× You are not currently logged in. To receive all the benefits our site has to offer, we encourage you to log in now.

EBD JOURNAL CLUB: An empirical examination of the impacts of decentralized nursing unit design


Objective: The objective of the study was to examine the impact of decentralization on operational efficiency, staff well-being, and teamwork on three inpatient units.

Background: Decentralized unit operations and the corresponding physical design solution were hypothesized to positively affect several concerns—productive use of nursing time, staff stress, walking distances, and teamwork, among others. With a wide adoption of the concept, empirical evidence on the impact of decentralization was warranted.

Results: Documentation, nurse station use, medication room use, and supplies room use showed consistent change across the three units. Walking distance increased (statistically significant) on two of the three units. Self-reported level of collaboration decreased, although assessment of the physical facility for collaboration increased.

Conclusions: Decentralized nursing and physical design models potentially result in quality of work improvements associated with documentation, medication, and supplies. However, there are unexpected consequences associated with walking, and staff collaboration and teamwork. The solution to the unexpected consequences may lie in operational interventions and greater emphasis on culture change. (1 Continuing Education Unit)


Host: Sheila Bosch, PhD, LEED AP, EDAC

Authors: Debajyoti Pati, PhD, FIIA, IDEC, LEED AP & Thomas E. Harvey, Jr., FAIAI, MPH, FACHA, LEED AP

Article: Pati, D., Harvey, T., Redden, P., & Summers, B. (2015). An empirical examination of the impacts of decentralized nursing unit design. HERD: Health Environments Research & Design Journal, 8(2) 56-70.

Click here for more information and registration.



EDAC Course ID:
September 2, 2015
Class Frequency:
EBD Journal Club