Affiliations: School of Kinesiology, University of Minnesota,
Minneapolis, MN, USA | Director Patient Care, Neonatal Services, Children's
Hospitals and Clinics, Minneapolis, MN, USA | Clayton Consulting, Inc., Northfield, MN, USA
Note: [] Address for correspondence: Thomas J. Smith, School of
Kinesiology, 226 Cooke Hall, University of Minnesota, 1900 University Ave. SE,
Minneapolis, MN 55455, USA. Tel.: +1 651 688 7444; Fax: +1 612 626 7700;
E-mail: smith293@umn.edu
Abstract: This study collected staff responses to an occupancy quality survey
before, and 6 and 22 months after, St. Paul Children's Hospitals and Clinics
(CHC) replaced an open bay (OB) with a private room (PR) neonatal intensive
care unit (NICU) design. Staff interview responses and task activity
observations also were collected. The goal was to assess how this change would
influence staff perceptions and performance. As a result of the transition from
the OB to the PR environment: (1) rankings of overall physical environment,
patient care, job, technology, and off-the-job quality significantly improved;
but (2) rankings of patient care team interaction quality significantly
declined. Results for the 22-month PR survey indicate essentially no meaningful
changes in rankings of occupancy quality from the 6-month survey, suggesting no
consolidation of quality gains in the intervening 16-month period. Written
comments pertaining to private room NICU design issues by survey respondents,
targeting problems with unit operations, may explain this finding.
Collectively, the findings suggest that NICU operational management was not
effectively modified to deal with the new design, and that an OB to PR NICU
transition requires a systems approach to macroergonomic challenges imposed by
the new design.
Keywords: Health care environments, macroergonomics, occupancy quality, perceptual response survey, task analysis
