“Reflections” is a new column featuring thoughts and commentary by former HEALTHCARE DESIGN Editor-in-Chief Richard L. Peck.

Since when did Tom Cruise (aka “Jerry McGuire”) start running a hospital? Within the past few months, actually.

At least, that's the image that came to mind as I listened to hospital financial advisor Kenneth Kaufman's outstanding presentation at the recent Academy of Architecture for Health (AAH) Leadership Forum. Kaufman, proprietor of the healthcare financial counseling firm Kaufman Hall, admitted to trying to provoke his all-architect audience, and frequently joked he'd be happy to leave the room in one piece. But, in fact, he performed a profound service for his listeners.

Kaufman said healthcare designers were caught in a “perfect storm” of a sour economy, a massive capital crunch and the vast uncertainties of healthcare reform. More to the point, the hospital CFOs he consults with are caught up, he said, in the same storm. Never having been entirely comfortable with typical mega-million dollar construction projects, CFOs are more reluctant than ever to confront these financial challenges, Kaufman said, quipping, “They would rather have 17 consecutive root canals than do another project.”

Even when the money is available or can be found, he said, they're looking to designers to speak their “language” in conveying value. While aesthetics and patient/staff satisfaction are important, they are no longer enough-CFOs want to know: (a) can they get something good for less? and (b) what will be the dollar return for the design investments they make?

Interestingly, in an interview slated to run in our November issue, readers will find noted interior designer Jain Malkin using this language. She refers to feedback she's received from recent hospital clients on the impact of these projects. According to Jain, they spoke of a marked growth in hospital visits, diagnosis/treatment procedures, and surgeries, and claimed that the new environments were drawing people in. These concepts (with numbers attached) are clearly expected to become the common parlance of healthcare designers in the future.

So, when Tom Cruise barks at you about money, Mr. or Ms. Healthcare Designer, don't shy away. You can show him the money, in the experience and evidence of dollar value generated by your design. You just have to focus on this a bit more than you've become accustomed to. HD

Healthcare Design 2009 September;9(9):80