Clinicians were involved in the patient care spaces, clinical workflows and patient journey through the care process at Atrium Health Union West located in Stallings, N.C.

Images courtesy of Perkins&Will

Incorporated in 2010, the Nursing Institute for Healthcare Design (NIHD) has come a long way in laying the foundation for the next generation of clinicians entering the world of health care design.

The idea for NIHD came from Debbie Gregory, R.N., DNP, a registered nurse who returned to school to study space planning and interior design, finding few resources available for the nurse community interested in contributing to health care design through research and assisting in design decisions. Along with her Vanderbilt Nursing School colleague, Laura Buchanan, R.N., BSN, MBA, she began researching health care design to determine how nurses would contribute as part of the design team.

At the Healthcare Design Conference + Expo in 2005, an impromptu meeting for the nurses in the audience eventually grew into NIHD, a nonprofit organization dedicated to engaging and integrating clinical expertise and planning into the design of health care environments. NIHD now has approximately 150 members and an eight-member board of directors.

An NIHD member for seven years, President-elect Anthony Mistretta, R.N., MS, principal of health for the Los Angeles office of Perkins&Will, says the organization has provided learning, resources and networking opportunities that paved the way for his successful design career.

“NIHD was founded on the basis that the nurse’s voice is essential in the success of hospital and health care design,” Mistretta says. “Our mission is to engage and integrate clinical expertise into the planning and design of built health care environments. This requires us to think about the next generation of nurses who want their voices heard and to grow our presence in the industry.”

While nurses are making progress in the design world, there are clear objectives for the future, says Angela Boyle, MS, EDAC, NIHD executive director.

“There is still not an established career path for nurses entering the field of health care design,” Boyle says. “There isn’t currently a dual degree; however, a few academic institutions have launched certificate programs that inform nurses on innovation and health care design concepts. Many nurses find themselves in the health care environment that inspires them to go to school for architecture and design, so they enter the health care design industry in several ways. But our members are advocates for giving nurses and other clinicians a much-deserved voice at the design table.”

In the beginning, NIHD functioned mainly as a networking organization to connect health care designers with colleagues who have similar career goals. Since then, the organization has branched out in many ways, including holding virtual meetings and webinars and offering resources including toolkits, research, peer education and mentoring. A community blog offers a place for industry news, member updates and more.

“One of biggest benefits we offer to members is giving them the opportunity to meet like-minded individuals, to ask questions, interact and talk to one another,” Boyle says.

Mistretta, who earned a Bachelor of Science degree in nursing from West Chester University of Pennsylvania, says NIHD has helped him form important industry connections. “I have been exposed to a wealth of colleagues who are in unique niche positions such as myself,” he says. “It can feel like you’re on an island doing design work as a clinician, but NIHD has connected me with a network of similarly skilled clinicians.”

Leaders in the health care design field, Gregory now serves as a senior clinical consultant for Smith Seckman Reid Inc., Nashville, Tenn., and as co-editor of Health Environments Research & Design Journal; and Buchanan is a clinical health care consultant and business analyst for InfoWorks Inc., Nashville.

In an expanding leadership role, NIHD is an association partner with the Healthcare Design Conference + Expo as well as a supporting organization with the International Summit & Exhibition on Health Facility Planning, Design & Construction (PDC Summit).

While the majority of NIHD’s members are registered nurses, they welcome everyone to join to help elevate the clinical voice in health care design. For more information on NIHD, facilities professionals should go to