Insights
Jun 11, 2026 _ insights
Linking Evidence and Spatial Configuration: A Typological Review and Analysis of Neonatal Intensive Care Unit (NICU) Design
The design of Neonatal Intensive Care Units (NICUs) has a significant impact on patient outcomes, family experience, and staff workflows. Yet design decisions are often made without a clear framework that links spatial configuration to measurable performance outcomes.
At this year’s Environmental Design Research Association conference, I presented a study I co-authored with Shan Jiang of GBBN and Lindsey Fay of the University of Kentucky. The study addresses a central question: How do common NICU layout typologies compare in terms of documented design outcomes? To answer this, we used two methods: a systematic literature review and a spatial configuration analysis of representative case studies.
Phase 1: Systematic literature review.
Using Preferred Reporting Items for Systematic reviews and Meta-Analysis PRISMA guidelines, we reviewed research on three NICU space types: patient rooms, staff spaces, and ancillary/support areas. Patient room layouts included open bay, dual occupancy, single-family room (SFR), and couplet care within a SFR. Staff spaces included centralized, decentralized, and hybrid nurse stations, along with huddle stations and workrooms. Ancillary spaces included family lounges, staff break rooms, and respite areas. Across these categories, we identified distinct evidence-based performance profiles related to outcomes such as infection control, feeding, length of stay, acoustics, communication, teamwork, and staff satisfaction. This review also revealed gaps in the evidence, especially for newer and hybrid NICU layouts.
Phase 2: Spatial configuration analysis.
We then analyzed three NICU case studies using Space Syntax methods, including step depth and J-graphs, to examine relationships among key spaces. These layouts were evaluated against the evidence-based framework developed in Phase 1, allowing us to compare the spatial advantages and tradeoffs of each configuration.
This research translates NICU design evidence into a practical comparative tool. By linking documented outcomes to measurable spatial properties, it gives planners and designers a clearer way to choose layouts that support specific clinical, operational, and family-centered goals. In short, it helps move NICU design from intuition to evidence.
See the presentation here.
Learn more about our NICU design work here.
See more of our healthcare design work here.
Learn more about research at GBBN here.
Zahra Daneshvar, EDAC is an interior designer and researcher at GBBN. Zahra combines her passions for interior design and research to create healthcare environments that uplift both patients and staff. She likes to incorporate new technologies, like video mapping, in her design process to help create immersive experiences and opportunities for positive distractions. She is a co-author of “Examining Efficacy in Open-Bay and Single-Family Room NICU Designs,” published in Advances in Neonatal Care. Her research and insights have been presented at the Kentucky Conference on Health Communication, and at the Environmental Design Research Association’s annual conference.
