This study investigates the nursing unit design for care quality and efficient operation, evaluating visibility and walking distance of nurses in the different form of layout. Sufficient visibility from nurses’ station to patient rooms and corridors can increase nurses’ care abilities to understand the needs and movements of patients. The workload and time caused by nurse’s walking can be diverted to patient care. Isovist analysis and agent-based simulation are experimented to investigate the effects of spatial layout on visibility and nurses’ accessibility to patients. In the isovist analysis, the nurses’ station facing patient rooms were more effective in nurse-to-patient visibility. In the nurse’s walking trail analysis, uneven walking distance of each nurse appeared due to the asymmetric patient room layout centering the nurses’ station and heavy room allocation plan. Understanding the potential impacts of design parameters enables designers to predict possible behaviors in each design alternative and to make effective and efficient design decisions for the occupants. This study underlines the role of the physical environment in the delivery of patient care and nurse’s well-being. It presents an evaluation framework integrating syntactic analysis and agent-based simulation to predict the effect of the spatial layouts on the hospital activities.