With the nationwide trend of increasing premature births, HSHS St. John's Children's Hospital needed to make significant changes to its existing 45-bed, 15,000-square-foot Level III NICU. At the outset, project leaders knew they wanted to build upon the latest evidence-based design insights from other best-in-class facilities. The design team and clinicians visited multiple benchmark facilities, collaborating with staff and leadership to better understand lessons learned and industry best practices.
Kahler Slater, the clinical design team and women's and children's healthcare experts, along with partner firm Smith Hager Bajo, targeted multiple patient outcomes that could be improved through the new environment, including average length of stay and readmission rates. A post-occupancy evaluation (POE) conducted in 2025 found improvements across every outcome measured.
Many of the project's successes can be attributed to innovative design features. The expanded NICU introduced a tiny baby sub-unit dedicated to the highly specialized needs of its smallest patients, as well as a milk lab where technicians can fortify mothers' breast milk with additional nutrients. A dedicated family respite lounge and overnight sleep suites also contributed to family satisfaction scores in the 90th percentile.
The two-phase expansion more than doubled the original NICU footprint and introduced a mix of room types, including single, twin, and couplet care rooms, as well as open bays, providing valuable flexibility to accommodate changing patient needs and evolving care models. HSHS St. John's Hospital was one of the first hospitals in the nation to offer couplet care. Designed to allow mothers and their NICU babies to stay in the same room, couplet care has been shown to facilitate essential parent-child bonding through earlier skin-to-skin contact and increased breastfeeding success and is associated with reduced lengths of stay and lower infant morbidity.
The couplet care rooms have also supported a variety of additional uses. These extra-large rooms, equipped with identical dual headwalls, have accommodated unrelated patients during census surges and provided a dignified setting for family rituals such as baptisms and funerals.
These and other key findings from the HSHS St. John's Hospital NICU Renovation post-occupancy evaluation (POE) were featured in the medical journal Neonatology Today. Read the full article here.
