• David E Leaf, Peter Homel, and Phillip H Factor.
• 7 Dazian, Beth Israel Hospital, 1st Ave at 16th St, New York, NY 10003, USA.
• Chest. 2010 May 1;137(5):1022-7.

BackgroundArchitectural design of health-care facilities can influence patient safety; however, it is unknown whether patient outcomes are significantly affected by ICU design.MethodsSix hundred sixty-four patients admitted to the medical ICU (MICU) of Columbia University Medical Center during 2008 were included in this retrospective study. Patient outcome measures, which included hospital mortality, ICU mortality, ICU length of stay (LOS), and ventilator-free days, were compared based on random room assignment. Rooms that were not visible from the MICU central nursing station were designated as low-visible rooms (LVRs), whereas the remaining rooms were designated as high-visible rooms (HVRs).ResultsOverall hospital mortality did not differ among patients assigned to LVRs vs HVRs; however, severely ill patients (those with Acute Physiology and Chronic Health Evaluation II scores > 30) had significantly higher hospital mortality when admitted to an LVR than did similarly ill patients admitted to an HVR (82.1% and 64.0%, n = 39 and 75, respectively; P = .046). ICU mortality showed a similar pattern. ICU LOS and ventilator-free days did not differ significantly between groups.ConclusionsSeverely ill patients may experience higher mortality rates when assigned to ICU rooms that are poorly visualized by nursing staff and physicians.

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