Nurse Led Innovation in Design

by Joyce Durham, RN, AIA

by Joyce Durham, RN, AIA

I was very honored to be invited to contribute to the Nursing Institute for Healthcare Design (NIHD) book entitled Nurses as Leaders in Healthcare Design: A Resource for Nurses and Interprofessional Partners, which was graciously sponsored by Herman Miller Healthcare.

Nurses as Leaders in Healthcare Design A Resource for Nurses and Interprofessional Partners

I chose to write about innovation in healthcare design and was joined by several colleagues in writing Chapter 3, Nurse-Led Innovation in Healthcare Design.  My interest in this area came from my frustration with so many healthcare projects beginning with the goal of completing something “new, different, and better”.  But, by the completion of a project, it was hard to define what was new, different, or better.  It seemed to me, with so much change in health care delivery models and technology, there should also be similar changes in healthcare design.

This led me to realize innovation was difficult, so I decided to figure out why and write about achieving innovation in health care design.  There is an old saying “write about what you know”, which turned out to be very true.   The learning curve was steep, but, today, I have a much better understanding of what it takes to achieve innovation in healthcare design.

In my initial study of innovation, I learned several key things that really explain the challenges in innovative healthcare design:

  • First, innovation doesn’t just happen; there is a specific three-step process as illustrated below.


  • Second, great innovations come out of a supportive environment where trial and error is encouraged which, unfortunately, is not common in health care organizations.
  • Nurses, like many professionals, have great ideas and many are implemented, but they don’t become innovations until they are replicated and shared. Unfortunately, this is an area of weakness for nurses.

The first half of Chapter 3 focuses on the innovation process and how to implement it.  The second half, which I personally find more meaningful, consists of three case studies of nurse-led innovations that resulted in disruptive and sustainable innovations in healthcare design.  The case studies include:

  • Single room maternity care (SRMC or LDRP)
  • Acuity-adaptable or universal medical/surgical rooms
  • Single family rooms for neonatal ICU care

Although I strongly recommend reading these case studies, I will share with you what I think are the common characteristics between the three case studies and the secrets to how they “got it done”:

  • They all started with an “aha” moment, someone simply asking “Why are we doing this?”
  • The nurse innovators assembled a team of like-minded professionals and there was strength in numbers.
  • The journey wasn’t quick or easy. Even though they all faced resistance, there was trial and error, and there were some failures, they persevered.

In addition to Chapter 3 on innovation, the book has an enormous amount of research, case studies, and best practices compiled from nursing experts with immense knowledge, experience, and passion for improving healthcare design.  I encourage any healthcare professional involved in a facility project to read the book before starting a project and to share the book with colleagues.

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