This year Healthcare Design introduced a new series called Take Five, inviting healthcare design professionals to tell us what was on their minds and why.

We heard from contributors on a range of topics, from technology and Lean to healthcare reform and millennials. These ideas provided a window into the industry and gave us insight and perspective on the issues facing the healthcare design world. (For more from our Take Five series, click on each person’s name or search “Take Five” on

So before we bid this year adieu, let’s take a look at some of the issues 2013 brought to the table.

1. Is Lean a method or a religion?

“We can learn a lot from tools like operations research, management by objectives, Six Sigma, and Lean. My concern is when a concept turns into a dogmatic religion. Early design is a reflective process, not a manufacturing production line problem. How we adapt these management tools to the creative process will be a major challenge/opportunity for healthcare architects.”—Frank Zilm, University of Kansas School of Architecture, Design & Planning

2. Collaborating across markets: “What took us so long?”

“A number of medical districts are positioning themselves for the future by combining their resources. These medical districts can accommodate research centers, wellness facilities, parks, roads, and even adjacent neighborhoods. This collaboration is done in an effort to weave healthcare into the fabric of the community and put an emphasis on wellness to keep patients as healthy as possible.”—Gary Vance, BSA LifeStructures

3. Accountability for safety

“Patient safety and health outcomes are becoming increasingly important to clients, and any positive contribution is not just welcomed but required as healthcare enters a new era. The bottom line is designs need to be better, stronger, and produced quicker for a good price; value is important in both first costs and lifecycle costs.”—Joe Sprague, HKS Inc.

4. Quick in, quick out

“Patients are becoming more educated consumers with easy access to information. The millennial generation has been exposed to technology its entire life and doesn’t expect or need human interaction at every turn. Home check-in, self-rooming, online medical records, and communication between physician and patients via email or telepresence are just a start.”—AECOM’s Sheila Cahnman, Christy Devens, and Mark Reckin

5. Making green dollars and sense

“With the U.S. Green Building Council’s approval of LEED v4, environmental sustainability continues to become more mainstream. Integrating, rather than distinguishing, sustainable strategies and techniques as part of the customary design process makes them less likely to be omitted from a project. Green becomes less specifically environmental and more inclusively dollars and sense.”—Walter Jones, Parkland Hospital

A host of new issues, challenges, and opportunities will take the stage in 2014 and I look forward to learning about them and seeing how our industry responds. What would you add to the list of top issues of 2013? And what’s on your radar screen as the new year begins? Share your thoughts below or contact me at

(If you’re interested in sharing your own Take Five in 2014, contact me at for submission guidelines.)