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Perceptual Effects of Physical and Visual Accessibilities in Intensive Care Units: A Quasi-experimental Study

Rashid, Mahbub, PhD, RA; Khan, Nayma, PhD; Jones, Belinda

doi: 10.1097/CNQ.0000000000000200
Original Articles

This article reports the findings of a 2-phase quasi-experimental study looking at the perceptual effects of physical and visual accessibilities on clinical staff in intensive care units (ICUs). In a previous CCNQ article by Rashid et al, the first phase of the study was reported comparing, among other things, physical and visual accessibilities and their associations with staff perception in 2 ICUs with the open-plan and racetrack-type layouts. The data for that phase of the study were collected in December 2014, which included the data on physical and visual accessibilities collected using the spatial analysis techniques of Space Syntax, and the data on staff perception collected using a questionnaire survey. Since then, the open-plan ICU has been completely redesigned using a layout composed of 4-bed pods (each dubbed as a HYPERPOD by the designer). However, the racetrack ICU has remained unchanged. In August 2016, more than years after the data for the first phase of this study were collected, the authors went back to the study sites to collect similar data using the methods of the previous study by Rashid et al. The purpose of the 2-phase study was 2-fold: (1) to see whether staff perception and their associations with physical and visual accessibilities observed in the racetrack ICU during the first phase would remain unchanged during the second phase of the study; and (2) to see whether staff perception and their associations with physical and visual accessibilities observed in the open-plan ICU during the first phase would change in the new ICU during the second phase of the study. The findings of the study comparing the racetrack ICU of the first and second phases show that while staff perception in this unit changed, its associations with the physical and visual accessibilities of the unit did not change during the period between the first and second phases of the study. In contrast, the findings of the study comparing the open-plan ICU of the first phase and the new ICU with 4-bed pods of the second phase show that staff perception as well as its associations with the physical and visual accessibilities of the unit changed in a positive direction from the open-plan ICU to the new ICU. It is concluded that staff perception is likely to change over time even in the absence of environmental changes, but any change in staff perception can be made more effective when it is associated with thoughtful environmental design changes.

Department of Architecture, School of Architecture & Design, University of Kansas, Lawrence (Dr Rashid); Department of Architecture, Bangladesh University of Engineering and Technology, Dhaka, Bangladesh (Dr Khan); and JMD Architects, Inc, Greenville, South Carolina (Ms Jones).

Correspondence: Mahbub Rashid, PhD, RA, Department of Architecture, School of Architecture & Design, University of Kansas, 1465 Jayhawk Blvd, Lawrence, KS 66045 (mrashid@ku.edu).

Funding for this project was provided by JMD Architects, Inc. The terms and conditions of this project have been reviewed and approved by the University of Kansas in accordance with its policy on objectivity in research. The authors gratefully acknowledge the fact that Greg Jones of JMD Architects, Inc, had envisioned this research project before his untimely death in 2014.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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