Back in 2011, Peter Bardwell, 2013 president of the American College of Healthcare Architects, and A. Ray Pentecost III, 2013 president of the International Academy for Design and Health, put together a list of 10 forces they saw changing healthcare design.

At the recent ASHE Annual Conference in Atlanta, Bardwell and Pentecost shared an update on their original list during the session “10 Forces Continuing to Change Health Care Design,” discussing the evolution of the challenges they’d originally identified and how they’re still influencing the industry—just in slightly different ways.

They covered the gamut of pressures, ranging from tightening reimbursements to the importance of information technologies to the migration of care away from facilities to a greater emphasis on health over medicine.

But what was particularly interesting were the six trends that Bardwell and Pentecost said have emerged as a result of these “10 forces.” Here’s a look at what they see shaping healthcare design today and in the future:

  1. Health continuum—Bardwell and Pentecost said that when population health is the measure being used to determine an organization’s success, disease treatment is no longer a sufficient means to achieve success. So our buildings need to support a new care continuum that focuses on wellness, not on responding to illness.
  2. Focus on outcomes and health—With an eye on keeping people healthy balanced with a need for more efficient operations, hospitals will likely turn to existing staff to work at the height of their competence limit rather than under it, with everyone coming together in a collaborative environment.
  3. Personal accountability—Patients will need to be not just empowered to take an active role in their own healthcare but inspired to do so. It will be critical to design an interface that’s attractive: “a place to be as part of normal life,” and not just when something bad happens, Pentecost described.
  4. New roles and partnerships—Facility managers, for example, will move from the boiler room to the board room and develop new relationships with designers, all being part of a conversation about where healthcare buildings stand in the future care environment. This process should include thinking about repurposing spaces, downsizing, recognizing shifts in demographics and answering those, and acknowledging that new care delivery models may very well make the physical space irrelevant.
  5. Continued consolidation—Bardwell and Pentecost anticipate healthcare to maintain the current forces at play: The big will get bigger and the small will get smaller. They predict the end of the independent community hospital.
  6. Doing even more with less—The days of “better, faster, cheaper” are over. “That’s a dead end,” Bardwell said. Instead, today’s facility planning should respond to changing care models and planning for how buildings will be used differently in coming years by asking the question, “Do we even need that in the future?”

What’s your take on these six trends? Any additions to the list? Email me at or leave a comment below.