Those who know me know that I’m an optimist by nature. I see most challenges as opportunities. Without a doubt, most of us in this industry have had more than our fair share of “opportunities” these past few years navigating through this economy and the new world order.

We’ve watched as firms closed their doors and unemployment in the architecture and design community rose dramatically, while projects were put on hold or cancelled altogether. We’ve also watched as healthcare struggled to define a sustainable future for itself. These have not been fun opportunities. But they have been opportunities all the same.

As an industry, we got leaner, smarter, and more creative. Healthcare started talking about accountability and connecting payment to outcomes, rather than just services rendered. And here we are, not quite on the other side, but we can see the light of a new day. Suddenly, the opportunities are starting to be a bit more fun again.

One of the more exciting opportunities on our horizon is for the building and design community to have a seat at the table as our nation redefines what our healthcare system is going to look like. Politicians and legislators are talking about accountability and outcomes, and that’s the right conversation to be having. A healthcare system that is reimbursed based on keeping its citizens well and providing the best long-term clinical outcomes is one we all can believe in.

Allowing us to duplicate success rather than mediocrity, IHI founder Donald Berwick tested best practices and new models of care delivery, and then broadcast what worked to the industry when he was administrator of the Centers for Medicare and Medicaid Services.

But the one thing nobody is talking about at a national level is the role the built environment plays in better health outcomes and reducing the cost of care. It’s the weapon still missing from the arsenal and one that we as a community are in a unique position to represent. We know that the decisions that are made about how healthcare facilities are designed can reduce patient falls and injuries, lower the potential of hospital-acquired infections, and reduce the chances for staff injuries. This helps caregivers do what they want to do most—give quality care.

And we know that this is just the tip of the iceberg.

Over the course of this next year, we need to find our voices in unison and find our way to participate in the discussion about health outcomes. We know that quality care doesn’t happen in a vacuum. Wherever care is provided, there is a physical space in which it’s provided. Whether it’s a hospital patient room, primary care doctor’s office, big box retail store, or a person’s living room, the physical environment is the one variable that is always present.

So as we start this New Year, let’s make this our charge and our challenge. Let this be the opportunity we seek. By the end of 2012, let’s find ourselves as part of the conversation. It’s not that we’re not wanted or needed—our voices have just not been heard yet.

Think about what you could do, whether it’s on a national or local level. Who do you already know in your community who you could reach out to? Who could you sit down with to share your ideas and the latest research that connects the built environment to health and economic outcomes? How can you be a part of the groundswell that could help shape the future of our healthcare system?

We are all connected to thousands of others through LinkedIn, Facebook, and Twitter. It’s great to share videos of cats playing the piano, but what about sharing links to evidence-based design research studies, exemplary case studies, or any number of the things you learn as you read through this magazine each month?

Start that groundswell. Make noise. Be heard.

What we have to share is exciting stuff that rarely gets outside the walls of our community. You are an untapped resource not just to our industry but in your local community as well. You have unique knowledge and insight that would be useful and appreciated on local building commissions or on committees that serve your local healthcare institutions.

The Center for Health Design has a cornucopia of data, research reports, white papers, and assistance available to you to support you in this work. Just reach out to us at or to me personally at These are the challenges that lead to the fun kind of opportunities, so seek yours out. HCD 

For more information on The Center for Health Design, please visit