The HCD 10 Team MVP

Bryan Langlands

AIA, ACHA, EDAC, LEED GA, principal, NBBJ (New York)

Mission statement: “Guided by the importance of innovation and collaboration, I’m passionate about rethinking healthcare—from how spaces are planned and designed to how healthcare is delivered. I believe both should constantly evolve to meet the ever-changing needs of patients and the advent of new technologies.”

Who he is: Langlands is a principal, senior medical planner, and regulatory expert at NBBJ, with his day-to-day routine dedicated to directing user group meetings, overseeing master planning for major academic medical centers, and designing large hospital expansions. He recently took that expertise to the Facility Guidelines Institute (FGI), serving as a member of the 2018 Health Guidelines Review Committee (HGRC), the body responsible for updating the FGI Guidelines documents every four years.

Year in review: In his role on the HGRC, Langlands became an invaluable contributor to the revision process. He first identified the need for the Guidelines to allow the diversification of spaces in the emergency department (ED) to address the needs of lower-acuity patients. He next put competition aside to collaborate with architects and fellow ED experts David Vincent and Jim Lennon of HKS Inc. as well as Dr. Christine Carr of the Medical University of South Carolina and American College of Emergency Physicians. The group penned the white paper “A Case for the Low-Acuity Patient Treatment Station: Reducing the Length of Stay for Emergency Department Visits.” The document formalized an optional alternate stream of patient flow and identified right-sized space for keeping lower-acuity patients out of the ED proper and reducing length of stay for all.

Additionally, Langlands chaired an iteration of the Procedures Task Group for the 2018 Guidelines, leading efforts to standardize, simplify, and clarify the requirements for spaces where clinical engagements take place. For example, he shared new ideas related to exam, procedure, operating, and imaging room minimum requirements, including revised definitions and reasoning for a new classification system for imaging rooms. This included a newly established “anesthesia work zone” that defines the minimum square footage needed for the set-up and use of equipment by an anesthesiologist.

Industry impact: Langlands is leading the charge in solving a national dilemma of overcrowding in EDs. The move offers those in the design community as well as healthcare providers a way to approach authorities having jurisdiction with another option for providing appropriate space for emergency care and treatment. His leadership on moving this issue forward better ensures its adoption in the 2022 Guidelines. By focusing on these requirements, Langlands has offered clarity in terms of interpretation and application. And by proposing alternate space for the treatment of lower-acuity patients, he’s legitimized what’s already happening in many EDs today with an added layer of minimum requirements for square footage, visibility, infection prevention, patient safety, and privacy.

What’s next: Already at work on the 2022 Guidelines revision cycle, Langlands will serve on the HGRC Steering Committee and chair the Beyond Fundamentals group, putting him at the helm of a paradigm shift within FGI. Beyond Fundamentals has been introduced to bridge the gap inherent in the four-year revision cycle of the Guidelines document, by providing a resource library that will enable the industry to stay current with trends and market forces that affect facility planning and design. This will include best practices, design recommendations, draft minimum requirements, checklists, diagrams, and evidence-based research. The organization is working toward a point where Beyond Fundamentals makes up the majority of the resource, offering professionals guidance on what they “should do” rather than what they “must do”—and opening up more opportunities to innovate.