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NICU offline while still maintaining an overall
bed count of 15-18 throughout the project. The
project team also focused on "connecting" the
two spaces so they could operate as a single unit,
including modifying patient monitoring systems, security and communication devices, and
shared staff and supplies. Concurrently, new
NICU on-call rooms and electrical closets were
built adjacent to the unit in preparation to support future phases of the project.
Phase 2: Construction Part 1-The first
phase of construction focused on renovating a
portion of the existing staff workroom, storage
room, the reception area, pneumatic tube station, and 12 NICU bays, turning them into seven
new NICU beds. The spaces that were taken
offline were relocated to the temporary unit and
an infection control risk assessment wall was
built to separate the construction zones from
operational portions of the existing NICU and
temporary spaces.
The design team worked with NICU staff to understand and help develop solutions to all operational and clinical needs, identifying provisional
locations for the supply storage system, pneumatic tube system, supplies, and medications.
For example, the pneumatic tube station needed
to remain operational throughout the project. It
was first moved from the existing nurses' station
(demolished in Phase 2) to a temporary location in an adjacent corridor until its new permanent location was built at the end of Phase 3. The
6-inch pneumatic tubing was extended to the
temporary station while construction activities
occurred around it. Once the new station was
complete, the system could then be reconnected,
and normal operations could resume.
A thorough review process engaging multiple
departments was developed to get consensus and
buy-in on the proposed operational changes, and
the project team met with staff every week during construction to provide updates and work
through unforeseen obstacles. At the completion
of this phase, several newly renovated spaces, including four private NICU rooms and three private NICU bays, a reception and nurses' station,
a team workroom, pneumatic tube station, clean
and soiled utility rooms, staff lounge, and equipment storage, became available.
Phase 3: Construction Part 2-With Phase
2 operational, construction began on renovating the remaining eight NICU beds and support
spaces to create 11 new NICU beds. This process
involved displacing most of the unit's support
spaces, including the medication and formula
prep alcove, staff lounge, lactation room, offices,

clean and soiled utility, and the unit's mechanical room. These spaces were
strategically selected to be renovated last to provide continual support
to the active unit while new support areas were built out during the earlier phase.
At this stage, the new staff lounge, soiled and clean utility, and storage
rooms were moved into their new spaces. However, to accommodate the
displaced medication room, formula prep, and clean supplies, the team relied on the newly constructed staff workroom as a temporary "home" for
only essential, frequently used supplies and materials.
Phase 4: Integration-During the final phase of the Allison Family
NICU renovation, the temporary infection control partition was removed
and the two halves of the new NICU were reconnected. Work was strategically broken into segments, including connecting above-ceiling mechanical systems, tying ceilings together, completing flooring patterns, and
finishing wall and paint touch-ups. This work was dictated by census numbers and took place in smaller containment set-ups to minimize disruption
to the unit-approximately five sections, lasting two to three days each.
The new NICU opened in February 2018 with a host of new features, including two large quad rooms that give parents of multiples the ability to
be with all their babies in one space; centralized monitoring so all nurses
within the unit can view patients' vital signs at any point and respond accordingly; and designated medication prep and formula and breast pump
prep rooms, which allow nurses to perform important tasks in a private
setting and support efforts to decrease errors and increase efficiencies.
The new private patient rooms, which reduce stimulation to both sound
and light, can be adjusted to individual patient needs, while further promoting family-centric care for babies.
LESSONS LEARNED

Six semiprivate bays provide the privacy families
desire, while allowing
staff members direct observation from the centralized nurses' station.

While every phase of the Allison Family NICU renovation included an area
of focus that came with its own hurdles, there were also many overarching
challenges to solve.
For example, a critically important aspect of any NICU is security. This
became increasingly more challenging with a multiphase project and two
physically separate spaces across the hall from each other operating as a
single functioning NICU. For instance, the existing infant protection system had to be reworked and rewired several times to accommodate the
changing entrances to the unit, temporary construction access, and egress
doors. The project team worked closely with the users and hospital's security and IT departments to ensure there wasn't a lapse in service.
Additionally, attention to noise, vibration, and infection preven-

FEBRUARY 2019

Healthcare Design - February 2019

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