Designing a Hospital? Ask Nurses First

Alexandra Wilson Pecci, for HealthLeaders Media , February 7, 2012

"The CEO took a really big approach and decided to really involve nursing and those at the bedside in the design because he really felt like the employees were closer to the patients and would better know how to design the hospital," Buckner told HealthLeaders.

Involving the bedside staff in the design of a facility is a smart move. According to a research brief from the Robert Wood Johnson Foundation, "nurses at all levels and in every setting have a critical role to play on multidisciplinary teams charged with assess­ing, planning, and designing new and replacement facilities."

The paper discusses the importance of nurse involvement in hospital design using case studies from hospitals around the country. For example, the nurses at St. Mary's Medical Center North in Powell, Tennessee, "advocated for wider doorways to facilitate patient handling, nonslip floors to prevent falls, and supply servers with pass-through doors and view windows to allow nurses to see patients from the hallway and a list of attributes of these smartly designed hospitals," the research brief said.

Similarly, rooms at Cass Regional are large, and not only provide enough room for equipment and transporting patients, but for the nurses to move around easily. ADA-compliant showers allow nurses to simply wheel patients directly into the shower in a wheelchair if needed, Buckner says.

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4 comments on "Designing a Hospital? Ask Nurses First"

Mary K Parker (3/5/2015 at 8:51 AM)
I would add that not only do the patient care facilities for patients need to be evaluated, but the "behind-the-scenes" support architecture needs to be evaluated, too. I work in a beautiful LEED-certified facility and the staff rooms are definitely suboptimal. It's as though they ran out of money when they got to the staff and we were left with the dregs. Unfortunately, this means that my scooter-dependent ward clerk can't get into the room where we do shift change because the doorway is not ADA-compliant, our copy machine (which prints PII documents) is in an unprotected alcove where someone could snatch documents before we walk down the hallway and turn the two corners, and housekeepers and greeter staff have taken over our staff lounge because they were not considered when developing "off-stage" areas for breaks and meals. To say I am disappointed is an understatement.

Steve Moore (2/16/2012 at 9:58 AM)
As a healthcare architect and medical planner for over 25 years, and also having the privilige of working with the staff in the design of the Cass Regional Medical Center, it is incredibly important to have the staff involved not only in the design but also in making the mock-up room and installing all items in it. Not all healthcare architects fully appreciate the world you live in. As an example, on a another project of similar size to Cass, we had a scheduled review of the mock-up room. The princile-in charge, although greatly experienced in architecture was not quite 'healthcare savvy', and thought the mock up review would be a 15 minute exercise. 45 minutes later, after reviewing the location of every item and how it affected the flow of the nursing activities, (ie where do we really want the sharps container? it fits here...but it makes much more sense there because...)we left the room. His eyes were opened! The greatest flaw in healthcare design is we have become so used to doing things the way we have, and designing things the way we have, that we do not know why the left hand is doing what it is doing, and how the right hand can help or support it. Staff input is vital, and so is design leadership, but more vital than anything are new eyes to see the old ways and see a new and better way of doing things.

Kim Mills (2/15/2012 at 11:00 AM)
Our nursing staff designed our patient care units for our new hospital. We were allowed to decide down to outlet placement, number of drawers in cabinets, and square footage of some rooms. It gave our staff great pride and feelings of worth but most importantly, it made our new beautiful building very functional.




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