Innovation in intensive care: the Fluid ICU

EGM architects has developed an innovative Intensive Care (IC) concept: the Fluid ICU. The design was created with input from the enthusiastic intensivists of the Ikazia Hospital (Rotterdam). This new ICU aims to provide patients with optimal support in all phases of their stay in the IC, from the initial acute care to recovery. Privacy and personal autonomy are key factors in this [1].

 

The new Intensive Care

EGM r&d, the research department within the architectural firm, is at the heart of this innovation. Their starting point is the idea that environmental stimuli (perceived consciously or unconsciously) influence health and recovery. Scientific research into the influence of the environment on health has been conducted in ICUs since 1980. One of the outcomes is that a demonstrable relationship has been found between the amount of daylight and a view outside, and the occurrence of delirium (sudden confusion) [2]. Patients in an ICU without windows were at greater risk of developing delirium than those in an ICU with windows. Confusion, manifested for example by disorientation, hallucinations and reduced awareness, can have a negative impact on recovery, length of stay and premature death. Healthcare professionals are also influenced by their immediate surroundings. Good acoustics, for example, contribute positively to health in the ICU [3, 4]. That is one of the reasons why walls in the Fluid ICU are angled. This prevents a flutter echo and allows nurses and intensivists to understand each other well.

 

Animation Fluid ICU

The impression below shows the Fluid ICU from the perspective of both the care staff and the patient and their relatives.

 

Adaptable to patient’s needs

In the first phase of an ICU admission, during acute care, the Fluid ICU is organised to be as stress-free as possible. Everything is geared to optimally support the patient's rest and the concentration of the care professionals. For example, the alarm takes the form of a light signal instead of sound, with the aim of reducing stress.

After the initial acute care, the patient gradually gains more control over his surroundings. This is important for a better recovery. A grip on reality and distraction from pain are offered in various ways. For example, the curtains can be drawn from the bed by remote control to regulate the view outside. The day-night rhythm is supported by biodynamic lighting and good blackout curtains. In the ceiling above the bed is a digital screen, which can be tilted and viewed from a lying and sitting position. The screen can provide soothing images and sound, entertainment and exercises for recovery. Digital contact with loved ones is also made possible via this screen. Since contact via tablet and telephone is not possible for every ICU patient due to illness [5], the screen offers a great advantage.

As soon as the patient's condition allows, family and friends can meet the patient in person in the Fluid ICU. A special bed is integrated in the wall of the room for overnight stay of a close relative.

In summary, the Fluid ICU transforms from a neutral room with little stimulation to a richer and warmer environment.

 

Research

The innovative concept was developed in 2019, before the COVID-19 pandemic broke out. With the pandemic, the importance of an ICU that supports recovery and health of staff and patient has become even more apparent and relevant. The collaboration of Ikazia and EGM therefore comes at a fitting time and is looked upon with pride. Architects Arnold Sikkel, AnneMarie Eijkelenboom and Marijke Veryser from EGM architects have been involved in the concept development and design of the Fluid ICU.

 

Sources

  1. Andersson, M., I. Fridh, and B. Lindahl, Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology-dense environments. Nursing Inquiry, 2019. 26(4): p. e12301. DOI: https://doi.org/10.1111/nin.12301.
  2. Keep, P., J. James, and M. Inman, Windows in the intensive therapy unit. Aneasthesia, 1980. 35: p. 257-262. DOI: https://doi.org/10.1111/j.1365-2044.1980.tb05093.x.
  3. Sundberg, F., S. Olausson, I. Fridh, and B. Lindahl, Nursing staffs' experience of working in an evidence-based designed ICU patient room; an interview study. Intensive and critical care nursing, 2017. 43: p. 75-80. DOI: https://doi.org/10.1016/j.iccn.2017.05.004.
  4. Ryherd, E.E., K.P. Waye, and L. Ljungkvist, Characterizing noise and perceived work environment in a neurological intensive care unit. The Journal of the Acoustical Society of America, 2008. 123(2): p. 747-756. DOI: https://doi.org/10.1121/1.2822661.
  5. Dhala A., Sasangohar F., Kash B., Ahmadi N., and Masud F., Rapid Implementation and Innovative Applications of a Virtual Intensive Care Unit During the COVID-19 Pandemic: Case Study. J Med Internet Res 2020. 22(9). DOI: https://doi.org/10.2196/20143.