Flexible Openings in Two ICUs Improve Functionality, Provider Wellness

By Tysen Gannon  

Growth in healthcare design and construction has increased year after year since 2019. With this growth, there have also been revisions to design best practices. While addressing campus safety, changing technological needs and creating less-clinical common spaces are often cited in key healthcare trends. Focusing on care areas like patient rooms, provider workspaces and respite rooms can support more future-focused healthcare designs as well. 

For example, using flexible design principles in these areas can help optimize functionality by allowing multiple specialties into a single space. This helps a medical center utilize a building’s square footage more efficiently and adapt to changing patient needs. Both benefits reduce the need to plan future construction and renovations, which can both disrupt lifesaving care and eat into a facility’s budget—a key consideration given national healthcare construction costs have increased by approximately 20% since 2020. 

While there are many pathways to achieving design flexibility, door specification remains one of the most cost-effective ways to create more flexible spaces. Particularly, the use of commercial sliding and flexible opening swing doors can support floorplans that not only meet the current needs of medical providers and patients but also allow easy reconfiguration for longer viability. This is of particular note for intensive care units (ICU). 

Maximizing Floor Programming 

Healthcare designs often focus on optimizing space use to increase the number of patient rooms and types of provider areas. Flexible opening doors, such as sliding doors or swinging doors that have an auxiliary leaf, can provide wider openings without requiring space to accommodate larger swing arc trajectories. On one hand, this supports the easy movement of patient beds and equipment. On the other, it allows a higher degree of programming within constrained spaces. It can also increase storage space in common areas. 

This consideration drove the specification of sliding doors on the 12th floor ICU at the University of Kentucky’s Albert B. Chandler Hospital. In this project, the goal was to expand corridor size to provide space for mobile equipment and potential overflow areas for large patient surges. Sliding doors in respite and workspaces maintain the open corridor design without compromising the useable space in these rooms. They also allow a higher number of rooms in a given area without the risk of an opened door limiting access to another room. 

Likewise, the designers for the pediatric ICU at Atrium Health Levine Children’s Hospital in Charlotte, N.C., specified flexible opening swing doors for the project’s patient rooms. These systems can maximize opening width for special uses without requiring larger-than-average large swing arc trajectory for everyday use — all while meeting code-driven egress requirements. These doors meet the medical staff’s requirements for functionality while also maintaining efficient space use. 

Acoustic Isolation 

While optimizing space use continues to be emphasized in healthcare design, it is not the only trend to be considered. Although Covid-19 exasperated burnout for healthcare professionals, the issue had been documented decades prior. As more medical centers adapt to shifting demands, prioritizing designs that support wellbeing is receiving added focus. Numerous factors contribute to occupant wellness. However, acoustic isolation is critical to multiple avenues of provider wellbeing. 

For instance, in the ICU at the Albert B. Chandler Hospital, the sliding doors achieve Noise Isolation Class (NIC) ratings of up to 39. This means, when installed, these doors can reduce sound transfer by 39 decibels. This rating provides the functional benefits of limiting distractions in provider work areas and supporting a robust approach to Health Insurance Portability and Accountability Act (HIPAA) compliance. It also reduces alarm fatigue and contributes to more peaceful respite areas. 

Considering that there are approximately 40 alarms per patient per hour in an average ICU, designing respite areas that are acoustically isolated can help providers remain rested and alert during their shifts. Not only does this lower the potential for burnout but it can translate to improved patient outcomes. 

Maintaining Visual Connection 

Improving patient outcomes will continue to drive design choices in healthcare settings. This can include creating spaces that readily accommodate the latest technology or following recognized best practices such as providing patients with quality views of the outside and plenty of access to daylight. It can also include designing a floor with open sightlines so providers can visually monitor patients and connect with staff easily. 

The need to maintain visual connection influenced door specification in the PICU at Atrium Health Levine Children’s Hospital. Installed in patient rooms, workstations and more, the various full-lite glass door systems help maintain a level of visual connectivity without compromising acoustic isolation. Providers can monitor patients and know the staff on a floor without having to open a door, potentially disturbing a patient’s rest or disrupting a colleague’s work. 

Functional Healthcare Design 

Whether a project is a high-acuity or low-acuity space, or moving from one to the other, it is important for project stakeholders to ask how its design works for patients and providers. Understanding the interconnectedness of design, patient outcomes and provider wellness can help professionals make more informed decisions. 

As a repeated component of the built environment, flexible opening door systems provide a significant degree of design flexibility. When these systems feature full-lites of transparent glass and premium acoustic performance, they can also improve the functionality of multiple types of healthcare settings—from ICUs to medical office buildings. Both benefits of flexible opening systems can help project stakeholders build facilities that meet patient and provider needs both now and in the future.  

Tysen Gannon, LEED AP, AD Systems, has more than 15 years of experience in the architectural products industry, including roles in sales, product management, research and marketing, with a focus on glass and glazing, fenestration and façade systems. Learn more at www.specadsystems.com.