In 2005, Debbie Gregory, a registered nurse, returned to school to study space planning and interior design. The chasm of misunderstanding between space planning and design became apparent while she studied programming and schematic design, and within the accompanying healthcare research and design projects.

She questioned, "Is anyone asking for the nurses opinions on the design and function of their work environments?”, so she began investigating.

Little data was available from the nursing community. The only available research was in the emerging field of evidence-based design. Impressed with this concept, Debbie felt that nurses could be contributing significantly to research and design decisions.

Along with her Vanderbilt Nursing School colleague, Laura Hayes, they began researching healthcare design to determine how nurses would contribute as part of the design team.

At a Healthcare Design Conference in 2005, they asked the speaker to announce an impromptu meeting for nurses in the audience. Creating a survey on the spot for the 10 nurses who showed-up: this became the database from which ‘Nurses in Healthcare Design’ was born.

The conference began the challenge of discovery to determine where the nurse fits in to the design process and design team. During her internship, one role became obvious to Debbie: a nurse is the natural interpreter between the the two professions, to bridge the communication gaps by literally translating professional terms (to a nurse; ADA Guidelines would suggest the American Diabetic Association’s recommended diet.)

Debbie realized that she could help designers pose the right questions --

such as a facility’s local demographic, its specific nursing population, identifying its’ nursing care model and its goals for growth -- all critical to achieving successful facilities.

Debbie and Laura officially launched the Nursing Institute for Healthcare Design (NIHD) in 2010, as a 501(c)(6); a not-for-profit association dedicated to educating and inspiring nurse leaders about their role in healthcare design and construction. The organization provides tools and research, peer education, mentoring and a connection to other members and partners.

Nurses from around the world contacted NIHD, eager to be a part of designing clinical spaces. On the design side, architects, contractors, facility managers, hospital administrators and clinicians have become involved.

The collective goal is to impact this new collaborative relationship in facilitating trust, respect and shared goals, for improved clinical work environments and ultimate patient outcomes.

Many in the design community are placing clinicians on their staff to educate and facilitate the exchange of information between staff and clients. This has given nurses a voice of advocacy and a role that serves as a reminder to consider the end user perspective when designing a space. Healthcare systems are placing nurses within the facility planning department to be an "owner’s rep” and ensure the design intent meets the corporate mission. This is the beginning of the future in design collaboration where the patient and end-user are the focus.