Share this article on:

Guidelines for intensive care unit design*

Thompson, Dan R. MD, MA, FACP, FCCM (Co-Chair); Hamilton, D. Kirk FAIA, FACHA (Co-Chair); Cadenhead, Charles D. FAIA, FACHA, FCCM; Swoboda, Sandra M. RN, MS, FCCM; Schwindel, Stephanie M. MArch, LEED; Anderson, Diana C. MD, MArch; Schmitz, Elizabeth V. AIA; St. Andre, Arthur C. MD, FCCM; Axon, Donald C. FAIA, FACHA; Harrell, James W. FAIA, FACHA, LEED AP; Harvey, Maurene A. RN, MPH, MCCM; Howard, April RN, CCRN, CCRC; Kaufman, David C. MD, FCCM; Petersen, Cheryl RN, MBA, CCRN

doi: 10.1097/CCM.0b013e3182413bb2
Special Article

Objective: To develop a guideline to help guide healthcare professionals participate effectively in the design, construction, and occupancy of a new or renovated intensive care unit.

Participants: A group of multidisciplinary professionals, designers, and architects with expertise in critical care, under the direction of the American College of Critical Care Medicine, met over several years, reviewed the available literature, and collated their expert opinions on recommendations for the optimal design of an intensive care unit.

Scope: The design of a new or renovated intensive care unit is frequently a once- or twice-in-a-lifetime occurrence for most critical care professionals. Healthcare architects have experience in this process that most healthcare professionals do not. While there are regulatory documents, such as the Guidelines for the Design and Construction of Health Care Facilities, these represent minimal guidelines. The intent was to develop recommendations for a more optimal approach for a healing environment.

Data Sources and Synthesis: Relevant literature was accessed and reviewed, and expert opinion was sought from the committee members and outside experts. Evidence-based architecture is just in its beginning, which made the grading of literature difficult, and so it was not attempted. The previous designs of the winners of the American Institute of Architects, American Association of Critical Care Nurses, and Society of Critical Care Medicine Intensive Care Unit Design Award were used as a reference. Collaboratively and meeting repeatedly, both in person and by teleconference, the task force met to construct these recommendations.

Conclusions: Recommendations for the design of intensive care units, expanding on regulatory guidelines and providing the best possible healing environment, and an efficient and cost-effective workplace. (Crit Care Med 2012; 40:–16)

Professor (DRT), Surgery and Anesthesiology, Albany Medical College, Albany, NY; Associate Professor (DKH), Center for Health Systems and Design, Texas A&M University, College Station, TX; Senior Principal (CDC), WHR Architects, Inc., Houston, TX; Senior Research Coordinator (S.M. Swoboda), Schools of Medicine and Nursing, Johns Hopkins University, Baltimore, MD ; 2010-2011 Tradewell Fellow (S.M. Schwindel), Medical Planning Intern, & Intern Architect, WHR Architects, Inc., Houston, TX; 2008-09 Tradewell Fellow (DCA), WHR Architects, Inc, Houston, TX; 2006-2007 Tradewell Fellow (EVS), WHR Architects, Inc, Houston, TX; Director (ACS), Surgical Critical Care Services, Washington Hospital Center, Washington, DC; Design Leader (JWH), Healthcare GBBN Architects, Inc., Cincinnati, OH; Educator and Consultant (MH), Glenbrook, NV; Research Coordinator (AH), Department of Medicine, Pulmonary/Critical Care Medicine, Wake Forest University, Wake Forest, NC; Professor (DCK), Surgery; University of Rochester, Rochester, NY; and Cook Children’s Health Care System (CP), Fort Worth, TX.

*See also p. 1681.


The American College of Critical Care Medicine (ACCM), which honors individuals for their achievements and contributions to multidisciplinary critical care medicine, is the consultative body of the Society of Critical Care Medicine (SCCM) that possesses recognized epertise in the practice of critical care. The College has developed administrative guidelines and clinical practice parameters for the critical care practioner. New guidelines and practice parameters are continually developed, and current ones are systematically reviewed and revised.

Dr. Anderson and Ms. Schmitz are full-time employees at WHR Architects. The remaining authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail:

© 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins