Unless specified otherwise, the following recommendations apply to the newborn intensive care built environment, although most have broader application for the care of ill infants and their families.

Where the word shall is used, it is the consensus of the committee participants that the standard is appropriate for future NICU constructions. We recognize that it may not be reasonable to apply these standards to existing NICUs or those undergoing limited renovation.

We also recognize the need to avoid statements requiring mandatory compliance unless a clear scientific basis or consensus exists. The standards presented in this document address only those areas where we believe such data or consensus is available.

Individuals and organizations applying these standards should understand that this document is not meant to be all-encompassing. It is intended to provide guidance for the planning team to apply the functional aspects of operations with sensitivity to the needs of infants, family and staff. The program planning and design process should include research, evidence based recommendations and materials, with objective input of experts in the field in addition to the internal interdisciplinary team that includes families who have experienced newborn intensive care. The design should creatively reflect the vision and spirit of the infants, families and staff of the unit. The program and design process should include:

• Development of vision and goals for the project
• Education on design planning and processes for changing organizational culture
• Review of articles on patient- and family-centered care, individualized developmentally supportive care, teambuilding, evidence-based design, facility planning, and other relevant aspects of clinical practice.
• Visits to new and renovated units
• Vendor Fairs
• Program Planning
• Space planning, including methods to visualize 3-D space
• Operations planning, including traffic patterns, functional locations, and relationship to ancillary services
• Interior planning
• Surface materials selection
• Review of blueprints, specifications, and other documents
• Construction of mock-ups
• Preparation and planning for change in practice for staff and families in the new unit
• Building and construction
• Post-construction verification and remediation
• Post-occupancy evaluation