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.

John Michael Currie is a 40-year veteran of the healthcare design industry and serves as vice president of healthcare at Baskervill (Richmond, Va.). Here, he shares his thoughts on infection prevention, project budget constraints, and the importance of beauty in healthcare spaces.

1. Learn what your clients know

Design professionals need to deliver new approaches that stretch capital dollars to provide greater returns. I spend a part of my research time every day reading what my clients read. I’m looking for common ground so I can understand where planning and design can contribute to solving problems while addressing cost and accessibility issues.

2. Expand the view—and approach—to patient safety

Patient safety is a familiar topic, but I think our industry needs to start considering infection prevention, errors, physical harm, and the stress of care together under the rubric of patient safety and not as siloed topics to be addressed by different people. Planning and design can address every facet of this expanded view of patient safety, from proper material choices and mechanical systems to physical support for ambulation and acoustical control. The staff has the same needs for safety, too. Provide a setting that supports careful care processes and think about the unfortunate consequences of failing to do this.

3. Support clinical efficiency

Old rules of thumb about planning no longer apply. Today we need data and analysis to inform design.  With the shortage of primary care physicians and the increase of non-physician providers (nurse practitioners and physician assistants), who will see more patients and what is the nature of these encounters as this shift occurs? How does this change influence planning? Exam room counts, shared visits, communications technology, the evolution of the patient centered medical home, and other factors can add efficiency if we plan and design using this knowledge.

4. New financial formula: Costs increases, revenue decreases, and constraint on capital

A recent article in Fortune, “It’s not Obamacare that really has hospital execs worried,” by Laura Lorenzetti, makes a very complicated issue quite clear. In the piece, the author outlines that labor shortages and increased labor costs will inevitably hit the cost of care. Reductions in payments will hit even harder. And the reduction in revenue (especially inpatient revenue) will make things tougher.  Health systems are reluctant to take on new debt in the face of this unpleasant formula.

5. Beautiful designs are not unaffordable

Economist and Stanford Graduate School of Business professor Alain Enthoven said, “In some cases our hospitals are rather more beautiful than we really need, if we are trying to get health care out to all Americans.”  Perhaps the word he was looking for was “extravagant” rather than “beautiful.” We should never forget the elevating effect of beauty on humankind. People respond to beauty – with benefits too numerous to discuss here – and it does not need to break the bank. This is what design professionals do, and, at the end of the day, it may be the greatest benefit we bring.

John Michael Currie

Want to share your Top 5 ideas in 2015? Contact senior editor Anne DiNardo at for submission instructions.