Chris Powers (Image credit: Courtesy of Wold Architects and Engineers)
In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what has their attention and share their ideas on the subject.
Chris Powers is a healthcare practice leader at Wold Architects & Engineers (Nashville, Tenn.) with more than 30 years of experience spanning architecture, health system operations, and owner representation. Here, Powers shares his thoughts on balancing predictability with speed, adapting facilities to changing operational needs, and developing more flexible approaches to healthcare planning.
1. Predictability is healthcare’s most strategic advantage
While speed-to-market matters, it isn’t always the best or right goal. Healthcare organizations have always prioritized project schedules, but today’s reimbursement pressures and growing demand for care have made schedule predictability an even greater strategic advantage.
Finishing early can be counterproductive if staff, equipment, or operational plans aren’t aligned to support an accelerated opening. Additionally, many funding streams and grants mandate facilities open by set dates to secure essential reimbursement, making precise planning critical.
As financial realities shift investment toward outpatient centers, targeted renovations, and freestanding emergency departments, greater emphasis is placed on opening precisely as planned. Teams adept at on-time delivery will give healthcare owners greater confidence to better navigate the mounting financial and operational complexities of today’s market.
2. Design at risk to compress schedules
Predictability should remain the priority, but calculated risk can help healthcare organizations meet aggressive schedules when circumstances allow. Conversations about speed-to-market have increasingly pointed toward approaches like prefabrication and standardized designs, which offer the consistency, quality, and efficiency needed to reduce constraints and mitigate risk.
Because prefabrication requires upfront investment, many healthcare owners favor a design-at-risk model, funding design costs early to advance the project before full approval. This approach carries risks: stalled funding, shifting project scope, or budget spillage, which can require early work to be reworked later or render it obsolete.
For organizations willing to accept and manage these risks, the payoff of planning for a compressed schedule in an industry where speed is often synonymous with financial survival is significant.
3. Hospitals are changing faster than their buildings
Healthcare delivery is constantly evolving, but most facilities weren’t designed for today’s operations. As teams, departments, and service lines relocate; patient populations shift; and spaces are repurposed, health systems must also reconcile facilities designed for entirely different operational models. These changes make flexibility a more immediate priority than expansion alone.
Successful projects and programs must address operational realities from the beginning, including staffing models, existing workflows, and organizational structure. By involving clinical, facility, and finance leaders early, project teams can uncover challenges rooted in the organization’s care delivery model, not just design or construction.
Understanding how caregivers truly use their environments leads to efficient, valuable spaces that support operations and remain relevant long after construction is complete.
4. Healthcare still learns best from healthcare
Digital tools like artificial intelligence, simulations, and workflow analytics let project teams test ideas earlier than ever. These technologies yield valuable insights, but nothing compares to the experience and wisdom of those delivering care on the front lines every day and navigating these environments firsthand.
Some of the most meaningful design improvements continue to come from honest and timely post-occupancy evaluations and candid conversations with nurses, physicians, and facility managers. These interactions often uncover workflow bottlenecks or operational successes that are not visible in drawings or simulation models. As care environments grow increasingly complex, there’s no substitute for learning from the lived experiences within completed facilities over time and in practice.
5. Rural healthcare needs different solutions, not smaller versions of urban ones
Rural healthcare leaders are acutely aware of the need for future-focused planning. According to Wold’s recent State of Rural Health Planning in America report, 92 percent of respondents are engaged in or preparing for facility planning. However, 72 percent said they don’t feel well-equipped to lead a capital project from planning through construction. Limited resources can prevent long-term planning from becoming reality.
This gap makes a coordinated approach essential. Rural organizations are balancing aging facilities, workforce shortages, and financial pressures while evaluating and implementing the services their communities need most. The research reveals almost equal prioritization for hospitals and specialized facilities, highlighting that a one-size-fits-all model doesn’t always work. Ultimately, resilient, unique plans connect community needs with operational realities, funding, and long-term success.
Want to share your Top 5? Contact Senior Editor Robert McCune at [email protected] for submission instructions.
