among the 12 ‘around-the-clock’ emergency service units following this reform.

Further reading l A user-orientated, evidence-based design project of the first Finnish single room ICU, Results of EVICURES project (2016). VTT Technology 252. inf/pdf/technology/2016/T252.pdf

Figure 6. The new unit has ‘smart’, electronically operated, medicine cabinets.

Acknowledgement l This article, entitled ‘Designing the ICU for the future - Seinäjoki Central Hospital, Finland’, first appeared in Healthcare Facilities, the magazine of the Institute of Healthcare Engineering Australia (IHEA). IFHE Digest thanks the author, the magazine’s publisher, Adbourne Publishing, and the IHEA, for allowing its reproduction, in slightly edited form, here.



©Samuel Hoisko

©Samuel Hoisko

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106