The Center for Health Design’s Built Environment Network (BEN) is a collegial network of executive-level professionals who are dedicated to improving safety, quality, and sustainability in healthcare. These industry leaders meet quarterly to tackle some of today’s most pressing healthcare design issues through open, strategic discussions that set a direction for the future of the built environment.

During their meeting this summer in San Francisco, the group discussed current challenges the healthcare design sector faces and the ways architects, contractors, engineers, and owners can work collaboratively to maximize operational outcomes and efficiency while also creating an enhanced experience for patients and their families through all phases of design and construction.


The challenges ahead

As part of their discussion, BEN members shared the challenges they expect to face in the industry during the next five years, with answers ranging from concerns about capital constraints and uncertainty in the political arena to creating flexible, affordable, and future-ready facilities. “I’ve been in the business for 30 years, and every year presents the same challenge—how to do more with less,” says Stephen Carbery, vice president, facilities, design, construction, and real estate at Yale New Haven Health System. “The larger projects tend to be well funded. Believe it or not, it’s the smaller projects that have trouble receiving funding.”

Cindy Nuesslein, a principal at Mazzetti + GBA, says the healthcare landscape is always a bit murky when the administration changes, leaving many with questions about the future of care delivery. “As I talk to my colleagues across the country, everyone is saying they’re closing their checkbooks for a while because they’re not sure how they will have to adapt,” she says. “People are sitting and watching, which prevents progress.”

Other BEN members identified challenges in continuing to expand their capabilities while driving down costs and creating sustainable solutions. Don Orndoff, senior vice president, national facility services, Kaiser Permanente, says his organization is focused on finding ideas that raise the bar on quality to support business needs and functions, while also presenting Kaiser “as stewards of the environment.” “If you’re not thinking about how the environment impacts the people who work and visit those spaces, that’s a problem,” he says. “We put a lot of focus on getting behind sustainability standards in terms of the types of materials we’re using to make the environment safer and more energy efficient. To accomplish this, we have to invest in high-performing systems to get improved building performance. And, of course, once you layer that on with affordability, that’s a big challenge.”

Carbery says another challenge he’s facing is labor shortages in different markets. “People are not going into the trades like they used to,” Carbery says. “Finding quality laborers, painters, and electricians that create good work on a consistent basis can be difficult.”

Paul Reiser, executive vice president, Boldt, agrees there’s a decrease in capacity of labor in the workforce. “The way to counteract that is through prefabrication, preassembly, and modularization,” he says. “Another countermeasure to that is uninterrupted workflow. There is so much waste in what we do in the labor industry and it impacts productivity. If we can create uninterrupted workflow, we can increase productivity.”


Building the right project team

As part of its discussion, the BEN group also identified the specific components that must be considered to deliver a successful healthcare project, with ideas ranging from having a common vision to getting the best suited team involved.  “You need the right people with the right personalities,” says Bob Biggio, vice president, facilities and support services, Boston Medical Center. “On top of that, you need to ensure they’re open-minded and understand and respect the multitude of perspectives the other team members may have.”

Carbery adds that the drive to success needs to start at the top. “Having a solid vision and commitment from senior management is key; and having an exceptional business plan falls right after that,” he says. “We’ve seen people start off in one direction and make changes midway and that’s something that can make a project unsuccessful. If you’re able to assemble a solid team paired with a strong owner, you’re on your way to a successful project that will deliver on all the outcomes and stay on or under budget.”

Biggio believes the way to ensure success is to incorporate an integrated project delivery (IPD) format, which guides all team members toward a common goal. “Sometimes what you want to do architecturally may not be in alignment with the owner’s needs and wants,” he says. “In order for architects and engineers to make that shift, [team members] need to be more open minded. They need to put themselves in the owner’s shoes and understand the perspective of what the owner would like. That requires everyone to check their egos at the door.”

Nuesslein adds that the project team can’t forget to incorporate the clinician’s perspective either. “Clinical design decisions are going to advance the industry faster than anything else. When we talk about efficiencies, sustainability, and patient satisfaction, we’re now realizing the built environment significantly impacts the quality of care,” she says.

For more information about the Built Environment Network, visit The Center’s website at

Amber N. Jones is a freelance writer for The Center For Health Design.