The U.S. lost thousands of healthcare workers during the COVID-19 pandemic and it’s not clear how the industry will retain new workers going forward. Many providers retired early while others left the field in search of less emotionally taxing work. The good news is that enrollment in nursing schools is up all over the country, but nurses aren’t known for staying in one place for too long. The industry has one of the highest turnover rates in the medical profession, with 16.5% of all nurses employed in hospitals quitting their jobs within the first year, costing hospitals $4 to $6 million annually.
“The nation’s healthcare delivery systems are overwhelmed, and nurses are tired and frustrated as this persistent pandemic rages on with no end in sight. Nurses alone cannot solve this long-standing issue. If we truly value the immeasurable contributions of the nursing workforce, then it is imperative that HHS utilize all available authorities to address this issue,” says American Nurses Association President Ernest Grant.
As the nursing shortage gets worse, industry leaders are looking for ways to make the job more hospitable for workers. Increasing nurse pay and staffing ratios would help reduce the stress of the job, but what about changing the design of the hospital as well?
Hospital designers Teri Oelrich and Bryan Langlands recently sat down to talk about how workplaces can be improved and how they are affecting nurses.
Planning for Efficiency
The architects say the layout of the facility can have a major effect on workplace efficiency. Special attention should be paid to the location and types of rooms that exist in the facility and how often nurses need to access them. They argue that designers should get input from nurses regarding how they typically navigate the space and spend their time at work.
Studies show nurses spend only 31% of their time with patients. The rest of their time is dedicated to activities such as waiting for lab data responses, patient transfer, searching for required equipment, and documentation. Aside from patient rooms, nurses tend to spend most of their time at medication, clean, and soiled rooms.
They advocate for what’s known as the “open core” model, which means having patient rooms on both sides of a central work zone corridor, while eliminating physical impediments within the areas of direct care. For example, anything not related to direct patient care (such as elevators, mechanical shafts, stairs, electrical closets, offices, and toilets) should be removed from the area between patient rooms, giving providers unobstructed access to the space.
They also advocate for doubling the width of the standard eight-foot-wide corridor seen in many hospitals to sixteen feet. This leaves room for decentralized team workstations with supply and equipment alcoves stocked with the most in-demand items. In addition, this layout creates neighborhoods for caregivers that locate nursing staff near patient rooms and supplies, with greater access and visibility to both.
The surfaces in the hospital say a lot about your workspace. The architects recommend moving away from traditional solid wood doors that can leave patients and staff isolated from each other. According to the designers, “full-height glass doors, whether swing or sliding, allow for greater situational awareness, the ability to nurse from outside the room, maintain sight lines to patients, improve visual communication, increase natural light to the support areas, and reduce social isolation.”
Time for Automation
You might not like the idea of working alongside a robot while you’re doing your rounds, but Oelrich and Langlands say the time for automation is near. Self-driving robots and automated vehicles can increase efficiency in the workplace. They can be programmed to perform simple, yet time-consuming tasks, such as transporting supplies directly to the patient or operating room. They can also travel in potentially dangerous work environments, such as those with contagious pathogens.
Nurses are also using built-in staff wall terminals that tell them exactly what a room needs when they touch the screen. They can then quickly order more supplies with just a touch of a button. Patients can also use tablets and mounted controls to request help, change the lighting, or open the shades on the windows.
Bring Amenities to the Nurses
Finally, the architects say it’s best to bring the things that nurses need and crave directly to the nursing station, so providers can enjoy these amenities without the stress of leaving their post. This may include dining and seating options for enjoying a break, computer and Wi-Fi access, showers, and even luxurious items like yoga or massage to help nurses relax after a long shift.
Administrators can use small and leftover spaces to bring these amenities closer to workers, such as bathrooms, corridors, and even stairwells, so they don’t have to go out of their way or waste precious time during their break.
Hospitals are adding amenities to improve staff satisfaction and retention, including day care, pet care, dry cleaning, salon services, and made-to-order food that nurses can take home after a shift.
Oelrich is a former nurse and one of the first-ever clinicians to work for an architecture firm. She has helped design some of the world’s top health institutions including Kaiser Permanente, University of Washington Medical Center, and the Children’s Hospital of Chicago.
Langlands is a healthcare programmer, planner, and designer of academic medical centers. He has worked on multiple healthcare facilities, including NYU Langone Medical Center, Atrium Health, Jefferson Health, Penn Med, and the Children’s Hospital of Philadelphia.