Saint Alphonsus Neuro, Surgical, Trauma (NeST) ICU, Idaho: Photo Tour

Saint Alphonsus Health System, a healthcare provider in southern Idaho and eastern Oregon for more than 125 years, operates one of the region’s most state-of-the-art trauma centers.

With advancements in neuroscience and technology, Saint Alphonsus recognized the need to evolve its neuro critical care offerings and bring these services to Idaho. The organization engaged multidisciplinary architecture, engineering, and interior design firm Cushing Terrell (Boise, Idaho) and general contractor Andersen Construction (Boise) to help them create the state’s first Neuro, Surgical, Trauma (NeST) Intensive Care Unit (ICU) at its Regional Medical Center in Boise.

The project involved renovating the third floor of the medical center’s south tower, all done while the surrounding hospital services remained operational. The 38,500-square-foot NeST ICU has 18 fully equipped critical-care rooms and 17 variable acuity rooms.

Rooms on the east end of the unit are for variable acuity patients and rooms on the west end are for critical care patients. New staff areas, nursing alcoves, and team centers were also added with two team centers located at each end of the ICU.

Wayfinding is key

Wayfinding was another key element of the project with a focus on solutions to aid the efficient flow of patients, staff, and visitors. The design team employed signage, flooring materials, and vibrant wall graphics to help guide people through the floor plate.

For example, the patient-room side of the corridor features a lighter band of flooring to highlight room locations, while darker flooring designates team centers. The approach helps break up the linear nature of the long corridors. A similar approach was implemented at the ceiling with soffits surrounding the nurses’ alcoves and team centers.

Graphic wall protection panels throughout help brighten staff work areas as well as play a role in wayfinding and placemaking.

To further aid circulation, the project team designed two corridors, with one for staff to use when transporting patients to and from the NeST ICU, while the other is for the public to use while moving between the NeST ICU and the main hospital. This later corridor, designed as a respite area, features clerestory windows to provide access to daylight and views of downtown Boise and the surrounding foothills.

Improved functionality for patient rooms

One of the project challenges was to create a functioning space within the confines of the 1960s-era tower. The existing column placements, concrete subfloor, and low ceilings all impacted the design.

The project team carefully considered the placement of patient rooms so they would fit within the existing constraints.

Additionally, rooms needed to be designed with enough space to utilize a mobile CT scanner, which would eliminate the need to transport patients to another tower on campus for a scan, saving time for staff and improving the patient experience.

The resulting design solution was to double the room size with bathroom facilities re-located back-to-back in an outboard configuration, which allows for greater patient visibility from the nursing alcoves.

To accommodate the new configuration of patient rooms and bathrooms, building systems were re-routed, while at the same time ensuring patient care could continue on the adjacent floors.

Additionally, patient rooms in the new ICU are fully equipped with technology and accessibility systems such as ceiling booms and ceiling-mounted lifts, which enhances flexibility of the rooms and improves the ability for staff to move, monitor, and care for patients.

The room set-up as well as nurses’ alcoves with views directly into the patient rooms support Saint Alphonsus’ continuous care model. With a 2-1 nursing ratio to serve patients with a high level of acuity, the continuous care approach aims to keep ICU patients in close contact with their primary care nurse throughout their stay.

Care team space improvements

Another goal of the project was to improve the workspaces of the care teams. Team centers were designed at each end of the ICU floor and provide a separate work area where staff can come together to collaborate on patient care and enhance a sense of community.

The team centers are accessible to patients and visitors but also offer some separation to ensure private conversations stay private and healthcare workers can focus on the tasks at hand. The team hubs feature large-scale images of wildflowers printed on a material that doubles as wall protection. The end walls of each center have a thick translucent panel with a subtle leaf pattern that creates some privacy as well as visual interest.

Fully equipped with technology and located in areas that are easily accessible for staff, the team hubs can inspire knowledge sharing and result in a higher level of patient care.

Creating a sense of comfort for patients

Patients tend to be in the ICU for an average of three weeks due to the level of care needed. As a result, families and visitors are often on site for longer periods of time, as well. To accommodate these longer stays, patient rooms feature in-room space for family members. Furnishings include a sofa that pulls out into a full-size bed, casework cabinet with storage space for belongings, multifunctional counter space that can be used as a desk, lounge/sleeper chair, and private bathroom.

The use of different types of flooring within the rooms also creates a subtle delineation for the family zone, ensuring staff have ample space to perform their patient-care duties.

Like the rest of the ICU floor, patient rooms feature natural wood tones, soothing colors, and wildflower graphic panels. Windows offer views of the surrounding valley and foothills. The soothing aesthetic extends to the colors palette, which reflects the blue of the Boise River and the greens of the nearby foothills.


Project details for Saint Alphonsus Neuro, Surgical, Trauma (NeST) ICU


Facility name: Saint Alphonsus Neuro, Surgical, Trauma (NeST) ICU

Location: Boise, Idaho

Completion date: February 2023

Owner: Trinity Health/Saint Alphonsus Health System

Total ICU floor area: 38,500 sq. ft.

Architecture firm: Cushing Terrell

Interior design: Cushing Terrell

Engineering: Cushing Terrell

General contractor: Andersen Construction