Evolving Leadership in Healthcare Design
Nurses and other healthcare professionals have always had opportunities for diverse careers. Healthcare professionals can advance into management, education, specialized clinical practice, schools, sports teams, and even the movie industry. This issue of HERD discusses how healthcare professionals and those involved in healthcare design are using their art, expertise, and critical thinking skills to improve both patient care and the built environment.Billions of dollars have been spent in the design and construction of healthcare facilities since the building boom of the 1990s. As a result, the healthcare design industry has had several opportunities to evaluate the effectiveness of the built environment to improve the patient experience and enhance the work environment for healthcare professionals. Perhaps a result of this building boom, or perhaps because of the pioneering spirit it engendered, nurses and other healthcare professionals began to enter the design and construction industry to integrate their perspective and expertise into the design and of healthcare facilities. Today, many healthcare professionals, especially nurses, are long standing employees of architectural firms.A survey completed by the Nursing Institute of Healthcare Design (NIHD) found that nurses have been employed by architectural firms or the design industry since the early 1980s. The roles of physicians, nurses, and others have included visioning, strategic planning, operational improvement, space programming, team liaison, and conceptual thinking. Their roles have evolved to include advising on the healthcare facility guidelines, technology and equipment development, interior design, architecture, product development and implementation, simulation modeling, and research.Those of us who work in the healthcare design industry may think of a building or a specific environment when we hear the word design. However, healthcare design encompasses so much more. The word design means "to plan and fashion artistically or skillfully." Nursing is both an art and a skill. Nurses work artfully to develop rapport with their patients and their families, design solutions to motivate patients who are uninvolved in their care, creatively schedule analgesia to manage a patient's pain, find solutions for the patient who cannot sit up by him or herself, and create workarounds when the proper equipment or supplies are not available. Skill is related to the knowledge base, training, and critical thinking required to care for a myriad of disease processes that a nurse faces over the course of a day, week, or year. The right combination of art and skill cannot be readily observed or taught and the value of this insight in the design process is irreplaceable. The nurse and other healthcare professionals possess a combination of skill, knowledge, awareness, and experience that has a positive impact the design of the care delivery model as well as the design solution for the supporting environment.Today, that art and skill is being used to lead the design of the future healthcare delivery model. The leadership opportunities in the domain of design are plentiful. The "Spheres of Influence" in Figure 1 illustrate how the healthcare professional's expertise permeates the patient care environment. The influence may or may not have a direct correlation to an end product within the environment; however, all dimensions require leadership, clinical knowledge, and advocacy for both patients as well as other staff members. The concentric circles demonstrate how the strength and influence of the clinician's leadership, knowledge, and advocacy can impact the end result of the project, both the clinical aspects as well as the design of the built environment.The first "sphere" (orange) demonstrates how healthcare professionals have the opportunity to use their knowledge to influence strategic planning within the healthcare system, collaborate with the development of patient access solutions, lead safety and quality initiatives, impact the future care delivery model, and identify and implement process improvement strategies.
HERD