Best Practices in Nursing School Design: Culture of Well-Being

May 30, 2019
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Ayers Saint Gross designs top-tier spaces to support educating nurses equipped to handle the future as healthcare delivery systems continue to transform. This two-part series dives into the influences that are changing the way nursing students learn and the way nursing faculty teach. Read Part 1.

Culture of Well-Being

Perhaps more than any other building type, schools of nursing and allied health have the special ability to promote health literacy and reflect the core values of their programs and the profession through building design and architecture. As healthcare delivery systems focus more on preventative approaches to health, lifestyle, and behavior, the design of the built environment should exemplify core values and be mindful of its impact on human health and wellness. Projects that want to advance healthy building strategies can seek WELL Certification to improve the health and well-being of its occupants.

Healthy building strategies that engage the mind and body include: incorporating biophilia through exposure to nature, activating interior circulation with prominent staircases, utilizing ergonomic and kinesthetic furniture to encourage occupant comfort, and addressing environmental needs for air, water, nourishment, and light. For example, designing flexible classrooms or exterior plazas to host fitness, wellness, or interprofessional events could be showcased as part of the building and professional outreach. Access to green spaces and natural light create healthier work and learning spaces for students, faculty, and staff. These design features become popular congregation spots, supporting a lively and collaborative culture.

Opening soon, the Duke University Physical Therapy / School of Nursing Education Building (designed by Ayers Saint Gross) will include a flexible seminar and wellness space for a variety of student activities. The room will function as a large seminar room for instruction, two small conference rooms for group meetings, or as a wellness hub for fitness and community outreach events. In the same vicinity, reservable low-speed treadmill workstations overlooking a landscaped garden will offer active furnishings to reduce the time faculty and students spend seated. Ergonomic furniture selection for both office and study areas is another important way that universities are promoting wellness.

Treadmill Workstations, Duke University Physical Therapy / School of Nursing Education Building
Low-speed treadmill workstations support wellness at Duke University

This type of flexibility in spaces has already proved successful at the University of West Georgia School of Nursing. A flexible seminar room off the building’s commons was designed as both a classroom and a yoga studio, utilizing an oversized barn-style door to allow overflow into the public spaces during a large wellness event.

Flexible Seminar Room, University of West Georgia School of Nursing
Flexible, multipurpose space at the University of West Georgia

Just as important, landscaped outdoor study areas provide meditative environments to support the well-being of students who will soon be supporting the well-being of so many others. 

University of West Georgia School of Nursing
Meditative outdoor space at the University of West Georgia

The culture of wellness in nursing and allied health extends beyond the school walls. Increasingly, schools want to be engaged in community health and gear curricula towards the regions they serve. This approach better prepares the workforce for local healthcare cases they will face in their careers. Whether it’s reaching patients in remote areas, screening clinics for a disease that’s especially prevalent in the community, or providing care at the student health clinic, it is a best practice of clinical education to consider these spaces.

University of Pikeville Health Professions Education Building
Skills learned at the University of Pikeville HPEB
help fulfill the health needs of the community

Community integration was embedded in the programming and mission of the recently launched Kentucky College of Optometry at the University of Pikeville Health Professions Education Building (HPEB). The school is in eastern Kentucky, a region with one of the highest rates of preventable blindness in the country. The HPEB includes a flexible classroom, assembly space, student lounge, study and meeting spaces, faculty offices, clinical skills labs, and an extensive primary care clinic with specialty operatory equipment. The project fulfills the university’s mission of service and defines the standard for excellence in optometric education and vision care in an area with an acute need.

Looking to the future, exciting developments in nursing education will broaden the impacts of community engagement and wellness. Interprofessional and cross-disciplinary education that engages other allied health disciplines and university majors like engineering can create dynamic teams to solve complex issues. Assistive technology and robotic solutions are continuing to advance healthcare. The built environment must support these developments with makerspaces and cross-disciplinary education labs to enable collaborations with engineering programs.

Understanding the latest technology and methodologies is crucial for students. Practical applications are seen in dementia care, where technology is facilitating seniors to live independently longer. To allow for easy monitoring, in-home devices record and send data about daily patterns to caregivers. Assistive devices are being developed to facilitate timely reminders for medication, locate items, or can trigger a comforting audio recording of a family member. Telepresence robots and companion robots can help improve mood or quality of life for people with dementia, to serve patients in a health crisis, and are finding their way into simulation-based education as a tool to practice communication and better prepare students for a career in nursing. Among the spaces that will be
located in the Duke University Physical Therapy / School of Nursing Education Building is the new Health Innovation Lab, which will provide for this interdisciplinary innovation and education.

As nursing schools plan for future curricula and building projects, Ayers Saint Gross will continue to lead the ways architecture can and should support the efforts of students, faculty, and staff to prepare the next generation of nurses for their careers. Educating highly qualified nurses and healthcare professionals fulfills a critical need, and well-designed spaces help meet this challenge. We look forward to seeing what the future holds, and working to create it.

Laura Hall, AIA, LEED AP BD+C, WELL AP is an associate principal based out of the Baltimore office. Contact Laura.

Best Practices in Nursing School Design: Flexible and Adaptable Learning Environments

May 2, 2019
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Ayers Saint Gross designs top-tier spaces to support educating nurses equipped to handle the future as healthcare delivery systems continue to transform. This two-part series dives into the influences that are changing the way nursing students learn and the way nursing faculty teach. Read Part 2.

Flexible and Adaptable Learning Environments
Our allied health projects have flexibility embedded in the planning and organization of the spaces. Spaces that adapt to evolving methodology is essential as pedagogy, technology, healthcare demand, and specialized care needs shift. A well-designed building can be the framework that allows a program to endure changes and remain at the forefront of educating the modern workforce.

Creative and thoughtful design ensures clinical learning environments are both flexible (easily modified) and adaptable (able to serve a new use), while leveraging synergies and shared resources to maximize efficiencies. Considerate yet simple diagrams communicate the specific departmental aspects while illustrating where overlap exists and are the parti that translate into practical space layouts.

Concept Design – Frostburg State University Education & Health Sciences Center Department of Nursing
Concept Design – Frostburg State University Education & Health Sciences Center
Department of Nursing

Working with Frostburg State University, Ayers Saint Gross devised a concept to meet long-term goals for the Department of Nursing while adhering to the programmed space allocation. The inaugural Nursing program growth had surpassed the initial concepts outlined in the Part II program and future degree offerings necessitated a greater variety of space types. Understanding their drivers, we conceived two versions of an open skills lab that could also function as four dedicated simulation labs. Key adjacency to a flexible classroom essentially acts as a flex space to serve three functions: (1) a fully functional classroom, (2) a clinical learning class lab facilitating skills instruction and demonstration on the classroom side and hands-on implementation on the adjacent bays, and (3) a generous footprint for future simulation lab growth and program expansion. Providing a heightened level of flexibility with operable walls, mobile equipment, etc., allows instructors freedom to be creative in imagining scenarios.

As the healthcare delivery models evolve, Interprofessional Education (IPE) is becoming indispensable to modern health professions for the value it brings to education – providing hands-on collaborative clinical learning where students apply critical thinking to learn about and communicate with other disciplines in a safe environment. Initial space planning design should consider how the learning environments perform and transform to allow for a multitude of IPE scenarios and an influx of students and faculty from other health professions programs.

During design for the Auburn University School of Nursing, there was a distinct adjacency established between the large active learning classrooms, the building commons, and the outdoor greenspace for opportunities to host a variety of events. One success of this concept was realized during their inaugural Disaster Day Drill IPE event where Nursing and Osteopathic medicine students worked together to triage and treat patients in a large-format simulation. This scale and realism would not have been possible without Auburn and Ayers Saint Gross’s close collaboration and holistic approach to designing a building equipped to do more than standard skills training and instruction. The green space was transformed into triage spaces filled with simulated victims to be evaluated by the practicing students and the buildings’ EAGLES Center was transformed into the simulated hospital ER. “During the disaster drill, this spacious simulation area allowed for a total of 48 patients with 32 utilizing beds and 12 seated in chairs. The simulation area was divided into four “pods,” which acted as four separate hospital emergency departments.” Notably, the realism of this event prepared the osteopathic medical students to be tested for their Basic Disaster Life Support certification. The finale to the drill concluded in the dividable, flexible active learning classroom for a comprehensive group debrief.

As a formal learning environment, this space integrates technology and team-based learning, while also being flexible enough to test new pedagogies. A vertically folding operable partition expands the teaching environment to support a range of clinical learning scenarios. Down the hall, two collaborative tiered lecture classrooms allow for multiple learning arrangements, live demonstrations, and remote broadcasting.

Faculty and students acclaim that the new nursing building brings them together and note the impact of active learning environments being a “critical part of nursing education… specifically tailored to provide the necessary resources.” The space for informal learning, outside the classroom, was equally important to consider as classes scheduled in long segments necessitate spaces to inhabit during breaks. To maximize these options, the traditional prebrief and debrief rooms embedded in the simulation suite serve during off-hours as private or group study rooms. Occupants find that these spaces (with great daylight and views to campus) encourage faculty and students to engage for day-to-day interaction, capstone projects, and student organization meetings that supplement nursing training, such as global health initiative trips.

Adaptable Briefing Room Concept
Adaptable Briefing Room Concept

Ayers Saint Gross has designed three phases for Duke University’s School of Nursing. The Physical Therapy /School of Nursing Education Building bridges to the School of Nursing, continuing the expansion and consolidation of the school’s programs under one roof. The design team and user group worked extensively to conceive adaptable and flexible learning environments to meet their needs, focusing on strategies to mitigate resources taxed by the influx of distance learners during On-Campus Intensives. The design for a typical active learning classroom was adapted into three collaborative seminar spaces to supplement clinical learning, host workshops, and enable development in a state-of-the art learning environment.

Active Learning Classroom in Typical Configuration vs. On Campus Intensive Seminar Room Configuration
Active Learning Classroom in Typical Configuration vs. On Campus Intensive Seminar Room Configuration

The concept Ayers Saint Gross developed for Duke’s Standardized Patient Suite follows suit with maximizing adaptability and space utility. An “ante room” functions for charting, observation, post-exam evaluation, reflection, and as the separate entrance for the student or patient actor. The exam room side is fit out for a patient actor connected to a dedicated lounge and entry zone. Exam rooms are integrated with A/V capabilities and can also function for high-fidelity simulation utilizing a manikin.

Flexibility and adaptability are crucial, but these concepts are just the beginning. Join us for our next entry as we illustrate the importance and value of integrating wellness and community outreach into the design of nursing and health professions programs.

Laura Hall, AIA, LEED AP BD+C, WELL AP is an associate principal based out of the Baltimore office. Contact Laura.