Early Nursing Involvement is Key to Successful Design Process, Says Nurse Architect

    • August 9, 2006

Sharon Woodworth recognizes the value that nurses bring to the discussion when a new hospital is being planned and designed. Before she became an architect, she spent 15 years as a nurse at a children's hospital in Texas. Now she builds on her experience at the patient's bedside and specializes in the design of hospitals and health care facilities.

“Nurses have to be in the room and be empowered to be part of the process,” said Woodworth, a senior associate with Anshen+Allen in San Francisco, an architecture firm specializing in the design of health care and academic facilities. “Nurses need to be heard. To be heard, they need to be respected.”

Though Woodworth had not planned to specialize in health care architecture, her nursing background proved to be an asset when she applied for an architecture internship to gain practical experience. The firm was known for its health care architecture practice, and Woodworth immediately brought her powerful and unique perspective as a nurse to the table. Beginning with her first assignment, she has encouraged hospital and health care leaders to bring nurses into the design process early on.

She recalls meeting with a nurse who was the director of an emergency department at a hospital about to be rebuilt. In an early meeting, the director voiced concern over the location of the ER. The project's architects—who had 40 years combined experience designing hospitals—didn't ask why the location of the ER was so important. Woodworth did probe deeper, giving the director the benefit of the doubt that she must have had a good reason for asking the question.

Woodworth learned that the ER director was concerned because the entrance to the emergency department was in the same location where ambulances arrived to transport nursing home patients to the hospital, consequently clogging the ER. She knew the hospital needed another ambulance entrance, separate from the ER. Woodworth was able to uncover this important piece of information because her health care background helped her ask the right person the right question.

Woodworth emphasizes that she is a member of the architecture team, not a nurse representative, and insists that her clients have nurses at the table. In fact, Woodworth rarely shares her nursing background with her clients out of concern that they might substitute her experience for the advice and counsel of nurses working in the hospital.

“Nursing needs to be brought in when the RFQ (request for qualifications) is written,” she explains. “That document is all the architect knows about a project. If nursing is not part of the discussions to decide what will go into the project, then an important element is missing.”

“Too often, nurses are brought in once the design is completed, or if there is a problem,” Woodworth added.

Hospital executives thinking about new construction projects should be on the lookout for a certain kind of nurse to participate in the design process. Woodworth believes the best nurses for this work are creative people who can effectively describe the problems they face in their work, and those who are open to solutions proposed by the architects.

Woodworth encourages her clients to participate in the Pebble Project of the Center for Health Design, an RWJF grantee. The Pebble Project works with hospital partners across the country to demonstrate how health care facility design can improve the quality of care for patients, enhance operational efficiency and productivity, and increase staff engagement and retention.

Among the many design elements that hospital and health system leadership can consider when planning a new building, Woodworth believes that natural light is one of the most important.

“Hospital leaders and the architecture team are committed to creating a space that helps nurses to not make mistakes,” she said. “Bringing natural light into the workspace, not just into patient rooms, can help achieve this.”