After four days packed with facility tours, workshops, educational sessions, and exhibit hall hours, attendees of the 2014 Healthcare Design Conference held in San Diego Nov. 15-18 were left with some inspiring last words—and a charge to action.

In the closing keynote, three healthcare leaders joined in a conversation on the future of healthcare in the U.S. and how to prepare for it in “Changing Healthcare—Innovation and Leadership Forging a Bright Future.” On hand were Barry S. Rabner, president, CEO, and trustee of Princeton HealthCare System, Sierra Bainbridge, senior director of MASS Design Group, and Helen Zak, president and chief operating officer of ThedaCare Center for Healthcare Value.

The panel shared thoughts on how to achieve buy-in for new facility projects, keys to implementing change, and how the definition of architecture is expanding to create spaces that touch communities in a number of ways.

But the most powerful message of their conversation came when moderator Donna Deckard, director of strategic projects at The Center for Health Design, asked Rabner to provide insight on what he’s learned since opening University Medical Center of Princeton at Plainsboro in March 2012.

“Two years later, we know a lot about what’s working and what’s not working,” Rabner said. But, he added, those results aren’t being measured. “I got 650,000 square feet of stuff. No one wants to know how these things we did work better? I think people need to do research on this to see if it could be better,” he said.

Rabner said the facility could easily serve as a laboratory for healthcare design research, and, yet, nothing’s been done. For Rabner, he’s unlikely to build another hospital and said he doesn’t see a benefit to investing in studying Princeton's new environment, but he urged attendees to recognize that hospitals are likely to open their doors to those interested in pushing healthcare design forward.

“You do the research and help the next guy get it right. You pay for it. You do the research, and we’ll help,” he told the audience.

Zak concurred: “That’s all of our jobs: to step back and reflect.”

For Bainbridge, that means staying engaged on a project beyond completion, with MASS recognizing how relationships built through the design process can help once a building is inhabited. For example, post-occupancy evaluations determine results not so easily extracted before spaces are used. “The post-occupancy part needs to expand to be part of the package delivered,” she said.

Also thanks to those existing relationships, project teams are at a distinct advantage in assisting providers during the tricky first months of occupation, which Rabner noted rarely happens.

“We opened and everyone went home,” he said. To answer issues that arose once the new hospital was in operation, Princeton created a command center to field concerns and questions; whereas if the project team was available with familiarity for the design intent of the spaces in question, the move-in could have been more streamlined. 

Looking forward, the panelists each provided a few closing comments, with Bainbridge noting how MASS’s work overseas in underdeveloped nations has allowed the firm to explore design innovations in an environment not bound by the code restrictions so often encountered in the U.S., and that the next step of that process is to figure out how to bring those concepts here. “How can we innovate even in these constraints?” she said.

For Zak and ThedaCare Center for Healthcare Value, Leaning processes and finding a more efficient and effective healthcare delivery model for patients is key, and she urged attendees to respond to the changing healthcare landscape, thinking about the complexity of the system today and the handoffs that patients go through—and how to make it easier.

Finally, Rabner noted the skyrocketing cost of healthcare in past years that’s quickly coming to an end, and that end requires providers and their partners to identify ways to better care and cut costs, from reducing patient falls and healthcare-associated infections to improving patient satisfaction.

“We have to figure out how to call in the design of solutions,” he said.