When I’m designing healthcare spaces, I always keep three groups of occupants in mind throughout the entire process: patients, families/visitors, and staff. Although patients are usually at the top of my list, staff members are equally important since they spend the most time in the facility.

Turnover in staff is quite common, especially with nurses. I’ve reviewed several nurse resumes and it is shocking to see how many nurses are only in a position for a year; and they have a span of eight years with six different positions at different hospitals. According to the article, The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity*, the nurse turnover rate was predicted to be at 20% this year (the PriceWaterhouseCoopers 2007 report showed an average of 8.4%**). That turnover can be directly related to job dissatisfaction, and job dissatisfaction can be caused by the work environment.

Designers can play a direct role in taking several steps that can improve the stressful work conditions in healthcare facilities, and then aid in retaining more workers. The Ulrich article mentions considering staff health in regards to surface contamination, taking measures to reduce noise-induced stress, and designing patient rooms in radial units with decentralized nurses’ stations to reduce nurse walking time and increase patient-care time. More specifically, specifying antimicrobial products; selecting high-performance, sound-absorbing ceiling tiles; and planning nurses’ stations with direct sightlines into patient rooms through radial units can all be done by designers to improve the work conditions and environment.

By stepping into the staff’s shoes, we can better understand their long and stressful work conditions to design spaces that result in higher job satisfaction and retention.

References Cited:

*Ulrich, R., Zimring, C., et.al. (2004). The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity. Report to The Center for Health Design for the Designing the 21st Century Hospital Project. Funded by the Robert Wood Johnson Foundation. Retrievable online at: http://www.rwjf.org/files/publications/other/RoleofthePhysicalEnvironment.pdf

**PriceWaterhouseCoopers Health Research Institute. (2007). What Works: Healing the Healthcare Staffing Shortage . Retrievable online at: