Healing through design: Nursing perceptions of the health care environment

The purpose of this case study was to explore nurses’ and nurse administrators’ perceptions about how the built environment in a healthcare facility contributes to patient care delivery. The study focused on a group of nurses and nurse administrators as they made the transition from an existing patient care facility to providing care in a new facility. The experiences of the care providers in these two facilities were used to identify and characterize the design features significantly influencing their performance. How did caregivers perceive the impact of evidence-based design components on patient care? This was answered by determining what physical elements within the work environment were perceived among nurses and nurse administrators as barriers to providing quality patient care and which were perceived as enhancements to the provision of quality patient care. The study spanned 13 months with interviews and observations occurring at three intervals. The first at the original hospital one month before the transition, the second just three months after the move, and the final one year after the new hospital had opened. The study was descriptive in nature: introducing the participants in terms of their experience and patient responsibilities; providing information about the design of each healthcare setting; creating an outline of the planning and design process for the new facility; and recounting the nurses’ involvement in that process. The study revealed two primary components of the built environment, private patient rooms and decentralized nurse work areas, as having a positive impact on their ability to provide patient care. However, caregivers simultaneously expressed some preference for the social networking opportunities that a central nurse station design offers. One lesson from this study is that evidence-based design of healthcare facilities should include research from the perspective of those providing patient care. This study was conducted using qualitative data; further empirical study should be conducted to validate the perceptions of these caregivers about the value of the built environment