Susan T. Williams AIA Project Manager E Lynn App Architects, Inc. Englewood, Ohio		Cynthia A. Burger RN, BSN Director, NICU/Fourth Floor The Children’s Medical Center Dayton, Ohio

Over the last decade, advances in health care have accounted for significant increases in survival rates for infants of very low birth weight. The traditional neonatal intensive care unit (NICU) in which these infants develop and grow typically is characterized by sterile, bright, loud environments. Research has shown that this type of environment can actually have a detrimental effect on an infant’s development, and that an environmentally sensitive unit can enhance growth, shorten stays, and reduce hospital costs.

The newborn intensive care unit at The Children’s Medical Center (CMC) in Dayton, Ohio is a 31-bed, Level III nursery licensed by the Ohio Department of Health. Staffed by five full-time, board-certified neonatalogists, the unit is a regional referral center for low-birth-weight and sick newborns for a 20-county service area. All infants are transported to the facility by a regional neonatal transport team staffed by CMC.

The existing neonatal intensive care unit at CMC was built in 1982, during the introduction of new technologies to save infants of very low birth weight. The primary focus on medical intervention led to the sterile, highly technical, brightly lit, and noisy environment prevalent in most NICUs today. The nursery was visually enclosed and visitors, upon arrival, spoke to staff through an intercom in a solid wall. The impact of this environment on the infants' sensory and cognitive and on their families' well being and interaction were secondary to purely medical concerns.

After 15 years the existing unit did not meet new requirements outlined in the "1997 State of Ohio Quality Rules" or the "Report of the Consensus Conference on Newborn ICU Design: Recommended Standards of Newborn ICU Design, 1996." The possibility of moving to a new location was ruled out, due to a lack of options within the hospital. Additional square footage in the existing location was achieved by closing off a through-corridor and allocating administrative spaces to patient care.

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