New Neurosciences ICU Highlights the Value of Patient and Family Partnership
When Mike Lancaster had a massive stroke on February 19, 2013, his wife Robin, a former EMT, recognized the signs immediately and called for help.
Mike, who worked in Information Technology and Services at Wake Forest Baptist, spent 22 days in our old Neurosciences Critical Care Unit (Neuro ICU). “It is a miracle that he is alive,” Robin said. “From the EDU to the ICU to Rehab, Mike received excellent care. The doctors and nurses were fantastic.” Although she has nothing but compliments about Mike’s care, Robin said the time he was in the ICU was intense, stressful and often not very private. The old ICU’s design was based on the premise that doctors and nurses needed to see all of the patients at once and that families did not need to be at the bedside 24/7.
Last week, Robin and her husband toured the new, $16.5 million, 24-bed, high-tech unit that opened today on the 5 Ardmore Tower West. Robin calls the unit amazing, and their experiences helped shape its design.
Two years ago planning began for the Neuro ICU. Aarti Sarwal, MD, the medical director of the unit and a neuro-intensivist, said that the neurologists, neurosurgeons and nurses had been collecting ongoing feedback from patients and families who had been taken care of in the ICU and when they came to the clinic for follow-up. They further partnered with Robin and another patient asking them to attend planning sessions.
“They wanted to hear what the patients and families thought,” Robin said, “Right from the beginning I was very pleased to see that many of the things I would have suggested were already incorporated into the plan, including the size of the rooms, privacy and having the family areas close by.”
The new unit features small nursing stations just outside pairs of spacious patient rooms with windows and plenty of space for families to stay near their loved ones, a shower, couches that convert to sofas and have charging stations for electronics and calm colors and artwork of natural scenes from around North Carolina, all with the aim of creating a nurturing, healing and peaceful environment.
In fact, with a kitchenette, eating areas, washers and dryers and other amenities, families never have to leave the floor and can always be near. They can meet with the doctors in private family rooms that even provide audio-visual technology to help them and any loved ones far away understand the complexities of strokes and other neurologic or neurosurgical issues such as stroke, spinal injury or brain surgery.
Neuro ICU patients may require quick attention from numerous staff, including doctors, nurses and respiratory therapists. The new room design not only allows for all of these caregivers at the bedside, but also has booms that hide all of the wires, tubing and other equipment that provides the patient with oxygen, fluids and more to keep the patient connected while care is provided.
In addition, a key component of recovery is to get the patient on his or her feet as soon as is appropriately possible. Patient lifts in each room not only assist the patients but the lifts also make this safer and much easier on staff, where numerous people may have been required to move the patient before.
Because families are so important to the care of the patient at home after the ICU, this new model brings the families into the room and provides the opportunity and space for staff to educate family members regarding care of their loved ones at home. Family or caregivers can observe and then work side-by-side with staff so they are ready to take the patient home and care for them there.
The unit design also addresses that not all of the Neuro ICU patients will recover and their families may need privacy away from other patients and their families to adjust to the anticipated loss. A quiet hallway with rooms for those patients and private spaces for their families is part of the design.
As an academic medical center, training medical students, residents, fellows and nurses is part of our mission. Caring for a seriously ill patient and teaching at the same time is often difficult, Dr. Sarwal said. “Situations can go bad in seconds, and you may be making life and death decisions.” Having not only a training room but also the ability to do simulations with high-tech mannequins provided by the Medical Center’s Center for Applied Learning (CAL) provide excellent education for physicians and staff right on the floor.
Care for the staff is also an important part of the design, Dr. Sarwal said, with rubber-matted floors that are quieter, softer and easier on the feet for doctors and nurses walking thousands of steps a day. A respite room provides showers, lockers and space for staff members to step away from the high-stress ICU environment and rest quietly.
“I think this is so great that the staff will be able to do their jobs even better,” Robin said. “Anything that would help staff take care of the patient is good for patient care.”
Robin and Mike appreciated the opportunity to provide input on the new unit. “It shows that they care about patients’ concerns. We received very good care while my husband was here. And this will just be the next step.”