This well-known Chinese proverbactually it's a Chinese curse, but as an optimist I prefer to think of it as a proverboften pops into my mind as I contemplate all that is going on in the world and in our own industry of healthcare design. We truly are living in interesting times.

As a nation, our psyche changed after the terrorist attacks of September 11, 2001, and as an industry, we changed how we looked at safety issues in our communities' healthcare facilities, as well. As a population, the number of citizens reaching the age of 65 is exploding, as the baby-boom generation reaches what has traditionally been retirement age and, as an industry, we are being confronted with one of the largest healthcare building growths in 30 years. As a world, we have accelerated the development of new forms of therapy, new diagnostic equipment, and new ways to fight disease and, as an industry, we have designed new facility models for healthcare delivery to accommodate these advances.

Because our industry is challenged with such interesting times, we and our partners at Medquest Communications have made the decision to publish HEALTHCARE DESIGN quarterly rather than just as an annual review issue. Not only will we still feature the juried projects in our fall review issue, but three other times a year we will bring you the latest trends in facility design; the most recent results in the field of evidence-based design research; and in-depth, cutting-edge projects from around the world. Moreover, HEALTHCARE DESIGN will continue to focus not purely on the aesthetics of design, but on how the design of the physical environment impacts the quality of care, the economic health, and the organizational success of the facility itself.

With so many challenges facing our healthcare delivery system todayan increase in the cost of care and a decrease in reimbursements, a nursing shortage that has hit a critical level, the many facilities that need either replacement or major renovation, and healthcare consumers' increasing expectationswhat role can design play in helping to solve any of these, or at least in beginning to release some of the built-up pressures these forces have created?

Available research from healthcare providers who have made conscious design decisions and then documented the results has proven that, through design, winning healthcare organizations can provide a total optimal experience for patients, staff, and families; can sustain substantial strategic and business advantages over their competitors; can improve the quality of care; can enhance operational efficiency and productivity; can attract more patients; can more easily recruit and retain staff; and can increase philanthropic, corporate, and community support.

So where do we go from here? Innate to interesting times is the apparent lack of clear roadmaps. The tradition of looking to the past to understand the future does not seem to apply anymoretoo much feels too different. Albert Einstein once said, “The important thing is to never stop questioning.” It is in that spirit that we have designed this new issue of HEALTHCARE DESIGN, not only to provide you with valuable resources and information, but also to stimulate discussion, generate questions, and provide a variety of possible pathways.

We hope that you have enjoyed the 2001 and 2002 showcase issues of HEALTHCARE DESIGN and that you will continue to gain knowledge and insight from additional pages, in regular magazine format, in 2003. We encourage you to let us know how we can continue to fill these pages with information that will be useful to you and inspire new ideas.

We will try to be as interesting as the times. HD

The Center for Health Design is located in Pleasant Hill, California.