This study examines the relationship between physical design and communication in healthcare delivery. It explores the communication and work patterns of nurses in an Intensive cardiac care unit with a decentralized nursing station layout. This research investigates the impact of a decentralized nursing unit on interaction patterns of clinical staff. Using a combination of observation, interview and survey, data was collected on a 16- bed ICCU at the Cayuga Medical Centre two years after moving to a new facility. To examine whether behavior in and attitudes about the new space had changed over time, this data was compared to a study (Phase I by Ronojoy Dutta and Anton Villacorta) using similar methods in the same facility three months following the move to the new facility. Data was collected on the nurses‟ activities, duration of activities, interaction with other staff and time spent with patients at various locations in the ICCU. This phase also involved observation of backstage areas and the role they play in fostering interaction and teamwork among the multi-disciplinary clinical staff. The key element of this research has been to observe how the users have acclimatized and modified their work environment and to check whether decentralized nursing units should be propagated as the best practice in ICCU design. The Phase II study found that ratings of job satisfaction, job stress, teamwork, and feeling valued increased significantly from data collected three months after the move to the new facility (Phase 1). There were no significant changes in the overall observed interaction patterns. Nurses‟ interaction with doctors, in particular, remained at a very low level. Implications for nursing unit design are discussed.