Satisfaction by Design: Nurses Creating Hospital Spaces That Work

Abstract

To evaluate the impact of frontline nurse involvement in hospital design through a structured program evaluation using the Context, Input, Process, and Product (CIPP) Model. Nurses are primary users of hospital environments yet are often underrepresented in planning and design despite their expertise in workflow, safety, and patient‑family needs. This mixed-methods program evaluation examined a nurse advisor model implemented during the planning of a 552-bed pediatric hospital. Data were collected from 21 participants (14 design team members and 7 nurse advisors) using Likert-scale surveys and semi-structured focus groups aligned with CIPP domains. Advisor satisfaction with nurse involvement was significantly higher than observed in prior design projects ( Z = −1.983, P = 0.047, r = −0.75), whereas design team satisfaction remained stable. Preparation and training received the lowest satisfaction ratings ( M = 2.76, SD = 1.14), while nurse-influenced design elements ( M = 4.10, SD = 1.07) and final design outcomes ( M = 3.90, SD = 1.17) received the highest ratings. Higher design team satisfaction with nurse preparation was associated with both more effective collaboration (ρ = 0.621, P = 0.018) and satisfaction with nurse-influenced design elements (ρ = 0.566, P = 0.044). Qualitative findings highlighted nurses’ roles as translators of frontline experience into design decisions and described perceived impacts on emergency department patient flow, staff respite and lactation spaces, decedent-care environments, and other human-centered features. Structured nurse participation in hospital planning was perceived as strengthening collaboration, credibility, and influence over design decisions. This nurse advisor model offers a transferable approach to more clinically informed, human-centered design processes.