Healthcare Worker Wellness and the Surprising Impact of Flooring

By Mark Huxta

While the COVID-19 pandemic challenged the world with two of the most difficult years in recent history, healthcare workers were on the front line of the pandemic and have experienced a completely new level of strain and demand. Still, healthcare facilities are expected to provide a safe environment for patients and a positive working experience for staff. Be it in a hospital, outpatient facility, physical therapy clinic, pharmacy, or lab, providers’ physical health and emotional wellness directly impact the quality of care they deliver.

Today’s nurses are 52 years old on average. They work 10- to 12-hour shifts, walk numerous miles in one day, and experience other physically demanding aspects of their job. It’s therefore critical for healthcare facilities to enhance the ergonomic conditions of their staff’s environment to improve productivity and retention. Improved seating, better work tools, and new technology all contribute to a more ergonomically friendly healthcare space. The not-so-obvious contributor to employee comfort and health? The floor.

The topic of ergonomics as related to flooring should be comprehensively defined to include comfort, fatigue, musculoskeletal strain, and injury and emotional stress created by noise in the interior environment. Each factor contributes to or detracts from the general well-being of patients, residents, and staff.

Injuries among healthcare workers rank among the highest by industry, according to the Bureau of Labor Statistics. Musculoskeletal disorders account for one-third of all occupational injuries reported to employers, while back, leg, and foot fatigue follow closely behind. The prevalence of injury is a main reason why designers, facility managers, and healthcare administrators are paying more attention to creating environments that support the healthcare workforce.

Healthcare design and methodical flooring specification

Most traditional flooring products provide little, if any, ergonomic relief and can contribute to pain, discomfort, and fatigue in healthcare staff. Flooring performance was once solely measured by durability, maintainability, patient mobility, and affordability. While those characteristics are still important, today our expectations for a floor are changing.

When building and designing a space, the focus of the work environment must be on people and not just about product. Facilities should consider how flooring and other materials can enhance the lives of patients, residents, and staff. This is achieved by specifying a flooring product that is more appropriately designed and engineered for healthcare applications.

Studies confirm strong tie between built environment and wellness

Studies for healthcare facilities conducted by The Center for Health Design reveal a clear relationship between the built environment and nurse wellness. These studies also reveal the effect of nurse wellness on patient experience and health outcomes. A nurse who is not fatigued, stressed, or in pain provides better bedside care. Similarly, a therapist, pharmacist, or lab technician is more attentive and productive when the workplace provides enhanced ergonomics.

Hospital staff who have experienced ergonomic flooring report better underfoot comfort and relief and also often mention the reduced noise and more favorable acoustic properties of the product. Nurses have even told us they requested reassignment to other hospital departments because of the better flooring. Furthermore, flooring products that reduce noise and provide superior acoustic properties also support the patient healing process and reveal ergonomics’ larger role in product specification.

Drawing from lessons learned through evidence-based design research, today’s designers and architects are moving away from the sterile, institutional environment to looks that are more natural, warm, and homeopathic. Taking influence from the hospitality industry, the focus is on providing a soothing, pleasurable environment for patients, visitors, and staff.

Innovative technology and optimal flooring

To understand the science behind truly ergonomic flooring, we must consider force reduction and energy restitution. Force reduction measures the amount of energy the floor will absorb when stepped on. Energy restitution measures the amount of energy that is returned from the flooring to the body when a step is made. The storing and returning of energy are the key components to consider when selecting the right flooring for a healthcare setting.

A softer floor will absorb more energy and return less of it to the foot, requiring more force to take each step. Alternatively, a harder floor will return more energy to the foot, resulting in more discomfort to the body. Finding the optimal balance between force reduction and energy restitution is essential.

Ecore’s flooring products use a patented technology called itsTRU™ to fuse a performance wear layer to a 5 mm Ecore recycled rubber backing. The itsTRU technology has been tested and shown to significantly reduce fall impact as well as provide excellent footfall reduction and energy return compared to other traditional resilient floor coverings. Additionally, itsTRU products are able to reduce structure-borne sound, providing a much quieter space.


Ergonomic materials in the healthcare setting are officially getting the attention they deserve from designers, architects, and specifiers—including how floors can contribute to nurse comfort and health. Specifying a more comfortable, ergonomic flooring material can contribute to reduced chronic pain and thereby improve productivity while reducing absenteeism and workers’ compensation claims. When healthcare staff have a better quality of life, they provide better quality of care, which in turn can make meaningful improvements in patient satisfaction rates.

Mark Huxta is healthcare director of sales for Ecore, a company that transforms reclaimed waste into performance flooring surfaces that perform well beyond industry standards.