The Next Nurse Specialty—Architecture and Health Care Design?

Updated on August 24, 2016
Sandie Colatrella and John E. Baverso

In talking to Sandie Colatrella, RN, BSN, CLNC, you get an understanding that she knows her nursing specialty very well and is quite passionate about it. What is her specialty? Colatrella is the Vice President in charge of Health Care Operations and Research at the Pittsburgh-based firm, Avanti Architecture.

Colatrella now continues her original nursing mission of caring for patients within the confines of an architectural firm with a healthcare design specialty. She sees her role as helping the healthcare practitioners as well as patients by designing improved work spaces that incorporate comfort, safety and efficiency into the functionality of the plan.

Some statistics to consider:

Thirty-three per cent (33%) of all reported incidents to NPSA were “slips and falls” at a cost of approximately $24,962 per case. By including a shortened distance between the bed and bath into a design; limiting travel in open spaces with resting points; increasing capability for staff observation; carefully selecting flooring choices and improving ways of finding and incorporating patient lifts, slip and fall incidents can be reduced dramatically.

Two out of every one-hundred hospitals in-patients experience an adverse drug event at a cost of $4,700 per case. Research has revealed that medication errors can be decreased by 30% by increasing the size of medication rooms, reorganizing supplies, improving lighting and controlling noise and distractions therefore preventing misinterpretation of verbal orders and distractions that are at the root of medication errors.

Nurses traditionally have participated in health care design projects in a variety of consulting roles but a nurse, full time in an architecture firm is still rare.  Colatrella was the first nurse in this position in the Pittsburgh areas when she joined Avanti in 2006.
The role of health care architects has become increasingly critical considering it is estimated that $200 billion of health care construction is expected by 2015, according to the AHA.
There are 5,815 registered hospitals in the United States (per AHA) and, of those, approximately 65% are over 40 years old and antiquated or obsolescing.

By the year 2020 it is estimated that over 16% of the population over age 65 and the need for health care will increase exponentially. Health care in the future will move from the inpatient environment to over 90% being delivered in ambulatory care or specialized short stay facilities.

Anticipating these needs/changes will translate into successful health care architecture business. Colatrella and the Avanti team assist the facilities’ planning team with research to establish a foundation to lobby for facility improvements and capital expenditures by identifying how environmental design, combined with best practices, can positively impact optimal organizational structure, patient safety, performance and quality outcomes.

Design horror stories are abundant, according to the Avanti Architecture team. Most of the Avanti practice is based on problem solving, according to John E. Baverso, Avanti’s Managing Principal, who guides Colatrella with over 35 years of health care design experience.

“Most design errors occur because of lack of vision and communication,” he says. “Projects that are rushed forward without a detailed review of the functional program are the ones that are at risk of heading toward the completion of construction without the space accommodating the necessary clinical equipment or meeting regulatory requirements.”

Colatrella adds, “Our goal is for the architect to focus on the design.”

From an administrative standpoint and from a health practitioner view, a team approach to designing work space can increase practicality, decrease costs in the long run, increase patient satisfaction scores as well as decrease adverse events.

So the next time you look around your work space and ask, “Who in the world designed this?” or “Why would they have ever put that kind of door handle here?,” think of how you may be able to make an impact on future designs. Or from an administrative standpoint, consider how you might involve the staff in design decisions to increase functionality.

For more information, visit If you have questions regarding a current design project, contact Sandie Colatrella at Avanti Architecture. She can be reached at [email protected]. Additionally, if you’re a practitioner looking to explore how you can expand your horizons into the design field, contact Colatrella regarding the Nursing Institute for Health Design. She is the founding member of the organization.

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1 thought on “The Next Nurse Specialty—Architecture and Health Care Design?”

  1. Well that’s really exciting to hear. Thanks for sharing this post. Its really interesting to read. Hats off to Colatrella for her ideas regarding new architecture and health care design. Keep on like that. Have a nice time. 🙂

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