One thing is for sure in our uncertain healthcare future: Big box outpatient centers are expected to play a bigger role in helping healthcare systems expand their patient base and enhance care. These spaces, which integrate ambulatory services in one location, help overcome expansion issues on crowded main campuses, where land is at a premium. Technology has also enabled more services to move out of the hospital setting to a building that’s more convenient to patients and less expensive to build. And patients seem to prefer them.

Mervyn Alphonso, managing director development, NexCore Group (Bethesda, Md.), calls this the “retailing of healthcare.” Whereas big box retailers locate stores based on a certain service area or population criteria, more hospitals are focusing on providing the same level of convenience and access to their patients in outpatient centers “rather than coming to the mother ship, or main hospital,” he says.

As these facilities being to populate the healthcare landscape, often opening up in existing retail corridors and near services that patients already frequent, architects and designers need to approach these projects with a different mindset, says Kim Prentice, architect, managing director of development and operations, NexCore Group (Denver).

“It’s usually a business occupancy that these services are being provided in as opposed to an institutional occupancy,” he says. “So it’s a less expensive building that still can be dressed up and presented in a user friendly way.”

So what are some design considerations should you keep in mind when approaching a big box outpatient project?

1. Don’t replicate what you’ve already got

When United Health Services (UHS, Binghamton, N.Y.) decided to open its first integrated outpatient center in Vestal, N.Y., NexCore Group helped the provider rethink its practice patterns and patient flows to create a more open setting where provider groups—including primary care, specialty care, and imaging—flow into one another. These operational efficiencies can be more convenient for patients, cut down on waiting time, and make them more willing to return.

2. Design in flexibility

With so much flux in healthcare right now, it’s important to build for future needs. That may mean including areas on each floor, such as community or storage spaces, that can be transformed into a physician practice group or service area if the need arises.

3. Branding the experience

UHS used its Vestal project as an opportunity to rebrand, introducing a new logo on the building and choosing a design aesthetic that could be retrofitted into some of its existing hospitals. Using a mix of natural materials, including cherry wood veneers and stonework, and warm colors, the setting stands apart from the more clinical hospital setting and aims to become the new “status quo” for the provider.

“It’s a very competitive environment out there,” says Prentice. “So they need to do whatever they can to differentiate themselves to be more user friendly, appear more welcoming, and reduce waiting time.”

Prentice and Alphonso will discuss this topic indepth at the Healthcare Design Conference, (Nov. 16-19, Orlando) in the session "Big Box Integrated Outpatient Centers—Planning, Programming and Implementation.” For more information, visit