A leader in nursing and healthcare administration for 20 years, Karin Henderson serves as the system leader for the five-hospital Cone Health organization, responsible for more than $300 million in capital construction projects. On Feb. 23, 2020, Cone Health closed its maternity hospital, moving services into a new bed tower. With the COVID-19 pandemic in early stages at the time, Henderson was charged with evaluating the vacated hospital to determine if it was possible to transform its medical/surgical level into a critical care environment to treat COVID-19 patients.

She led a team of engineers, infection prevention and safety practitioners, Lean experts, and clinicians to determine how to alter the structure, air handling units and ventilation systems, and equipment to meet potential patient needs. Key aspects of building functionality were confirmed, such as the electrical load necessary to support dozens of adult ventilators and HEPA filters, oxygen flow capability, and HVAC to achieve negative pressure.

The effort resulted in the conversion of the 200,000-square-foot campus into North Carolina’s only field hospital at that time. Henderson assembled an 80-person team to guide the project, leveraging evidence-based design, infection prevention standards, and learnings from the Ebola outbreak to guide solutions implemented. And design was key to assuring staff were safe during care delivery.

For example, Henderson led her team in adopting a Lean philosophy for the flow of patients, equipment, and staff through the contaminated environment to optimize the placement of equipment and supplies, with temporary walls and taped areas designating contaminated and safe zones. Evidence-based design was likewise leveraged to achieve decreased touch points in the contaminated environment and increased time for staff at the bedside. Additionally, an end-of-life suite was added as a space where families could safely visit loved ones to say goodbye.

The field hospital, built in just 28 days, was used to treat more than 2,500 patients between April 2020 and March. Henderson and her team next took their learnings to apply them to opening three pandemic units for COVID-19 treatment on other Cone Health campuses as well as to construct a communicable disease unit on the main campus.

These spaces are now the destination care areas during this wave of the pandemic while also serving as a “lab environment,” where research can be conducted on how best to deliver care to contagious patients.


What do you love most about your job?

Working for a health system that fosters innovation and supports the risk of paradigm change. Typically construction is led solely by construction management and project managers; our organization supported a new paradigm where a nurse with deep clinical and construction experience was appointed to lead design and construction. I love drawing on my clinical experience and partnering with frontline staff who inform design based on evidence.

What industry challenge do you hope to solve? 

Reinventing the approach to traditional project delivery practices by expanding the use of integrated Lean construction along with evidence-based design to provide optimal value in the construction of the patient care environment.

Who inspires you?  

I’m always humbled by the wisdom and innovation at the bedside. The unique insights and knowledge of frontline staff are well documented in literature. When we empower that staff with evidence and data and authentically share with them the challenges of healthcare, we achieve more than we can imagine possible.

What’s the next major trend you anticipate for healthcare design?   

Pandemic readiness within the context of continual shortages of resources and capital. There is also a growing national awareness of the value of a Lean construction approach where all participants equally share in the risks and rewards of a project.

What did you learn over the past year? 

That it is kind of fun doing the impossible.