The 2026 Healthcare Design Conference + Expo, to be held Oct. 17-20 in New Orleans, will host more than 100 keynote and educational sessions on a variety of topics.
Healthcare Design is previewing some of the upcoming educational sessions in a series of Q+As with speakers, sharing what they plan to discuss and key takeaways.
Session: E17 – “Designing Resilient Emergency Departments: The Real-Life ED Behind ‘The Pitt’”
Sunday, Oct. 18, 11 a.m.-12 p.m.
Speakers: Anastasia Markiw, project manager, DesignGroup (Pittsburgh); Kathy Sikora, director, emergency services, Allegheny Health Network (Pittsburgh); Kristyn Svetlak, healthcare planner, project architect, DesignGroup (Pittsburgh)
Although the award-winning series “The Pitt” is set in a fictional medical center, many scenes were filmed at Allegheny General Hospital in Pittsburgh, where the emergency department (ED) is currently undergoing a complex, multiphase renovation.
In this session, the renovation’s design team will explore strategies to future-proof EDs for emerging public health crises, reduce wait times and improve throughput, and enhance both staff and patient safety. They’ll also share practical design solutions informed by the lived experiences of Pittsburgh clinicians, who provided the show’s creators and actors firsthand insights into the realities of emergency medicine.
Healthcare Design: “The Pitt” earned praise for its realistic portrayal of emergency medicine. What takeaways or insights from clinicians helped inform the real-world, multiphase renovation of the ED at Allegheny General Hospital?
Anastasia Markiw (Image credit: Sami Caun Photography)
Anastasia Markiw: One of the things that stood out most throughout this project was the complexity of everything happening behind the scenes in an emergency department. While the clinical team clearly communicated their operational needs, seeing the pace, intensity, and constant coordination represented in “The Pitt” reinforced just how much activity occurs in these environments every minute of the day.
Our planning process also highlighted how many departments are connected to ED operations, including environmental services, air transport, security, police, registration, material management, food services, inpatient units, and the operating rooms. Because of those interdependencies, it was essential to engage a broad group of stakeholders and gather feedback through multiple rounds of collaboration.
Most importantly, we saw how deeply the clinical team understood their existing environment and how committed they were to providing exceptional patient care. Their firsthand knowledge helped inform countless decisions throughout the renovation, ensuring the new spaces would better support caregivers and improve the patient experience.
HCD: Renovating an active ED presents many challenges. Share one of those challenges and how you addressed it on this project.
Kristyn Svetlak (Image credit: Sami Caun Photography)
Kristyn Svetlak: One of the biggest challenges was maintaining a fully operational emergency department while renovating the very spaces and circulation paths that staff relied on every day. Patient care could not pause, so every phase of the project had to be carefully planned for ongoing operations.
A key priority was maintaining, and in some cases increasing, patient capacity throughout construction. To accomplish that, the team strategically repurposed portions of the existing clinical decision unit into emergency treatment spaces, allowing care delivery to continue while other areas were renovated.
The project also required us to expand and modernize patient care environments, including meeting newer code requirements, while largely working within the existing footprint of the department. Success depended on a highly coordinated phased approach, developed in close partnership with clinical leadership from the earliest planning stages. Together, we identified which functions had to remain operational during each phase and how to minimize disruptions, including carefully managing utility shutdowns and other construction activities. The collaboration and flexibility of the clinical team were critical to keeping both patient care and construction moving forward.
HCD: Emergency departments can face mass-casualty events, extended surge periods, and patients experiencing behavioral distress. What adaptable design strategies can project teams consider to better equip EDs to handle these situations?
Markiw: Flexibility is one of the most important considerations when planning emergency departments today. The pandemic reinforced the need for spaces and infrastructure that can adapt to changing care models, patient volumes, and infection control requirements. Planning for future HVAC capacity and operational flexibility can help health systems respond more effectively to unforeseen events.
Strategic room placement also plays a major role. For example, locating behavioral health rooms near caregiver work areas can provide better visibility and oversight, while placing airborne isolation rooms near emergency medical services arrival points can improve patient flow and reduce operational challenges.
We also focused on creating spaces that can serve multiple purposes. Trauma rooms can support daily patient care while remaining available for surge events, and interconnected trauma areas allow staff and resources to be shared during mass-casualty situations.
Similarly, flex secure rooms can function as standard treatment rooms during normal operations and transition to support behavioral health needs as volumes increase. Determining the right balance of these adaptable spaces helps position an ED to respond effectively to a wide range of scenarios.
HCD: What design strategies can help reduce wait times and improve patient throughput?
Svetlak: One effective strategy is creating a forward-flow model that guides patients through registration, triage, care initiation, diagnostics, and results waiting in logical progression. This approach helps lower-acuity patients continue moving through the care process rather than remaining in a traditional treatment room for their entire visit.
Reducing bottlenecks and matching spaces to the level of care required can ensure patients spend less time waiting in the main waiting area and more time actively progressing through their treatment journey. This can improve the overall patient experience, support operational efficiency, and reduce the likelihood of patients leaving before being seen. This approach also allows health systems to use space more efficiently while maintaining access to care during periods of high demand.
HCD: What’s one takeaway from your session that you want attendees to remember?
Markiw: Flexibility should be at the center of emergency department planning. An ED must support a wide range of patient needs, operational demands, and emergency scenarios, sometimes simultaneously.
Whether responding to routine patient volumes, major trauma events, infectious disease concerns, or community-wide emergencies, the environment must be able to adapt without compromising care. Designing for flexibility creates a foundation that helps healthcare organizations remain resilient as needs evolve over time.
Svetlak: Every emergency department is unique, and successful solutions begin with understanding the specific needs of the community being served. Patient volumes, acuity levels, demographics, and care patterns can vary significantly from one hospital to another.
While there are common best practices in ED design, the most effective environments are those tailored to the realities of a particular organization and patient population. Taking the time to understand those operational and community-specific factors leads to design decisions that better support both caregivers and patients.
Find updates and additional information on the 2026 HCD Conference + Expo here.
