Today we had the opportunity to tour the Kaiser Garfield Innovation Center with Angelene Baldi, the architect who designed the new NICU standard at Kaiser. Kaiser started to look at redesigning their NICU rooms in 2006 when Angelene asked the question, “Why are we still doing an open pod format for our NICU designs?” Knowing that there was a trend in single rooms, Angelene suggested they research the single NICU room design concept. At the beginning of the project, 75% of her content expert panel were against single rooms. At the end of the research, 100% believed that single rooms in the NICU increased safety and positive outcomes for neonates in the NICU.
Kaiser follows an evidence based design process:
1) Hypothesis, background, research
2) Proposal, Content Expert Panel Setup
3) Evaluation Criteria, Benchmarking, Virtual Tours
4) Analysis, Develop, Test
5) Documentation Approval, Communication
Angelene walked us through their entire design process which spanned 7 years. She was able to run this research remotely with a team of clinicians at Kaiser from around the country. She stressed that the virtual tours she could share with the Content Expert Panel through visual reports allowed everyone to focus and review the most important aspects of the NICU, and saved thousands of dollars in travel expenses to tour existing facilities in person. I can imagine that 50% of her work was just trying to get people who were against the idea in the first place to consider the option. Through countless prototypes and tests, she and her team were able to show the panel that the new design would not only be neutral in cost (same costs as open pod design) but yield better health outcomes for NICU babies. In the end, the new design is “semi-private.” There are two rooms that share a sliding door. This is to allow for privacy when needed, but also help nurses keep an eye on both of their patients at once when the sliding door separator is opened (there is a 1 nurse to 2 patient ratio in Kaiser NICUs).
Angelene is a little self-depreciating when she says, “I’m only the architect.” She said this in the context of hoping our students would understand that without the help of the doctors and nurses, her design would have looked very different, and be much less functional. She did have one regret however with their process: that they did not collect adequate input from NICU parents.
I would argue that Angelene was not only the architect, but a thought leader, an advocate for promoting a new “best practice” in the NICU environment and an extremely detailed oriented conductor/coordinator of design feedback and documentation. The work we saw today was not only a reflection of a passionate designer, but a savvy business person who knows what it takes to make change happen. We know this is not an easy endeavor at any organization. I applaud Kaiser for listening to Angelene’s original question, and allowing the time and resources to answer the question thoughtfully.
Many thanks to Angelene for her time today.
