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

Architect Mary Frazier, principal at EwingCole and member of Healthcare Design's Editorial Advisory Board, has 20 years of experience in the planning and design of healthcare facilities. Here, she shares her thoughts on technology’s role in improving care, the need for better hospital food, and emergency department design.

1. It’s not a building, it’s an experience

A visit to a hospital or healthcare setting is oftentimes measured against other healthcare institutions rather than industries known for hospitality service. Examining how high-caliber service industries interact with their guests and transferring those concepts into the healthcare setting make more sense. Ultimately, the entire path of the patient visit must be examined and improved, but we can start small by focusing on the initial interaction with the patient. Could the hospital dispatch Uber to pick up an elderly patient to make the trip less stressful? If patients choose to drive, does wayfinding make their destination clear and simple to find? Do those directions and signals match what is outlined on the system’s website? When the patient arrives, is the valet friendly and welcoming? These are small touchpoints at the inception of the visit, however research has shown that the first and last moments of an interaction are what individuals hold in their memory as a permanent snapshot of the entire event.

2. The hospital of the future doesn’t exist

We’re surrounded by buildings that claimed to be “the hospital of the future” when they were designed and built. The assumptions and decisions those designers made, no matter how forward thinking, were out of date as soon as the doors to the building opened. The only true hospital of the future is one that maximizes its ability to accommodate change. Modular wall, floor, and ceiling systems are components of that flexibility. Incorporating soft space (such as storage) next to hard space (such as ORs) allows those rooms to easily expand if demand or equipment warrants. Engineering systems designed for additional capacity reduce the cost of future upgrades. Locating mechanical spaces and shafts along exterior walls allows a clear internal footprint for planning and ensures mechanical rooms can be enlarged if required. Finally, standardizing multiuse spaces, such as procedure or exam rooms, not only reduces the cost of construction but helps provide future flexibility.  

3. Mobile technology continues to explode

Patients are embracing mobile technology as a way to proactively manage their health outside of the hospital. Simple methods of home monitoring have existed for years but newer solutions are easier to use and have a greater ability to transfer and access data. As patients embrace that technology so are health systems. Banner Health enlisted 600 of its patients who are covered by its insurance plan and have a minimum of five chronic conditions into a program to monitor their condition 24 hours a day. The patients are given a number of biosensors that allow nurses to track their data and intervene when necessary by calling patients or having health coaches make home visits. The goal is that immediate monitoring, evaluation, and subsequent action improve the overall health of patients while reducing the cost of care.      

4. Why don’t hospitals serve better food?

I love chocolate croissants as much as the next person, but why are they a food choice in a healthcare facility? Hospitals should be the gold standard for healthy eating since patients go there to get better and food is a crucial part of wellness. However, as I walk through the public spaces of hospitals or visit their cafeterias I’m amazed at the choices. Facilities should focus on healthy organic food choices with vegetarian or low-fat options. Additionally, healing or rooftop gardens could incorporate a farm that’s accessible to the staff and patients to provide them the opportunity to relax and reconnect to nature. 

5. The emergency department is still the front door

The flow of patients to the hospital emergency department (ED) is not slowing down even with the introduction of alternate care locations. Using Lean design to redesign and expedite patient treatment, we’ve have been able to decrease the door-to-doctor time and expedite low-acuity patient volume through the ED. The introduction of results lounges allows us to reserve treatment space, the department’s most valuable resource, for those who need it. For patients who do need a treatment room, uniformity is the key with interchangeable case carts to maximize room utilization. Additionally, private rooms respond to the need for increased privacy while addressing infection control concerns. Observation units managed by the ED are regaining popularity although they’re successful only with a clearly defined observation policy. Security has always been a concern within EDs and RFID tracking devices or phones that incorporate a staff emergency assist button are becoming more popular.

Mary Frazier

Want to share your Top 5? Contact senior editor Anne DiNardo at for submission instructions.