After attending the HEALTHCARE DESIGN.05 conference in Scottsdale, Arizona, a small group of registered nurses was inspired to address a knowledge gap it found among nurses who are increasingly being invited to the planning table. Since then, the Nursing Institute for Healthcare Design (NIHD) has been helping to educate and inspire nurse leaders in their role in healthcare design and construction. Online Editor John Oberlin discusses NIHD’s mission and goals with the director of operations, Laura Hayes RN, BSN, MBA.

Oberlin: What is the main purpose of the NIHD?

Hayes: To inspire and educate nurse leaders about their roles in healthcare design and construction.

Oberlin: And how was the organization formed?

Hayes: In early 2005 my colleague from nursing school, Debbie Gregory, who had gone back to get an interior design degree, knew I was interested in nurse retention, workflow, patient safety, and that kind of thing. She thought I would be interested in what she was learning about healthcare design and that there was actually research and literature out there about designing hospitals to improve outcomes for nurses and patients. Because we didn’t know this information, we assumed there were a lot of nurse leaders who also don’t have access to this information.

As we were studying more about the topic, she came across some information from The Center for Health Design, and we decided to go to the 2005 HEALTHCARE DESIGN conference in Scottsdale, Arizona. On the plane home from that trip we were inspired to get information out to nurses. There were a lot of people in attendance but only a handful of nurses. And we knew that nurses are a group that needs to know that this type of research exists. But although we were obviously not experts in this field, we thought we could act as gathers and disseminators of information for nurse leaders. We considered having a nursing conference or trying to speak at nursing conferences, and that’s when we thought an online resource would be more efficient. We began our Web site in the spring 2006.

Oberlin: Tell me a bit about the online resource.

Hayes: First of all, nurse leaders are being invited to the table, and the chief nursing officer is now considered one of the executives of the hospital. So now, instead of a director of nursing, there are chief nursing officers who are considered higher-level executives making higher-level decisions. They get to the planning table and don’t have the information and preparation they need because we didn’t have anything about healthcare construction in nursing school.

Through the online resource they can be inspired by knowing that there are nurses out there who are knowledgeable and could be a resource on this subject. “NIHD Connect” is where we pull together basic healthcare design and construction information—articles, videos, books, and links—we find about such topics as patient room design, hospital unit design, noise in the work place, and safety features. A lot of those design features deal with patient safety and infection control. You know, my mother knows you should put the sink by the door, but is this being done everywhere? So by reading some of this basic information about healthcare design and construction, the nurse leader will be equipped so she or he at least knows what to advocate for at the planning table. Or, if something doesn’t ring true, they know where to go and dig deeper into the topic.

Oberlin: Where does the nurse-designer collaboration process need improvement?

Hayes: I think architects still have a tendency to discount the nurses’ views, and sometimes that is because the nurses may not be giving the best answers. For example, I might ask a nurse at one hospital and they might tell me one thing, and then I ask a nurse at another hospital and she tells me the complete opposite. So if the architects are not getting good answers from the nurses, they may decide not to pay attention to them and only include them as a courtesy. And the problem may be that the nurses are telling them different things because of the way they are using the space or because of a lack of knowledge that, yes, you do need to put the sinks by the door.

For example, my partner Debbie was in one of her design practicums at a local hospital, and there was a huge disconnect between the architects and the nurses. The architects were talking about ADA—meaning the American Disabilities Act—and the size of a doorway. And the nurse thought they were talking about the American Diabetic Association diet, which is something nurses would talk about all the time. They had these blank looks on their faces, not knowing what they were talking about. Sometimes there’s a disconnect because of language and nomenclature.

Oberlin: Do you think healthcare design and construction should be included in nursing education, particularly for those looking to move into management positions?

Hayes: Yes, there should be some basic healthcare design and construction included in undergraduate nursing curriculum. As we talk to nurse educators and different universities, we hear that they have so much they have to include that it would be difficult to get a whole course on this topic. We are thinking that our online resource course could be a component of a fourth-year undergraduate management class, which all nursing students must take. There wouldn’t have to be a big emphasis on it, but just enough to be exposed to it.

Oberlin: What’s in NIHD’s future?

Hayes: We formed NIHD as a limited liability company, but it lends itself to a nonprofit, or it could be purchased by a university. We are looking for collaborating partners now. But it’s our on-going mission to keep gathering articles and links in an organized manner so nurses have somewhere to go.

We’re also looking to start a product gallery, so when nurses say, “OK, we have to decide about headwalls, or flooring, well gosh what’s out there?” we can provide a resource to help them choose. And as part of our upgrade going live this weekend, we also are providing an opportunity to hear from experts, share case studies, and discuss with one another in a forum for posting questions and getting answers.

For more information on the Nursing Institute for Healthcare Design, visit or contact Laura Hayes at