Over dinner recently, a colleague who’s the CEO of a health system that just completed a hospital replacement project said something that made me think about our responsibilities as architects. “You [architects] are so good at describing architectural ideas and concepts, and it’s all cool stuff. And as the owner, I want that cool stuff.  But you sometimes have a way of making that cool stuff sound like it’s free—but it’s not,” he said.

His statement, while anecdotal and somewhat humorous, has stuck with me ever since.

As designers eager to convince our clients of creative design solutions, isn’t it incumbent upon us to also convey the potential cost implications of those ideas as well as the proven benefit of the solution?

Owners have to make complex, value-based decisions based on a wide variety of factors, including of course, financial impacts. I would argue that developing an accurate cost metric for construction isn’t typically within the expertise domain of architects, but rather of builders. Designers need to work closely with builders or reputable cost consultants to track the cost implications of that cool stuff to help the owner make informed decisions.

In the same vein, when we make recommendations to owners about planning and operational solutions, we should be able to provide enough proof—or evidence—that the solution will, in fact, work for their needs.

Traditionally we would cite other projects where a similar solution proved to be effective for a similar organization, under similar circumstances. But the variables are significant and an element of “applied anecdotal science” goes with the recommendation. Few people would purchase a car without driving it first. However, owners have traditionally had to purchase a building design with limited definitive evidence that, at least planning-wise, it will perform as we claim it will.

The tools of data-driven design provide mathematical analysis to help verify performance before construction. Below are a few examples.

BIM. While we’ve experienced the tremendous benefits of building information modeling (BIM) when it comes to multidisciplinary design coordination, this detailed understanding of building systems has allowed architects, engineers, and builders to achieve a new level of granularity in developing cost models that decreases the guesswork in aligning the design with the owner’s budget (allowing us to better account for design solutions).

Parametric modeling. This tool allows designers to track several metrics of different design concepts “live” as we study them, such as comparing building areas within the program, tracking revenue-producing space versus overhead space, solar orientation, travel distances, and the flow of materials throughout a facility. Live parametric modeling allows us to adjust the design to satisfy our performance metrics.

Simulation. Simulating scenarios allows designers to virtually demonstrate—three-dimensionally—how areas of the facility might perform based on real operational parameters. We can witness how different planning typologies for an ED, an ambulatory clinic, or an OR suite might perform for a variety of staffing models and program solutions. This virtual world shows flow, reveals bottlenecks and resource utilization, and allows us to adjust the physical plan to optimize performance.

As designers, whenever possible, we need to demonstrate the financial and operational value of our planning and design recommendations to our clients. If we can do this, we demonstrate our own credibility and the owner can make informed, educated decisions regarding the design—including how to pay for the cool stuff.


Chris Bormann is HDR’s East region healthcare director and is responsible for growing and sustaining HDR’s healthcare practice in the eastern U.S. Chris has more than 25 years’ experience in planning, master planning, and designing complex healthcare facilities as well as formalized training in healthcare facility planning, including an extensive hospital administrative residency and a master’s degree in healthcare architecture.