Igor Kleytman ’08, CPEN, uses his nursing experiences to consult with medical facility designers
By Maddie Scharrer
Imagine you have a worsening condition that sends you to your local emergency department. When you walk in, you grab a chair sandwiched between two other sick patients, the room so small that it’s either that or stand. You’re eventually called back to be examined and are stationed at a bed separated with only a curtain from the one next to you. While you wait, you try shutting your eyes, but your neighbor is coughing, machines are beeping, and you can hear nearly every detail of a conversation that is probably meant to be solely between doctor and patient in the next bed over. The design of the hospital is negatively impacting your experience to receive quality care.
Now picture you’re a nurse on duty navigating this unit. You’re doing your best to discuss medical history discreetly with your patient, but you can sense their unease at the lack of a sound barrier. Doubtfully, you hope that same thin curtain can contain each patient’s sickness in the compact environment. You do your best to maneuver swiftly around the curtain-enclosed rooms, but the cabinets and machinery crammed within make it a maze to navigate. As you head back to the centralized nursing station, you can feel how far you’re getting from some of your patients, and you’re assessing how quickly you could get back to the bedside if one of them had an emergency. The design of the hospital is directly impacting your ability to provide quality care.
The inner workings of health care spaces are crucial for both the comfortable recovery of the patient and for accommodating the compassionate work necessary of health care staff. In other words, health care facilities should be designed with both patients and providers in mind. Health care facility design is an essential key to the healing process, and scenarios like these can happen when building designers are unaware of the needs of a facility; when they are not in touch with people who have a foot in the health care world. Luckily, the process of including health care clinicians in the planning and design of facilities is becoming more common.
“I fell in love with this idea of being able to help design spaces to make them better for both patients, families, and most importantly the clinicians.” — Igor Kleytman
For hospitals like Rady Children’s Hospital – San Diego (Rady Children’s), the importance of clinician consulting became especially important during the design phase for a new critical care tower. As a result, during the planning states of this new portion of the hospital, Igor Kleytman ’08, CPEN, was introduced to a different side of health care: clinician consulting. In clinician consulting, health care workers are actively involved in facility design, giving health care professionals a voice during the crucial design phase to help builders understand the functionality needs of various workspaces. These experts bring valuable insights into the practical requirements of clinical workflows, patient care, and operational efficiency. By incorporating the perspectives of experienced nurses, facility designs can be optimized to support advanced medical practices, enhance patient outcomes, and streamline health care delivery – ultimately fostering an environment where both providers and patients thrive.
As Rady Children’s prepared for its new facility, Kleytman was asked to join a clinical team to provide ideas for the new tower’s design plans. He used his knowledge of patient-staff workflows and emergency room (ER) unit operations to provide designers with a nurse’s perspective. Kleytman relied on his years of experience working in various bedside leadership roles, such as being a preceptor and a sedation committee representative for the ER, to help him provide key insight and feedback during the planning of the new building.
After his first exposure to health care consulting at Rady Children’s, Kleytman was hooked. He felt his input could continue to create a positive impact on the way hospital units are designed. The newfound passion inspired Kleytman to explore opportunities in the consulting industry.
“I fell in love with this idea of being able to help design spaces to make them better for both patients, families, and most importantly the clinicians,” Kleytman said.
“Architects and designers aren’t clinicians; they don’t know phrases, words, or procedures, and what that means in terms of space, staff, condition of the patient, and how that will work operation-wise in a new building.” — Igor Kleytman
During his search, Kleytman discovered nurse representation in the consulting field was slim, but he stayed determined to find a way to get involved. “I started networking with as many people as I could in the industry to try to get in. It’s a very small, niche world of nurses in this field,” Kleytman said. But Kleytman recognized that nurses have a unique understanding of how facility design can impact both patients and medical workers, and therefore should be represented more in this industry, and he persisted.
Kleytman’s determination paid off. He was hired as a health care clinician consultant for NBBJ Design, an “ideas-driven” design firm. There, Kleytman was one of five nurses in a consulting position. He helped “lead and collaborate with designers and architects” to provide a connection between design teams and hospital personnel.
Kleytman’s valuable nursing experiences served as a basis for his understanding of how to improve the design functionality of medical spaces. Often, he helped NBBJ designers understand procedures that occur in specific hospital units and what kinds of spaces they require.
“Architects and designers aren’t clinicians; they don’t know phrases, words, or procedures, and what that means in terms of space, staff, condition of the patient, and how that will work operation-wise in a new building,” Kleytman said.
While all aspects of his nursing experience helped him consult for NBBJ, working in multiple types of facilities throughout his career provided Kleytman insight on the differences amongst hospital spaces. These experiences taught him that “there is no one way to do something in health care,” and “each institution adapts to their standards of operation.” With this knowledge, Kleytman can explain to designers that there is no one-size-fits-all for health care design.
“I think UW nursing always pushed critical thinking and to think outside of the box.” — Igor Kleytman
Providing the best medical design consulting advice also meant Kleytman needed to stay current with his nursing practice and understanding of hospital spaces. To do so, he remained active in nursing practice even after obtaining the consulting position at NBBJ, switching from his full-time ER nurse schedule to the triage call center on a per diem basis at Rady Children’s.
Kleytman noted that going from being an experienced bedside nurse to a beginner corporate consultant was challenging. However, his UW–Madison School of Nursing education prepared him to adapt to the new position. In health care consulting, Kleytman needed to think alternatively and critically, skills that the School of Nursing helped cultivate.
“I think UW nursing always pushed critical thinking and to think outside of the box,” Kleytman said, adding that his consulting job focused on exactly that: helping designers find alternate solutions to improve medical facilities.
Today, Kleytman continues to work at Rady Children’s in the radiology/IR unit while also working with firms as a clinical advisor for operational readiness, transition, and activation of new hospitals and healthcare sites. His education from the School of Nursing, along with wisdom from his nursing and consulting experiences, make him an asset to the clinician consulting world where he can help ensure both patients and health care workers get the optimized spaces they need in health care settings. Kleytman understands that “not everything can be cookie cutter” in health care facility design, and continues using this knowledge to innovate medical spaces in ways that cater to both patients’ and health care workers’ needs.