From the opening session at the Healthcare Design Academy on “Five Takeaways to Share with the C-Suite,” to the closing session on “The ‘Real’ Retailing of Healthcare,” the message was clear: healthcare providers and the teams that design their spaces need to keep changing and adapting in order to survive.

While in the past, healthcare operated under a build-it-and-they-will-come-type philosophy, today’s marketplace calls for new ambulatory care strategies, a laser-sharp focus on patients’ wants and needs, and the ability to identify the best model, location, and service offering for the community you’re serving.

“As the trends change, you better make sure you’re changing what you offer,” advised Paula Crowley, CEO, Anchor Health Properties, during her session on retailing of healthcare.

Several ideas were presented during the regional event, held in Bethesda, Md., February 26-27, from changing and Leaning up the design process and rethinking delivery modules to the evolution of ambulatory care and consumer expectations. Here are three ideas that stood out:

1. Give more attention to right sizing

Gary Vance, director of national healthcare, BSA Lifestructures (Indianapolis), told attendees that the industry hasn’t gone far enough in right sizing. “It separates user wants from user needs,” he said.

Using the example that a church can’t be designed and built for Easter Sunday crowds, he said healthcare facilities can’t be designed for peak times. By thinking of creative ways to right size, implementing Lean principles in operations and the built environment, and re-visiting old adjacencies that may no longer be relevant, he said design teams can put different things together and address what really needs to be in a space. For example, on a recent project, a smaller ED was utilized with adjacent flex space to handle peak time.

“Let’s utilize our experience in conceptual thinking and go back to the basics,” Vance said.

2. “C” stands for consumer and choice

“My wallet talks. I now have choices on where I go,” said Barbara Huelat, interior design principal, Huelat Davis (Alexandria, Va.), during the presentation, “The Pulse of Ambulatory Care,” with Gary Adams, principal, Huelat Davis, and Kevin Scott, principal, Davis Partnership Architects.

This expectation of choice means that consumers are looking for convenience, retail options, and tailored services, such as telemedicine, access to EMR, lifestyle coaches, and boutique physician practices, among others.

Within this host of new options, however, she says it’s still important to address human needs within the built environment. “How do we empower people?” she asked.

For example, she said while most facilities recognize that patients and families want access to nature, it shouldn’t just be a view to the outdoors but the opportunity to “feel the breeze.”

Adams suggested that design decisions be tested against the challenge, “Are we elevating the joy and dignity of the human experience?”

3. Going to the people

“Healthcare facilities are increasingly going to where the people are,” Adrian Hagerty, principal and regional vp, National Capital Region, Array Architects, said during his presentation, “Adaptive Reuse: A High-Performing Option for Healthcare.”

Among the reasons to consider adaptive reuse, Hagerty said, were the availability of real estate that enables providers to be closer to patients’ homes; accessibility, available parking, and alignment with existing transportation networks; and the speed of delivery.

Using case study examples, he said many times there’s not much cost difference between adaptive reuse and new construction—but the time difference can be faster with reusing an existing building or structure. “That to me is money because that’s revenue coming in,” he said.

Paula Crowley, CEO, Anchor Health Properties (Wilmington, Del.), built on that message in the following session, “The ‘Real’ Retailing of Healthcare,” by saying that there’s also real value in getting to market earlier than your completion.

Crowley discussed how healthcare providers can turn to retailers for important lessons on location, branding, and being nimble. “If you miss the location piece, you’ve missed it completely,” she said.

To help identify the right location, she said it’s important to get local expertise and understand the local demographics.

As more healthcare facilities adopt retail-like strategies and locations, she said providers should take the time to address their brand value and how they’re viewed by the community. “There’s a great opportunity to change it up at 50,000 square feet than at 150,000,” she said. “Just to design a building doesn’t cut it anymore.”

Jeff Kent, managing director, corporate facilities, Enterprise Services, Nemours (Jacksonville, Fla.), joined Crowley in the discussion, and said he’s working with Nemours on introducing a new clinic model this year. By using a kit of parts, he aims to be able to go to market faster and have a standardized design that will keep the organization from reinventing its design each time a new facility opens.

“We shouldn’t assume our current practice is best,” he said. “Our job is to continue to push the envelope.”

Healthcare Design’s next Academy event travels to Houston, April 27-28, to the George R. Brown Convention Center (Co-Located with Medical World Americas). For more information visit,