The 17 participants in my group introduced themselves by name, title, and company and shared a bit of what they hoped to get out of the conference that week. They were from all over the country, big hospitals and small—and there wasn’t an architect or designer in the bunch.

Nurture by Steelcase had arranged this hour-long get-together in its booth on the Healthcare Design Conference exhibit floor—with two groups of owners, meeting at the same time with different leaders from Nurture—and it turned out to be a pretty candid and productive discussion. The starting point was a list of 16 hot-button issues likely to be of concern for healthcare administrators, everything from “deliver positive experiences” to “promote sustainability issues.” Each participant was given three votes to cast for the issues that ranked highest from his or her perspective.

My group’s top vote-getters: “promote an integrated approach to care delivery,” “optimize space utilization and enable adaptability,” and “measure improvements in patient outcomes.” 

During the discussion that followed the revelation of these top issues, participants volunteered stories of their own efforts to meet these needs, with varying degrees of success. One hospital system had engaged its executives and service area leaders in multiple discussions about open-pod versus closed-pod caregiver spaces before deciding on the open-pod solution. But they hadn’t asked a key stakeholder: the doctors. “They hated it,” it turned out, because patients interrupted them too often and they wanted more privacy.

“Culture” and the role of the patient came up again and again. “You have to match your culture to your design,” offered one participant. “We got our medical staff to sign on to our processes ahead of time—and to the idea that the patient leads the process.” That was comforting; designers and architects we’ve spoken with are regularly preaching this message, so it was nice to hear it directly from the other side of the table.

But caregiver involvement in the design process—even from the beginning—doesn’t always translate into a perfect world for all users when everything is finished. “They don’t necessarily know what’s coming in technology,” said one administrator; added another: “The staff that goes through the mock-ups aren’t always the same people using the finished facility.”

Which brings us back to culture. A Pebble Project hospital administrator stated his solution plainly: Sometimes you might have to part ways with staffers who just don’t fit with the new approach. Making sure that everyone you employ is genuinely on board with the organization’s goals and care model, he said, also “makes the staff feel like they own the new building.”

As one gentleman summed up: (1) The organization’s goals must be defined, within the context of “what do we want this new building to do?” and then (2) the operations side must be addressed, i.e., “How are we going to work it?” Successfully navigating the competition between these two factors is at the heart of filling all three of the hot-button needs identified by this group—and the other 13 on the list, as well.