.Advocating for the Nursing Role in Program Design and Implementation.

.Advocating for the Nursing Role in Program Design and Implementation.

Advocating for the Nursing Role in Program Design and Implementation.

Nurses have long understood that “good design is good medicine,” says Jennie Evans, R.N., LEED AP, EDAC, Lean Six Sigma CE, senior vice president and associate principal for Dallas-based architecture firm HKS Inc

Despite their intimate knowledge of the patient care environment, nurses have not always been integral to the design of health facilities. But more and more, health care organizations, design firms and nursing groups are recognizing the value nurses can bring to facility design. While nurses feel the health care field has far to go to ensure that all nursing professionals are allowed to contribute meaningfully to the design of facilities, many nurses are helping to create — and even leading the design of — innovative health care spaces.Advocating for the Nursing Role in Program Design and Implementation.

This input often ensures that nurses’ workflow processes are not interrupted and helps to avoid significant additional project costs. In one hospital project, designers planned to place sinks in a location that would have required caregivers to have their backs to the patient while performing hand hygiene, an action correlated with lower patient satisfaction scores. But because input was provided early in the process, additional costs were avoided. In another case, nursing staff input led to a reduction in departmental size that contributed to more than $1 million in cost savings.Advocating for the Nursing Role in Program Design and Implementation.

Uniquely qualified

Nurses’ central role in patient care makes them uniquely qualified to provide constructive input on facility projects.

Mary Hubenthal, R.N., BSN, NE-BC, facilities operations program director for Phoenix-based Banner Health, is a former director of critical care and progressive care who is overseeing the design and construction of a 17-story patient tower atop the new emergency department (ED) at Banner–University Medical Center Phoenix. The project will bring the hospital’s total bed count to 764. “With my background in nursing and knowledge of overall ancillary department support services for nursing, physicians and patient care, I can recommend design changes and really make a difference in influencing how we care for patients and care for our teams as we move forward,” says Hubenthal.Advocating for the Nursing Role in Program Design and Implementation.

Pamela H. Redden, BSN, R.N., EDAC, executive director of clinical planning and development for the University of Texas at Austin’s Dell Medical School, says, “The nurse is the coordinator of care for the patient, so that makes it important that the nurse have input into the facility design process.”

“Hospital operations link to the built environment, and the physical layout has got to be in sync and aligned [with operations],” says Debbie Gregory, SN, BR.N., DNP(c), senior clinical consultant for the technology group at engineering design and facility consulting services firm Smith Seckman Reid Inc., Nashville, Tenn. Because they’re involved in the full continuum of care, “nurses are probably the best source for that type of operational alignment,” she says.Advocating for the Nursing Role in Program Design and Implementation.

The 24/7 nature of their job gives nurses insight into how a health care space functions at all times, notes Teenie Bracken, R.N., NNP, EDAC, clinical health care planner in the Philadelphia office of design firm EwingCole. “They also understand several scenarios that can play out in the space. They’ve lived through the ‘what-ifs,’” she says.Advocating for the Nursing Role in Program Design and Implementation.

Nurses can help to establish and maintain design and construction project priorities. “We understand hospital revenue matters. We understand administrator pressures, clinical pressures, quality pressures. We’re really savvy about these issues,” says Susan R. Silverman, MSN, president of the Nursing Institute for Healthcare Design and senior vice president and national director, project and development services, health care, for commercial real estate firm Jones Lang LaSalle, Chicago.Advocating for the Nursing Role in Program Design and Implementation.

When difficult value engineering decisions need to be made, the perspective of nurses can be especially useful, says Evans. “They will help the leadership identify the clinical priorities and help them understand what the staff can live without or what they absolutely must have,” she says. Evans describes an ED d