In this series, Healthcare Design magazine asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Bill Kline is an architect and vice president with SmithGroupJJR’s Washington D.C. office. He currently serves as a health practice leader. Here, he shares his thoughts on BIM, applying the new wellness model to building design, and building more energy and water efficient facilities.

1. The right team

I find leading design teams in today’s reform environment a tremendous challenge. The demands to optimize the scope, schedule, budget, and level of quality are pushing us to continually improve our performance. The information systems we now have available to enable this are unprecedented. But, paradoxically, the success of a project relies more on soft skills that transcend the technology. The teams that exhibit flexibility, creativity, positive attitude, drive, and a single, shared mission will always outperform.

2. The right methodology

Architecture is much more than problem-solving. Yes, the design must surpass the functional requirements to inspire and delight. As architects, our first impulse is to start drawing immediately, but there are functional and programmatic needs that have to be met. Even more importantly, we have to be sure we are solving the right problem and optimizing the processes for the client. Creative problem-seeking coupled with scenario-driven rapid prototyping is a method of analysis the entire industry must develop to provide owners with quantitative data demonstrating the value of different approaches to their enterprise.

3. The right delivery

Design teams today can be thought of as the means of production for the BIM model. They have supply chains for the knowledge and creativity required to integrate components and systems. The instruments of service (the drawings and specifications) are now assembled in a BIM model, which can also serve as a tool for the production of the building itself. Contractors and subcontractors add additional information and expertise, and often fabricate directly from the model. Teams maximize the delivery efficiency from beginning to end by eliminating waste, reducing duplication of effort, and creating better workflow. Regardless of what you call this process—Lean, delivering on the owner’s value proposition, innovation—we must serve owners, patients and families by delivering a better building, faster and at a lower price, from conception to completion.

4. Making wellness pay

Forward thinking healthcare systems and insurance companies are creating joint ventures, serving patient populations on a capitated basis, offering wellness care to the healthy, and managing patients with chronic comorbidities more carefully. Employers are creating wellness incentives, and even forming their own health systems. This new wellness model should extend to the building as well. Designers need to use our creativity to find ways to make the healthcare building a center for health, not illness. This could mean everything from indoor air quality and natural light to finding ways to engage patients, and staff, in their own health, such as walking paths, gardens, stairs, and community and patient education spaces and technologies. It’s a significant paradigm shift, and architects need to push innovative brick and mortar strategies to make this transformation possible.

5. Building smarter

Many of the design elements that create healing environments are also sustainable, and energy efficiency is one of the most important efforts to be considered. Significant savings in purchased energy expenditures can be realized in first as well as long-term costs if a carefully integrated plan includes state-of-the art engineering, a suitable selection of building components and thoughtful detailing. The efficient use of water requires the AE to plan and design construction and building systems that conserve water, inhibit the fouling of water sources and run-off, and provide landscaping schemes that make use of local native planting to reduce water consumption as well as maintenance. Measures designed for energy efficiency will be a crucial means to reduce operational costs: Every $1 a non-profit healthcare organization saves on energy is equivalent to generating $20 in new revenues, according to Energy Star. That’s pretty significant, and in our new reimbursement environment clients are starting to take notice and are motivated to lower energy costs, reduce water use, and build smarter.

Want to share your Top Five? Contact senior editor Anne DiNardo at for submission instructions.