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.

Barbara Wagner is senior vice president at Clark Construction Group-California (Irvine, Calif.). Here, Wagner shares her thoughts on tapping the wisdom of focus groups, the growing need for speed in bringing new healthcare facilities online, and how resiliency considerations can turn design on its head.

1. Collaboration and integration

A highly collaborative approach to building—one that’s inclusive of not only design, construction, and hospital facilities personnel, but also physicians, staff, and patients—yields a superior healthcare facility that promotes efficiency and fosters healing. Early inclusion in collaborative design sessions ensures that the finished facility meets the needs of its end-users. This all-inclusive approach sets the tone and structure for how team members impart and share knowledge and work together in a transparent environment focused on the project’s ultimate success. It also helps patients become partners in their care, as high levels of patient engagement make them more likely to follow up with their doctors, continue their medication, and maintain healthy living practices.

2. Always be innovating

In healthcare construction and design, we look for ways to be innovative while also working within the confines of the industry’s strict code requirements. For example, in the recently completed Southeast Louisiana Veterans Replacement Hospital in New Orleans, a major challenge was designing the facility to be able to remain fully operational during a storm or natural disaster and meet the Veterans Affairs’ antiterrorism security requirements. A shatterproof-glass façade was used that does double-duty by protecting occupants from the impact of an explosion or the 129 mph winds of a Category 3 hurricane. This facility blazes a new trail in terms of how to create a resilient facility and how to integrate that with the VA’s security standards.

3. Speed to market

Owners’ expectations related to speed to market continue to grow, requiring design and construction firms to identify and deploy new and innovative measures faster than ever before, without compromising on quality. For a hospital replacement wing project for Ventura County Medical Center in Ventura, Calif., Clark Design-Build, OSHPD, and Ventura County implemented a collaborative design-build approach that allowed them to deliver an accelerated delivery schedule. By phasing the project, the design, permitting, and construction could progress incrementally, which enabled construction activities to commence as soon as a sufficient design was in place—well before the overall design was completed and approved. Through this approach, the project went from programming to completion in four years—record speed for a California acute care hospital.

4. Value to the community

As Healthcare Design editor-in-chief Jennifer Kovacs Silvis wrote, “… healthcare facilities are becoming anchors of communities rather than outliers, opening doors to neighbors and supporting healthy initiatives—all in an effort to keep people well rather than treat illness.” We see this throughout the country with hospitals demonstrating leadership in health promotion by hosting farmers’ markets on their campuses as a way to make fresh, locally grown produce and other foods more readily available. These efforts also help strengthen local economies and communities—ultimately strengthening both the hospital’s mission as a community institution and the community’s ability to sustain its own population healthfully.

5. Flexibility

As the healthcare model continues to evolve, designing in flexibility is a necessary best practice. This requires stakeholders to think about the facility’s immediate requirements and look ahead to anticipate future needs, so that changes can be done without significantly impacting the design or facility. Among the considerations to plan for are: adding updated medical equipment and new technologies; incorporating modularity in the design to create larger or smaller spaces when needed; designing departmental adjacencies to enable one department to grow into another depending on future needs; and incorporating shell spaces, which can help reduce future renovation costs.

Want to share your Top 5? Contact executive editor Anne DiNardo at for submission instructions.