Probabilistic Return-on-Investment Analysis of Single-Family Versus Open-Bay Rooms in Neonatal Intensive Care Units—Synthesis and Evaluation of Early Evidence on Nosocomial Infections, Length of Stay, and Direct Cost of Care

Abstract

Cost savings associated with SFR units would justify additional construction and operation costs compared to OPBY units only when evidence on inclusive outcomes such as length of stay or direct costs of care is considered. A specific outcome such as infection rate potentially fails to capture all benefits of SFRs. As more evidence becomes available on full benefits and hazards of SFRs versus OPBYs, future studies should investigate the broader return-on-investment outcomes.

Reducing toxic stress in the neonatal intensive care unit to improve infant outcomes

“…Well-established parent education programs increase caregiver skills and knowledge; reduce parental distress, depression, and anxiety; and strengthen the parentinfant relationship in the NICU (Chertok, McCrone, Parker, & Leslie, 2014). Single-family rooms, when designed to promote the psychosocial needs of all users (i.e., infants, families, and clinicians), not only improve infant developmental outcomes (Lester et al, 2014(Lester et al, , 2016Shahheidari & Homer, 2012;Vohr et al, 2017), but also invite parental visitation (Raiskila et al, 2017), reduce noise (Liu, 2012), control infection (Sadatsafavi, Niknejad, Shepley, & Sadatsafavi, 2017), increase kangaroo care and breastfeeding rates (Jones, Jones, & Feary, 2016), and promote bonding and parental independence (Toivonen, Lehtonen, Löyttyniemi, & Axelin, 2017). The provision of human milk is critical to the optimal nutrition, health, and development of NICU infants (Crenshaw, 2014; Section on Breastfeeding, 2012), and breastfeeding support interventions significantly improve breastfeeding outcomes (Gharib, Fletcher, Tucker, Vohr, & Lechner, 2017;Haroon, Das, Salam, Imdad, & Bhutta, 2013;Relton et al, 2018;Renfrew et al, 2009).…”

Evaluación de la arquitectura hospitalaria: unidad de neonatología

“…El análisis de los datos recogidos se realizó por la misma autora en noviembre de 2018 y fue supervisado por los dos coautores. Tras analizar literatura científica sobre el diseño de las unidades de neonatología, se observa que gran parte de los estudios se centran en el efecto de la iluminación y el sonido sobre el desarrollo del neonato (28,29,30,31,32,33), la comparación entre salas múltiples y habitaciones individuales (34,35,36,37,38,39) o el diseño de la habitación individual (40,41,42,43). Sin embargo, el análisis de unidades en su conjunto, las relaciones entre sus locales e incluso la enumeración y características de los locales necesarios, se suele abordar desde las guías institucionales de cada país (44,45).…”

Single-Room Ward Design and Its Impact on Service and Patient Outcomes

“…There is emerging evidence that patients accommodated in open-bay rooms are at higher risk of nosocomial infections; adverse events; and breaches in their privacy (Allegranzi, 2011;Bloemendaal et al, 2009;Bonizzoli et al, 2011;Cheng et al, 2010;Lenhart, Stickler, Kriz, Angerler, & Tucek, 2008;Meredith, Jnah, & Newberry, 2017;Meyer, Schwab, & Gastmeier, 2010;Roberts et al, 2011;Skally et al, 2009). In response to this increasing evidence, organisations are prioritising single room design inpatient wards in preference to traditional open-bay wards when building new/redeveloping patient accommodation (Sadatsafavi, Niknejad, Shepley, & Sadatsafavi, 2017;Sadatsafavi, Niknejad, Zadeh, & Sadatsafavi, 2016).…”

“…Despite the evidence that open-bay room wards increase patient risk, there is scant evidence that single room wards reduce risk or improve outcomes. Specifically, there is limited evidence demonstrating the impact of a single room ward design on infection rates, patient satisfaction, clinician experiences, work flow and adverse events (Chaudhury, Mahmood, & Valente, 2006;National Health Service, 2008;Sadatsafavi et al, 2017;Sadatsafavi et al, 2016;van de Glind, de The risk of nosocomial infection can lead to devastating adverse outcomes. Patients with orthopaedic injuries are particularly vulnerable to infection (Cunningham, Kavolus, Bolognesi, Wellman, & Seyler, 2017;United States Bone and Joint Initiative, 2014).…”