An intensive care unit is the department where every design decision is measured against the most vulnerable patient in the hospital. The bed space must accommodate equipment, staff and services, the patient must always be visible and the risk of infection has to be reduced in every detail. Pre-finished modular systems meet these needs and add an advantage that intensive care units have learnt to consider essential: the ability to change.
What makes intensive care design different?
In intensive care the patient is connected to monitors, ventilators, pumps and other devices, and is cared for without interruption, day and night. This leads to four design needs that carry less weight in other departments.
- Space around the bed, because several clinicians and pieces of equipment must be able to work on each side of the patient.
- Plentiful services close at hand: medical gases, power sockets, data and alarms within reach.
- Continuous visibility from the nurses' station or the corridor.
- Infection control, with surfaces that are easy to clean and the ability to isolate patients.
Minimum dimensions and mandatory equipment vary from country to country and are set by national standards and by the requirements of the healthcare facility.
Open bays or single rooms?
Traditional intensive care units were often organised as large wards with several beds separated by curtains. More recent design favours single rooms, which can help reduce infection transmission, noise and patient stress, and give patients and families more privacy.
A single room, however, must not hide the patient from staff. This is why the walls facing the corridor or the nurses' station are often glazed, with glass sliding doors. A modular system makes it possible to combine solid panels, glazed panels and doors in the same unit, with the same construction language.
How do you keep visibility without giving up privacy?
Visibility comes from glazed walls and doors aligned with the nurses' station; privacy comes from a screening system that staff control depending on the moment.
For the privacy of glazed rooms, two solutions are particularly suited to healthcare settings: blinds or venetians sealed in the cavity of double glazing, which do not collect dust and need no cleaning, and switchable glass, which changes from clear to opaque at the touch of a switch. Fabric curtains hung in front of the glass, by contrast, are harder to keep clean.
Which services does an ICU bed space need?
Each intensive care bed space needs medical gases, numerous power sockets, data points, monitoring connections and staff call. These services are usually distributed on ceiling pendants, bedhead units or directly in the walls.
In modular walls the provisions are designed before manufacturing: outlets, panels, monitors and recessed cabinets arrive on site in their exact position, and the panels can be opened for maintenance. In a unit that works around the clock, being able to work on a service without demolishing a wall makes a real difference.
How are isolation rooms designed?
Isolation rooms separate a patient from the rest of the unit by means of air pressure.
| Room type | Pressure relative to adjoining spaces | For whom |
|---|---|---|
| Airborne infection isolation | Negative: air flows in from adjoining spaces and is removed by the extract system | Patients with airborne infections |
| Protective isolation | Positive: filtered supply air flows out towards adjoining spaces | Immunocompromised patients |
The room is often preceded by an anteroom, a small buffer space where staff change and which stabilises the pressures. Pressure values are defined by the mechanical services design, but they can only be maintained if the envelope is airtight: walls, joints, doors, service penetrations and pass-through boxes must limit air leakage.
Why choose a modular system for an intensive care unit?
A pre-finished modular system gives an intensive care unit six practical advantages.
- Hygiene: continuous, non-porous surfaces resistant to disinfectants, with engineered, sealed joints and no ledges.
- Airtightness: an envelope suited to maintaining the pressures of isolation rooms.
- Integrated services: provisions made at the plant and accessible for maintenance.
- Dry construction: less dust and shorter works, essential when neighbouring units stay open.
- Flexibility: modules that can be dismantled and repositioned to expand the unit or convert bed spaces.
- Wellbeing: glazed walls, daylight and finishes chosen at design stage, such as the full-wall printed murals in the operating theatres with ADAM walls at AMS Private Clinic in the Netherlands, help create a less hostile environment for patients and staff.
The COVID-19 pandemic showed how important it is to be able to increase or convert intensive care beds quickly. A unit built with modular systems adapts more easily than one built with wet construction.
What does ADAM supply for intensive care units?
ADAM S.r.l. has developed SALUS since 2006: the modular system for medical environments that covers operating theatres, intensive care units, patient rooms, corridors, communal areas and X-ray rooms. Through its ADAM Health division, ADAM also supplies medical doors, including hermetic automatic sliding doors, technical ceilings with hermetic lighting, recessed cabinets and pass-through boxes, and integrates monitors and PACS displays into the walls.
SALUS walls are designed and manufactured at the plant in Bernate Ticino, near Milan; overall, ADAM systems are installed in over 40 countries. Reference projects are listed on the Projects page.
For the other critical areas of a hospital, see the guide to modular operating theatres and the guide to hermetic and lead-lined hospital doors. To discuss an intensive care project, contact the ADAM team.