This study observed nurse transit times and activity patterns in an open bay neonatal intensive care unit (NICU) to understand opportunities for improving efficiency by redesigning the NICU layout, and to use these data to estimate the impact of an alternative pod room NICU layout under consideration. The transit times and activity patterns of 4 nurses were observed while working in the open bay NICU in a hospital. Nurses were observed for a combined total of 48 hours, and times and activity patterns were recorded using a customized template for electronic software running on a smart phone. These times and activity patterns were then projected onto a proposed pod room layout for the same NICU to estimate the impact of this redesign prior to actual construction. Results showed that the nurses spent 89% of their work time in the NICU and when in the NICU they spent 44.8% of their time charting neonate information, 40.1% on direct patient care at the incubator, 6.8% of their time in transit between NICU location, 5.4% of the time on washing or sanitizing their hands and 2.9% of the time searching for supplies. Based on this information and the spatial layout of the existing and proposed NICUs it was found that each layout has its own unique layout deficiencies, and the proposed layout does not necessarily improve efficiency. The proposed layout lowers transit times for movements from the incubator to the computer, the incubator to the medical supply cart, and the computer to the medical supply cart however the open bay layout lowers transit times for movements from the incubator to the sink. All other movement transit times depend on the specific pod unit within the pod layout where care is taking place.