In this series, Healthcare Design magazine asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Here, Bob McCleskey, CEO, Sellen Construction (Seattle), talks about construction trends in healthcare, how innovative techniques can help keep costs down, and what to expect in the future.

1. Prefab is not a fad

One of the biggest developments in recent years has been the adoption of prefabrication. For medical facilities, this means that plumbers, electricians, drywallers, and welders work off-site to build components such as headwalls, bathrooms, and other features with all the electrical, gas, plumbing, and nurse call lines integrated into a “plug and play” element. It’s not only faster to build this way, but it’s also safer, less expensive, and results in a higher quality.

2. The landscape is changing

With the economics of healthcare increasingly rewarding outpatient care, I don’t expect to see too many new medical centers in the near future. Hospitals will add facilities, build new wings, redevelop operating rooms, and the like, but trends suggest that big new hospital projects with new beds will be few and far between.

3. Outpatient facilities are HOT

Years before the Affordable Care Act emphasized preventive care, we were seeing the decline of hospitals and the rise of outpatient facilities. These projects are less expensive to build than inpatient hospitals while providing greater access to healthcare, especially in suburban and rural areas. With reform emphasizing prevention and outcomes, this trend will likely accelerate.

4. Tilt-up: It’s not just for warehouses anymore

For some medical office building (MOB) projects, we’re using tilt-up construction, which involves pouring concrete panels on slabs and then using a crane to hoist them vertically to become the walls of the building. We can cast brick or other products into the panels to provide architectural interest. Tilt-up works especially well in suburban areas where you have the space to create staging areas. We recently put up a new MOB in just two days.

5. Efficiency is king

Healthcare reform is focused on rewarding outcomes, not procedures. Doing more for less seems to be the direction for most of us. For construction companies, it means innovating alongside our customers and continually adjusting to meet the needs of our healthcare clients.

Bob McCleskey

Want to share your Top Five? Contact senior editor Anne DiNardo at for submission instructions.