Construction Project Relies
on Nursing Input
on Nursing Input
Tuesday April 10, 2007
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In an ICU room mockup, Bob Berry, an architect with the firm of Gresham, Smith & Partners, based in Nashville, Tenn., notes ICU nurse managers’ suggested changes. Shown with Berry are (left to right) Kelly Gonzalvo, RN; Kassy Basnight, RN; Sara Thrower, RN; and Lori Desmond, RN.
(Photo courtesy of Tampa General Hospital.)
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Today, healthcare organizations too are beginning to take advantage of simple mockups of their ultimate prototype to test design and functionality. It only makes sense to bring nurses into the planning process at this point since it’s they who will be using the new space. And of course it’s easier and less expensive to incorporate that information at the beginning of a project than later on.
Hospital staff used a 54,000-square-foot warehouse to construct a patient room and nursing station from each unit of the expansion; mockups were built using the actual dimensions of the final prototype for accurate assessment and depiction of the areas’ functionality.
A major goal of the expansion steering committee was to focus on intricate clinical details and on employee and patient safety in the mockups’ design. For example, the mockups included lift equipment and working stations designed by ergonomic experts to help lessen chances of injury — especially helpful for an aging healthcare workforce.
With the mockups in place, the steering committee embarked on the most important part of the project — evaluation and testing by the end-users, and making revisions based on these reviews.
Tampa General extended a general invitation to its clinical staff to view the mockups, and interdisciplinary teams of physicians, nurses, therapists, clinicians, infection control workers, technicians, and the lift team provided their input. Several nursing units held a weekly meeting at the warehouse and then assessed their respective areas.
According to Maureen Ogden, RN, MHA, vice president of cardiovascular services, asking nurses to participate in the design of the new clinical areas was crucial to their buying in: “It really kept everyone jazzed up about the expansion.”
Service-specific equipment was placed in each specialized room. For example, angiography props were hung from the ceiling in the interventional radiology-vascular lab. When the designers could not feasibly install the real equipment, they built true-to-life plywood models. To add a touch of reality to the windows in the patient rooms, they printed murals of the actual view from each expansion floor of either a marina or Tampa Bay.
Like patient rooms, the nursing stations were mocked up using real computer monitors, fax machines, printers, chairs, phones, and electrical outlets. The actual central stations would be equipped with advanced clinical and information systems technology — and this created a challenge for the architects as they grappled with limited countertop space for multiple pieces of machinery.
Mockups helped answer numerous questions: How wide and how long should the countertops be? Where to install physicians’ dictation area? Was the station ergonomically sound for employees? Was sufficient space being allocated in high-traffic areas?
Nursing evaluators documented their comments and suggestions, which led to hundreds of design changes. Because of this, designers revamped the mockups to reflect nursing and clinical input and reopened the warehouse for a second tour.
It was money well spent, though, because the alternative would have been a great deal more costly. Also, the mockups gave employee morale and satisfaction a boost. Surveys completed by the nursing staff showed that the changes made to the mockups based on their input increased their enthusiasm and their eagerness to be part of the design process. It gave nurses the opportunity to have hands-on input and increased the likelihood of staff buy-in to the design of their units.
The mockups also generated a great deal of excitement as employees became eager to see the end product. Studies on employee satisfaction have shown, over and over, that giving employees a chance to participate in projects that affect their work area increases the sense of job fulfillment. Satisfaction is further increased when employees feel they’re valued by their leaders.
What’s more, nurses recognized the dedication of senior management to making sure they were happy with the redesigned units. The mockups were a leadership-driven project — and this was evident to staff when managers not only gave them time off during work to visit the warehouse, but transportation across town to do so.
In effect, the mockups were a link between dream and reality — and invaluable in helping Tampa General staff achieve their goals during the project’s initial phase.
Denise Haas, MHA, MBA, is assistant administrator of patient care services at Tampa General Hospital. The article was written with the assistance of Deana Nelson, RN, BSN, MHA, CNAA, the hospital’s executive vice president of patient care services.
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