Angela Kolosky is associate principal and healthcare planning market leader at DesignGroup

Angela Kolosky (Image credit: Megan Leigh Barnard)

In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what has their attention and share their ideas on the subject.

Angela Kolosky is associate principal and healthcare planning market leader at DesignGroup (Columbus, Ohio), a multidisciplinary architectural, planning, and interior design firm.

Here, she shares the top five trends and issues getting her attention right now, including acuity shifts in healthcare, rural health, and trauma-informed design.

  1. Acuity shifts in healthcare

Over the past decade, there’s been a concerted effort to reduce low-acuity care  in emergency departments (ED) by moving patients to a more appropriate setting like an urgent care clinic and promoting outpatient services to limit the need for inpatient stays. This has been successful over the years helping reduce the strain on the ED, however, the pandemic created a significant shift to patients who are sicker. These patients tend to be more acute with comorbidities necessitating longer stays, need more resources, more likely to be admitted, and have a greater need for nurse and provider attention. Hospitals and EDs, despite general decreases patient volumes, may still need to increase their footprints to accommodate these extended lengths of stay.

  1. Rural healthcare

Whenever you pick up an article about rural healthcare, it often feels “doom and gloom,” with articles discussing another closure leaving communities without basic medical care. There are institutions, however, that are finding successful ways to manage costs, attract new providers, and stay local to keep delivering care, despite razor-thin margins. We’re seeing owners make larger re-investments in high-yield services such as specialty care and outpatient surgical services. Institutions are starting to keep specialty care closer to home, supporting chronic disease management, delivering local orthopedic care and recovery, and expanding access to behavioral health.

  1. Relationships

“Nobody cares how much you know until they know how much you care.” This quote, often wrongly attributed to my favorite president Teddy Roosevelt, sums up to me what it means to work within healthcare, especially for healthcare institutions and the architecture/engineering/construction sector. The impact of the trust we create with our clients for the long term to both them and their communities, ensures that architectural projects meet the needs of patients, staff, and the community. Our responsibility in the healthcare industry is being able to give honest, best professional opinions to allow for greater collaboration and communication within these multifaceted teams. Sometimes, even though architects like to build, operational solutions might be the right approach. The best idea might just come from your builder, and metrics must be tailored to the needs and culture of the institution.

  1. Staffing

Provider and nurse staffing shortages are a concern for health systems. Rising costs, the “do more with less” directives, and continued burnout for staff means more are leaving the field or not entering it at all. There’s also the high potential for a knowledge gap to occur between exiting experienced providers and the incoming new generation. Technology is laying the groundwork to improve the shortages by allowing what physical staff you do have to focus on what’s most important and more necessary for them to perform, like direct, bedside care and patient interaction. The future of artificial intelligence could include writing prior authorization forms, helping to speed up documentation and coding, allowing nurses and providers spend more time with their patients rather than paperwork. This could also be more physical with advent of “smart rooms” and technology that allows for remote monitoring such as in intensive care units when it might be difficult to have attending physician coverage.

  1. Trauma-informed design

Trauma-informed design is not a new concept; however, it has often been limited to work in behavioral and mental health settings. Trauma-informed design is finally gaining traction in its move beyond behavioral health clinics and inpatient facilities to help people wherever they are and in whatever circumstances they may be finding themselves in. A recent example is the new Directions for Youth & Families center in Columbus, which provides after school educational and counseling services to underserved communities, blends active and quite zones to let members chose how they want to engage, provides visual distractions, and purposely reduces the institutional feel through design by incorporating bright and playful spaces. We’re seeing this approach brought into community centers, schools, and even in the standard clinical setting, not just for patients but for caregivers as well. Techniques like active respite spaces, in addition to quiet areas, allows users choose the way they want to manage stress, transitional spaces that allow staff to decompress before heading home, or even the design of nurse stations to function more safely. These small, human-focused adjustments that we can make to a space’s design can in turn have tremendous impact on those who inhabit them.


Angela Kolosky is an associate principal and healthcare planning market leader at DesignGroup and can be reached at

Want to share your Top 5? Contact Managing Editor Tracey Walker at for submission instructions.