The healthcare industry is constantly evolving as technology, patient populations, care delivery models and reimbursement methods continuously change. The challenge for many healthcare owners is maintaining facilities that support the ongoing healthcare evolution, which means remodeling outdated facilities or building new.

Critical access hospitals have four key revenue-generating departments: emergency, procedure center/surgical, imaging/diagnostics, and clinic. When building new or remodeling, owners need to consider the most efficient way to optimize department productivity before beginning to design and build.

This means starting from a Lean perspective in the planning stage to streamline operations, eliminate redundancies, and right-size spaces with flexible programming in mind.

Let’s look at some key factors impacting finances.


Critical access hospitals essentially have the same program as larger urban hospitals, except they are smaller single-story buildings generally built on the outskirts of town. And while they’re often less expensive to build because of their smaller scale, new construction leads to more site work because infrastructure must be installed, from sewage and electrical to roads and graded site work.


Spaces should be planned for flexibility, which means right-sizing spaces that can flex back and forth between functions. Pre-op can be used as a procedure center, for instance, while a centralized nurses’ station will suffice for decentralized nurses’ stations (popular in larger urban hospitals) because there’s usually only one nurse on duty at a time. Flexible rooms allow for less equipment and fewer expenses without overbuilding. Square footage must meet programming needs but be able to expand.


Critical access hospitals are often modestly detailed to reflect the modesty of the community. Yet they will use higher-end material in select spaces to give a greater impact, such as cultured stone along the windows or door trim. The right splash at the right place with the right material can have a great impact. For instance, the MEP system often is located in the rooftop penthouse, which can be designed to serve as a community beacon.

Construction timeframe

Again, because they’re smaller, the construction timeframe for critical access hospitals is shorter and less expensive. An integrated project delivery structure can save time and money because all parties (architect/contractor/owner) are equally vested in maintaining costs and delivering on-time.