The healthcare industry is consolidating before our very eyes. Hardly a day goes by where a quick scan of headlines doesn’t reveal another new affiliation, acquisition, or physician realignment. Here in Cleveland, it’s tough to drive, well, anywhere without passing a Cleveland Clinic location—whether hospital, clinic, or medical office building.

At the same time, reform is no longer a topic of prognostication. It’s here. And that means costs have to be contained and quality controlled, thanks to the reality of a new pay-for-performance environment.

In the end, what’s taking shape looks a whole lot like another industry we all know well: chain restaurants.

The New Yorker recently ran a report by Atul Gawande, a surgeon, writer, and public health researcher. His “Big Med” dives into the inherent similarities between what chains like The Cheesecake Factory and big medicine strive to accomplish: delivery of high-quality, efficient services at an affordable price.

The problem is only one of the two are doing so successfully. Gawande explores the nuances of how The Cheesecake Factory maintains consistency and results across its brand: 160 locations, hundreds of menu items, and thousands of employees.

The chain has it down to a veritable science. And while Gawande connects the concept to healthcare from a care delivery standpoint, I think design plays just as critical a role in the process for both industries.

When you’re in a Cheesecake Factory, you know it. The building will be impressive, the décor  ornate, and the ambiance just upscale enough. And it’s consistent, from Boston, to Chicago, to San Francisco.

We've seen healthcare dip its toes into this same concept, too.

Of course, there’s the Kaiser Permanente template hospital design, which helped shape the mega-system’s new and renovated facilities since the mid-2000s, an effort that streamlined construction on dozens of its California facilities that had to be upgraded or replaced to meet seismic standards. (See "A Template for Change.")

Ascension Health, which has about 1,200 locations, has also adopted design standards as a means to rein in costs on capital projects, requiring approved architects to be used on projects of $10 million or more, in addition to adherence to its design guidelines. (See "Utilizing Design Standards Within A Large Healthcare System.")

And going back to The Cleveland Clinic, our staff here at Healthcare Design knows that when we tour one of that system's new facilities, it’s going to feature a minimalist modern design, be bathed in white, accented by curated artwork, and have diffused light streaming in through fritted glass. (See "Un-Architecture.")

It seems that as Gawande explores, and urges, the concept of healthcare delivery taking a page out of the chain service provider book, some health systems have already recognized—if not established—at least one of those corresponding standards. It’s just on the visual end.

So as the healthcare landscape continues to shift and meld with more consolidations and physicians returning to hospitals, will this trend only escalate? And, if so, what does that mean for unique, innovative healthcare design?