From preparing for an initial surge of COVID-19 patients to constantly replenishing personal protective equipment stockpiles, healthcare organizations are working overtime to provide quality care in the “new normal” pandemic environment. And while there’s no immediate cure for pandemic fatigue, there are steps organizations can take now to help inoculate them from the effects of the next crisis.

Market disruptions will continue to occur and the viability of an organization to continue to provide care for its patients depends on the ability to respond quickly and decisively. Here are some planning suggestions:

Set priorities—but not in stone. Now is the time to understand and clearly define your organization’s priorities. Begin by identifying each facility’s biggest need such as access (determining front entry location), service line growth (whether on or off campus), wayfinding, or capacity (whether too large or too small) and address it while maximizing value and minimizing expense. In many cases, hospitals have more than enough square footage, it’s just not optimally configured. Organizations should think strategically and critically about how to spend the limited capital dollars they have to leverage the most value. Set clear priorities, and then revisit them quarterly in order to build flexibility into this thinking.

Identify the variables. Planning and projections are only as good as the aggregate information. With all the information and statistics available on growth projections by service line, volumes, current capacity, and average length of stay (as well as how those numbers might change), it’s important to keep up to date on the data that matters.

One key variable is growth. Chart and project growth based on historic patterns and apply that data to project decisions. If the project doesn’t make economic sense based on historic data trends, it will make less sense when the unexpected, such as a global pandemic, natural disaster, or cybersecurity threat, occur.

For example, the campus of a nationally recognized comprehensive cancer care health provider had grown organically over time. As the facility’s surgical volume had increased, the surgeons had requested a dedicated surgeon’s lounge. The organization’s internal facilities group identified a 3,000-square-foot space adjacent to the operating room platform for the lounge. Before proceeding, the design team offered projected growth data to stakeholders, which concluded that the space wouldn’t accommodate the projected growth. As a result, the plans for a surgeon’s lounge were paused until a more appropriate location could be found.

Focus on BOTH the trees and the forest. Many healthcare organizations are so focused on day-to-day issues (the trees) that they don’t always see where they’re going. It’s important to take time to step back and look at the bigger picture (the forest) and develop a strategic master campus plan as well as a financial and market projection plan and address them equally. Visualize all the components of these plans along with the variables and priorities identified earlier, using a holistic and comprehensive approach.

For example, an urban hospital was planning a future lab expansion when it found itself needing to quickly bring a COVID 19 testing lab on-site. The facilities group recommended locating the temporary lab where the future lab expansion was planned. However, a review of the future lab program requirements revealed that the COVID-19 testing lab would severely limit the lab module efficiencies and future operations. The planning team was able to identify alternate space in the hospital to build out the testing lab that wouldn’t restrict or inhibit future growth and development. (Due to funding and regulatory issues, the project wasn’t implemented but it did highlight new opportunities for care delivery in relation to the overall master plan.)

Invite other perspectives. Approach strategic planning from an interdisciplinary perspective by inviting additional voices to the table, including frontline staff who understand the facility and protocols, as well as former patients, family representatives, and community leaders. This process will help obtain a better understanding of how customers perceive an organization and its initiatives. Another idea is to invite social anthropologists whose insights into human behavior and community outreach can be refreshing as hospital systems migrate from episodic acute care to promoting well-care. Population health requires a thorough understanding of the population in question and social anthropologists can provide that information.

Look to other industries and partnerships. During the early months of the pandemic, several hospitals reached out to hospitality chains to investigate space to convert for surge capacity. In the past, the healthcare industry had successfully leveraged lessons learned from the automotive industry and incorporated Lean principles into both operations and the design of new facilities. Due to increased pressure brought by value-based payment initiatives and other changes, it’s important that healthcare organizations form partnerships with different types of providers, as well as community organizations. Today’s healthcare systems are not prepared to deal with population health as it encompasses treatment, diagnoses, predictive analysis, and preventative care. No system can make this transition entirely on its own, but it can find success partnering with community organizations to determine growth strategies based on regional issues.

Consider climate change. From daily warnings of flooding during hurricane seasons to rare climate events like tornados and mudslides, it’s important to consider the impact of climate change when conducting crisis mitigation planning. But healthcare organizations shouldn’t focus solely on rising temperatures and rising sea levels but also on planning for the secondary effects of climate change, such as climate migration, whereby demographics may fluctuate considerably as people move from locations. As they migrate, unanticipated growth in certain areas might change the demographics and, in turn, how hospitals respond to them.

One shortcoming to crisis mitigation planning is that it can lead to inflexibility. Many people view the planning as defining concrete solutions to potential crisis events. The key is to stay nimble and allow your plans and facilities to adapt. Rather than identifying solutions, establish guidelines that allow your team to align the capital budget available with the future growth and potential events that could impact both.

The COVID-19 pandemic has taught healthcare organizations the importance of planning and being prepared for crisis scenarios. Now is an opportune time to look back on the lessons learned and apply them to future scenarios with the calculus underneath effective crisis mitigation planning.


Melanie Harris is healing practice director with BSA LifeStructures (Tampa, Fla.).  She can be reached at Chase Miller, NCARB, is director of planning with BSA LifeStructures (Indianapolis). He can be reached at