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

Ken Kramer is principal at Francis Cauffman (Philadelphia). Here, he shares his thoughts on project budgets and five steps to successfully managing budgetary discussions with clients and presenting creative solutions that maximize return on investment.

1. Find the real concern about spending

Often a client will express hesitation when it comes to committing their resources to a new project. Typically, the real concern is spending money on an aspect of a project that doesn’t add value. Most clients are willing to put their capital toward programs that directly impact a facility’s core operations because these create a measurable return on investment. To address this concern, we plan new facilities with core programs that add value, while repurposing existing facilities with necessary support spaces that do not require a large capital investment.

2. Use specific goals to measure success

In order to adjust a budget to best suit the client, it’s critical to establish a clear understanding of the client’s goals. For example, income-producing programs, regulatory required programs, and programs supported by research may top a client’s priority list. Using these goals as a barometer, we measure the effectiveness of budget items, considering which will deliver the results that the client wants. In all planning projects, we develop “what if” scenarios that forecast the outcomes of each item.

3.  Change the conversation

When a client says “no,” try to offer different ways of thinking about solving the same problems. It’s easy to promote new construction as a solution, but success often comes from leveraging your client’s current assets. To do this, spend the time to understand what’s important to them, how they think, and what makes their operations effective. After a discussion, the client may find that they don’t need to spend as much as they think in order to get the results they want.

4. Develop a program that meets the budget

There are many ways clients may consider stretching their capital and assets to implement a major project or expansion. In addition to repurposing existing facilities, some institutions choose to partner with third-party developers to sell off assets and then lease back, or even have these assets built for them. For healthcare clients, medical office buildings, parking facilities, and energy plants offer opportunities for investment partners. These areas are vital to the success of the facilities, but partnering allows clients to focus capital on their core mission.

5. Targeted conversations lead to tailored results

Work directly with clients to craft a budget for their project to alleviate concerns about spending money and help the design process go more smoothly. It’s important to plan for the future so the budget supports the client’s immediate needs and also identifies future growth. Inform your client about cost and expectations so they can make sound capital-cost decisions. The most successful planning and design projects stem from well-thought-out fiscal decisions.

Ken Kramer

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