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. This week’s Top Five list comes from Joe Sprague, director of health facilities, principal, and senior vice president at HKS Inc.

1. Focus on efficiency
We’re being asked by our clients to do more with less, by providing efficient innovative design, focusing on activated patient safety and satisfaction, and facilitating and improving patient outcomes, all while bringing accountability and value to the client. 

2. ACA
A new financial landscape is on the horizon for our healthcare clients as they adjust to the requirements of reform. Hospital-owned Accountable Care Organizations (ACO) are stressing accountability and prioritizing outpatient care through hospital networks. However, their facility, physical plant, and equipment needs have been compounding and are continuing to grow. In order to address these increasing needs within the constraints of a new financial structure we’re seeing clients requesting we accomplish more with less – and quickly! 

3. Desire for innovation
The industry is in catch-up mode and the pent-up demand of strategic initiatives execution and facility project demands are beginning to be released by hospital leadership.  And, frankly, they are being asked to do more with less, so why shouldn’t their consultants achieve the same? There’s a strong desire for innovation and efficiency, both in design product and process. 

4. Need for new processes
In this new era, we’re being pushed even harder on the innovation front.  The biggest strides we’ve made have come in process. For example, our business advisory practice, HKS Knox Advisors, is integrating operational improvement engagements with the design planning process, and our design studios are producing many projects through the integrated project delivery (IPD) method. We’re also producing master plans and facility development strategies in half the calendar duration than before. 

5. Accountability for safety
From a clinical perspective, we’re keeping our “eye on the ball” of patient safety and satisfaction and health outcomes as it relates to facility design. We’ve recognized for years, through the lens of evidence-based design, that our planning decisions have an impact on patient safety and health outcomes. This is becoming increasingly important to our clients – any positive contribution is not just welcomed but required as healthcare enters an age of accountable care organizations and quality measurements. The bottom line is designs need to be better, stronger, and produced quicker for a good price; value is important both in first-cost and life-cycle costs. 

These important considerations for any practicing healthcare architect should reflect that our healthcare planning muscles are being strengthened because of these demands. May the patients reap the benefits!

Joe Sprague

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