In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Kristina Krail, RN, is a healthcare consultant and transition services project manager at NBBJ’s New York office. Here, she shares her thoughts on technology integration, planning for project activation, and the importance of including nurse leaders on healthcare project teams.

  1. Bring on the nurses
    When nurse leaders augment their clinical expertise with design knowledge, they can help architects and medical planners in validating design assumptions about healthcare delivery. Furthermore, their experience in marketing, writing, presenting, critical thinking, performance improvement, and personnel management can enhance project performance and client deliverables. Nurses are fundamentally caring individuals, possess palpable integrity, demonstrate respect for all, and have a quest for excellence through a commitment to personal growth and life-long learning. What more could a design team ask for!
  1. Satisfy the staff and you’ll satisfy the patients
    Design that focuses on the needs of care providers will benefit patients more than design that focuses only on consumer amenities. This point was shared with me recently by a CEO of an acute rehabilitation hospital, who relayed feedback she got from patient user groups during the design of the organization’s replacement hospital: “Give the staff what they need, so that they can give us what we need.” She elaborated: “Those in need of rehab know firsthand it is the work of the therapists, researchers, doctors, and nurses that get them to a state of ability and independence.” A major component of patient satisfaction springs from satisfaction with the care experience and the care providers who create that experience. Therefore, take care of the staff’s design requirements, too, and they will take care of the patients’ needs.
  2. Address the full spectrum of safety
    Healthcare organizations aspire to an error-free culture of safety as part of a relentless pursuit of continuous quality improvement. Great progress has been made over the last few decades, but healthcare organizations still face challenges, including nosocomial infections, medication administration mistakes, work-related staff injuries, patient falls, and incorrect diagnoses. Multiple solutions have been developed—creating standard processes, mitigating distractions, establishing performance expectations, and requiring additional training and education—but one often overlooked answer is design. For example, the layout of a patient room can help decrease errors, increase hand-washing, and reduce fall rates; adjacencies can minimize travel time and supply utilization; and decentralized work stations can increase patient engagement. As designers and nurse leaders, we should be more effective in communicating these benefits.
  3. Technology integration can’t be an afterthought
    Advanced technology has become a standard in new healthcare designs; indeed, it’s often required to optimize the environment. Although this opportunity shouldn’t be passed up, it creates an extraordinary demand on the enterprise during the transition to the new setting. The information systems department is particularly pressured to have the prerequisite IT integration plan in place and functioning in time for a building’s opening. There’s also a huge knowledge transfer requirement that affects all user departments, not to mention the department(s) responsible for educating them. Technology is a project requirement and its success or failure has a direct effect on the most important components of the client’s business: patient care and finances. It’s an area that must be well thought out from the beginning.
  4. Don’t leave activation plans to chance
    It’s a thrilling time when a project is in the construction administration phase and materializing before everyone’s eyes. However, it’s also the most critical and complex time, requiring an extraordinary amount of effort and expertise to transition and activate the building safely and on time. Not only must new spaces and systems be fully operational, but staff must be comfortable with the space and a new way of doing business. This logistical coordination cannot be underestimated or left to chance. Thankfully, many healthcare organizations seek expert assistance and advice during this time, and designers would do well to encourage them to continue to do so. Ultimately, it’s the design and the designer that will be assigned the blame if the activation doesn’t go well. Conversely, they’ll be the ones to receive accolades if the activation goes smoothly and safely—with their design performing as perfectly as it was intended.


Want to share your Top 5? Contact executive editor Anne DiNardo at for submission instructions.