By Jamie Raymond RID, EDAC, LEED AP Partner, Four Point Design, Indianapolis
As the saying goes, a picture is worth a thousand words. While artificial intelligence tools can generate graphics in a matter of seconds, designers continue to appreciate the time, effort, and craft that goes into quality photographs of the built environment. The following are four factors design and construction firms should consider when engaging photographers to capture images of their healthcare projects.
Purpose
At Four Point Design, an interior design firm based out of Indianapolis and doing work around the country, we’re committed to quality photography to tell the stories of the spaces we design. While we regularly take out our phones and snap photos for documentation during the design and construction process, professional photography is a must. Whether we’re doing a case study or interviewing for a similar potential project, we need images that capture the essence of the interior environments, their purpose, and how they support the owner’s needs.
People
There was a time when architectural photography rarely included people. However, in recent years, the team has seen a shift, with more firms including the human element in their imagery.
While this takes a bit more coordination, it’s a change we’ve embraced, because as interior designers, we’re creating spaces for people. By incorporating people into our project photography, we activate the space, show its scale, and demonstrate how the environment will be used in real life. For example, during a recent photo shoot for IU Health Fishers in Indiana, designed with architecture firms HKS and MSKTD, we included moms-to-be for the women’s health services photographs and IU Health team members in the caregiver areas.
Process
Getting great photos requires an intentional, thoughtful, and respectful process.
We meet with our design partners to talk about the project’s goals and key components and generate a list of angles. We start at the front door and consider the patient journey as they move through the space. From showing the overall flow to zooming into details, we consider how we’re telling that story.
While we have the privilege to design the spaces, we are still guests in our owner’s facilities. A critical part of the process is planning and coordinating with the facility owner so that—on photo shoot day—the team is sensitive to any existing operations happening in the building.
Placement
From the angle of a chair to which desktop items are shown and how they are situated, details matter and affect what becomes the focus of an image. Taking care of the placement of items before the photo is taken results in less editing later.
We appreciate working with photographers who invite us to—quite literally!—look through the lens to make sure the scene is on point and supports the healthcare organization’s strong brand and the design team’s high standards.
Many of you may already know Marc Schweitzer—a respected healthcare architect whose work has helped shape more thoughtful, patient-centered environments across our industry. As a recipient of the Planetree Lifetime Achievement Award, Marc has spent his career advancing healthcare design in ways that truly impact people’s lives.
Today, Marc is facing a very personal challenge. He is living with kidney failure caused by Polycystic Kidney Disease and is currently undergoing daily dialysis while awaiting a transplant. A living kidney donor would not only improve his quality of life, but give him the opportunity to continue contributing to the field he cares so deeply about—and to spend more time with his family and community.
Like so many in healthcare, Marc has dedicated his career to improving outcomes for others. Now, he needs our help.
Even if donation is not something you can consider, simply sharing his story can make a meaningful difference. You never know who might be able to step forward.
To learn more, get involved, or help spread the word, please visit: marcneedsakidney.com
Sometimes the most impactful thing we can design is connection—let’s come together to support one of our own.
At OhioHealth Hardin Memorial Hospital, leaders were looking for a practical way to strengthen access to MRI services for their community.
Like many rural hospitals, they needed a solution that could support consistent imaging availability while remaining mindful of budget realities and patient demand.
For a period of time, the hospital relied on a mobile MRI trailer that visited the campus once or twice each week. While it provided an important service, availability was limited to the days the unit was on site, and patients had to step outside the building for their appointments. Hospital leadership began exploring options that could create a more permanent, convenient experience for patients while still fitting the scale and resources of the facility.
That’s where the idea of a prefabricated MRI suite came in.
Why a Prefabricated Unit Made Sense
For a smaller rural hospital, prefabrication can be an appealing option. Instead of constructing a full addition, the MRI room is manufactured off-site and then delivered to the hospital campus. The hospital still builds the foundation and makes the connection to the existing building, but the clinical space itself arrives mostly complete.
From a cost standpoint, that approach can be significantly more affordable than a traditional addition. It can also shorten the construction timeline.
For Hardin Hospital, it offered a way to move from a temporary mobile solution to a permanent MRI environment that was connected directly to the hospital.
Navigating New Territory
One of the most interesting parts of this project was learning how Ohio handles prefabricated healthcare units. These units fall under the industrialized unit code, which is different from the standard building code, so there’s a unique process for getting approval.
It was a great opportunity to dive into the process and figure out how everything fits together.
Working with a manufacturer who had already successfully completed a unit in Ohio made the approval process more predictable. It also showed just how valuable working with a team familiar with local requirements can be.
Prefabricated Doesn’t Mean “No Design”
Even though the MRI room itself is manufactured off-site, careful design and coordination are still key to a successful installation.
A big part of our role was reviewing the manufacturer’s design and making sure it actually worked with the hospital it was being attached to. Things like construction type and fire ratings still matter because once the unit is connected, it’s considered part of the hospital.
The connection points are really where the project succeeds or fails. We had to look carefully at how the door between the hospital and the unit worked, how utilities would connect, and how the foundation would support the unit’s platform.
The foundation in particular is crucial because the MRI suite sits on a raised platform. That meant recessing portions of the foundation and making sure the unit could be properly supported once it arrived on site.
Location also played a role. The unit connected near an existing exit corridor, so we had to maintain life safety clearances while still creating a functional pathway for patients and staff.
A Better Experience for Patients
The biggest change for patients is actually pretty simple.
Before this project, patients receiving MRI services had to leave the building and walk outside to the mobile trailer. Now the MRI suite is directly connected to the hospital. Patients stay in a conditioned environment with proper air quality and temperature control the entire time.
For a rural hospital, that’s a meaningful improvement. It creates a more comfortable experience and allows the hospital to provide imaging services in a setting that meets full hospital standards.
What We Learned
Looking back, there are a few key things that stand out from this project.
First, it’s important to work with a manufacturer who has already installed units in your state and understands the approval process. That alone can save a significant amount of time and frustration.
Second, even though the unit is prefabricated, you still need to approach the project the same way you would a traditional addition. Fire ratings, building codes, and connection details all need to align with the existing hospital.
And finally, the success of a project like this really comes down to coordination—between the hospital, the manufacturer, the design team, and the state approval authorities.
A Potential Model for Rural Healthcare
Despite some challenges along the way, the concept behind the project is still promising. For hospitals that can’t justify the cost of a traditional addition, prefabricated imaging suites offer a way to bring permanent services to their communities.
As codes continue to evolve, solutions like this may become more common—especially in rural settings where access to care is critical.
The key is understanding that while the unit itself may be manufactured elsewhere, integrating it into a hospital environment still requires careful design, coordination, and planning.
Designing effective healthcare spaces requires thoughtful planning, coordination, and attention to every detail. Our team partners with hospitals to create solutions that balance clinical needs, regulatory requirements, budgets, and patient experience. Contact us to see how we can support your next project.
Jessica is a board-certified healthcare architect with over 15 years of design experience. Her commitment to creating functional, efficient, and patient-centered spaces through well-coordinated drawings has led to a multitude of successful projects and clients. Her experience includes a broad range of project types with Parkview Health, Parkview Physician Group, Van Wert Health, and Franciscan…
Hospitals are often judged by what happens inside their walls – but the systems behind those walls determine whether care is possible at all. For Connecticut Children’s, the only hospital in the state dedicated exclusively to pediatric care, the need to expand was not simply a matter of growth. It was a matter of resilience.
Like many hospitals across the country, Connecticut Children’s was facing aging infrastructure. Its existing facility – nearly 30 years old – was operating with systems at or beyond capacity, limited redundancy, and equipment approaching the end of its useful life. Renovation options were increasingly constrained, and the hospital was running out of ways to modernize critical services while continuing to care for patients.
At the same time, demand for pediatric care was growing. Families across Connecticut were traveling long distances to access specialized services that the hospital aspired to provide closer to home. The organization’s vision was clear: expand access to advanced pediatric care, consolidate services, and create a modern, healing environment that could support patients, families, and clinicians – today and for decades to come.
The result is a new eight-story patient tower in downtown Hartford, designed to nearly double the hospital’s size and significantly expand clinical capacity, including much-needed NICU beds and critical care services. Behind the scenes, however, the project represents something even more transformative: a fundamental rethinking of how hospital infrastructure can be designed for uninterrupted care, adaptability, and long-term resilience.
Salas O’Brien served as the mechanical, electrical, plumbing, fire protection, medical gas, and technology engineer for the project, partnering closely with Connecticut Children’s, CannonDesign, DPR Construction, and design-assist trade partners to deliver a facility where no single system failure can compromise patient care.
Designing for zero downtime
From the outset, reliability was the project’s north star.
In the existing facility, a single failure could take out core services and directly impact patients. That reality shaped the new tower’s approach: full redundancy across all critical systems.
Power, air handling, medical gas, and life-safety systems were engineered so that maintenance, equipment failure, or external events would not interrupt operations. Electrically, the tower is fed by two new utility services connected to double-ended switchgear, creating a robust primary backbone. Emergency power is supported by N+1 generation and fully automated controls that allow generators to engage seamlessly during outages.
In a dense urban environment like downtown Hartford – where flooding risk, utility coordination, and limited site access add complexity – critical infrastructure required careful placement and protection. Emergency generators were elevated to mitigate flood risk, and utility upgrades were coordinated directly with city agencies to create reliability on a scale.
For a hospital, power consistency is not optional; it is fundamental to life safety.
Mechanical Systems Built for Resilience and Efficiency
The mechanical systems were designed with the same philosophy: no single point of failure, paired with long-term efficiency and adaptability.
Rather than relying on traditional high-temperature steam, the tower operates entirely on low-temperature hot water. Salas O’Brien engineered a new boiler plant and a chiller plant with year-round heat recovery, creating a system that is more efficient today and better aligned with the hospital’s future decarbonization goals.
Heat recovery chillers capture waste heat from cooling operations and reuse it for heating, allowing the building to heat and cool simultaneously while maintaining the precise environmental conditions required in pediatric and neonatal care. High-efficiency gas boilers with fuel-oil backup provide reliability without sacrificing performance, while operating temperatures remain compatible with future electrification strategies.
Water efficiency was also integrated into the system design. A condensate recovery system captures water from air-handling units and reuses it as cooling-tower makeup, supplying approximately 60 percent of demand in a high-use clinical environment.
Air Systems Built for Infection Control and Adaptability
In pediatric care, air quality and infection control are inseparable from patient safety.
The clinical space within the patient tower is served by three custom air-handling units, each capable of maintaining operations even if one unit is unavailable. Fully redundant air-handling systems support critical spaces, including C-section and fetal surgery operating rooms, infant resuscitation areas, and the sterile compounding pharmacy suite.
Patient rooms were designed to adapt as conditions change. In the event of an airborne infectious outbreak, acuity-adaptable rooms can automatically switch to full exhaust mode with some relatively simple control modifications, supporting isolation protocols without invasive renovations or operational disruption.
Medical gas systems were also engineered to support surge ventilator demand, allowing rooms to accommodate additional equipment during emergencies. The building was intentionally designed with a pandemic response mode, capable of supporting more patients, more ventilators, and higher-acuity care when it matters most.
Solving Complex Challenges in a Constrained Urban Site
Delivering this level of redundancy on a landlocked urban site required creative problem-solving.
One major challenge was locating the bulk oxygen system within tight spatial and code constraints. Through close coordination with fire marshals, city officials, and civil engineers, the team developed a compliant solution for the new tower that can backfeed the existing hospital, strengthening resilience across the entire campus.
Plumbing design required equal precision. Below-grade kitchen operations required pumped grease waste systems to reach street-level interceptors – another example of adapting infrastructure to site realities without compromising safety or performance.
Structural coordination was equally demanding. The new tower connects directly to the existing hospital, requiring alignment with floor-to-floor heights never intended for modern hospital systems. Early coordination and extensive prefabrication enabled major beam penetrations to be designed with large ductwork and piping in mind, reducing field conflicts and maintaining the overall construction schedule.
Delivering at Speed Without Compromising Quality
Time was a defining pressure.
Patient demand already exceeded capacity, with beds placed in temporary locations throughout the existing facility. Compounding the challenge, the project was launched amid post-pandemic supply-chain disruptions, with lead times for major electrical equipment stretching beyond 100 weeks.
To maintain momentum, Salas O’Brien worked closely with DPR Construction and trade partners to identify long-lead equipment early and release it before design documents were complete. This approach required rigorous risk assessment and clear communication, but it allowed procurement to move forward without sacrificing performance or reliability.
Releasing equipment mid-design is rarely comfortable for engineers. It succeeded here because risks were shared, decisions were aligned, and the team moved forward together.
Collaboration as a Design Strategy
That collaborative mindset defined the project.
Rather than a traditional top-down delivery model, the team adopted design-assist, bringing trade partners into the process early. Engineers, contractors, architects, clinicians, and facilities staff worked together in a “big room” environment, sometimes with dozens of stakeholders collaborating in real time.
Connecticut Children’s intentionally included voices from across the organization, from infection control teams to frontline nurses. While this approach added complexity, it made sure decisions reflected real operational needs.
Salas O’Brien’s long-standing relationship with the hospital strengthened this collaboration. Beginning with a mechanical and electrical infrastructure study in 2018, the firm brought institutional knowledge that helped define clear goals for redundancy, serviceability, and future readiness from day one.
A Healing Environment for Children and Families
While much of the project’s complexity lies behind walls and ceilings, its impact is deeply human.
The new tower reshapes the hospital’s presence in downtown Hartford, creating a welcoming main entrance on Washington Street with improved valet access, clearer wayfinding, and a more intuitive arrival experience. Inside, themed environments, natural light, and thoughtful finishes help reduce anxiety for children and families alike.
During construction, a nurse paused to look at the nearly completed tower and shared that what was being built would fundamentally change how she could do her job. The moment captured the project’s purpose more clearly than any technical metric.
Strengthening the Community
Beyond the hospital walls, the project has made a meaningful impact on the Hartford community.
The tower expands the hospital’s campus by approximately 40 percent, consolidating NICU and specialty services that were previously spread across multiple buildings. Families who once traveled out of state can now access advanced pediatric care closer to home.
The hospital partnered with the City of Hartford to improve Washington Street, committed to planting 100 trees in the Frog Hollow neighborhood, and coordinated parking solutions that benefit both hospital staff and local residents. Job fairs held with DPR Construction connected city residents to employment opportunities during and after construction.
Engineering for What Matters Most
At its core, the Connecticut Children’s patient tower demonstrates what’s possible when engineering excellence is aligned with purpose.
From redundant power and adaptable air systems to efficient mechanical design and collaborative delivery, every decision was guided by a single principle: children come first. The result is a facility built not just to operate, but to endure, adapt, and support care through whatever challenges the future brings.
For Salas O’Brien, the project reflects more than technical success. It represents a commitment to partnership, rigor, and designing systems that quietly – but powerfully – enable healing.
CT Children’s. Hartford, Connecticut.
Jeff Cichonski is a mechanical engineer with over 25 years of design and management experience. He is known for building long‑term client relationships through responsiveness, clear communication, and a balanced approach to design and project leadership. His work spans hospital expansions, complex renovations, and major infrastructure upgrade projects. Jeff serves as a Principal at Salas O’Brien.
Jim Norton has nearly two decades of design and leadership experience in the healthcare sector, contributing deep technical expertise and a collaborative approach to every project. His work spans master planning, new construction, and highly intricate renovation projects across diverse healthcare environments. Jim leads an MEP studio of 16 design professionals and serves as a Senior Vice President at Salas O’Brien.
There is a certain kind of work that rarely asks to be noticed, yet changes everything when it is done well. In healthcare, that work lives in the details most people never think to look for. The way equipment is organized. The way a room allows a nurse to move without hesitation. The way a space supports care quietly and consistently, without demanding attention.
At Paladin Healthcare, this kind of work has always been the point.
Paladin exists at the intersection of infrastructure and intention. It is a company built on the belief that the physical environment of care matters, not as an aesthetic afterthought, but as a functional partner in patient outcomes, staff wellbeing, and long-term operational success. What Paladin builds does not compete with care. It supports it. It creates the conditions for it to happen better.
That belief has shaped everything from the company’s origin story to its culture, its product philosophy, and its role in the healthcare community today.
Paladin Healthcare was founded in 2013 through a generational transition that was less about change and more about evolution. What began as Fairfield Medical Products became Paladin Healthcare, LLC, not to discard the past, but to sharpen it. The passing of leadership from father to son marked the beginning of a new chapter, one rooted in legacy but guided by a future-focused vision of healthcare infrastructure.
From the beginning, Paladin understood that progress in healthcare does not come from reinvention for its own sake. It comes from asking better questions. How do spaces need to function now? How will they need to function later? And how can infrastructure be built to evolve alongside the people who rely on it every day?
That mindset, respectful of history and relentlessly forward-looking, remains embedded in Paladin’s DNA.
More Than a Product Company
At first glance, Paladin may be known for its equipment rail systems. But reducing the company to a product category misses the point entirely. Paladin does not manufacture objects in isolation. It designs systems that think ahead.
The Universal ONE-Rail is a clear example. Built to integrate seamlessly with Modular, AMICO, Hill-Rom, and legacy Fairfield headwalls, the ONE-Rail was designed to solve a problem many healthcare facilities face quietly and expensively: the inability to adapt without rebuilding. Instead of forcing hospitals into costly tear-outs or rigid configurations, Paladin created infrastructure that absorbs change. Equipment can be added, moved, or upgraded without compromising safety, cleanliness, or workflow.
That adaptability is not a technical feature. It is a philosophical one.
Paladin designs for the reality of healthcare, not the idealized version. Departments shift. Technology evolves. Care models change. Infrastructure should not be the thing holding progress back.
What truly differentiates Paladin is not what it builds. It is how and why it builds it. Paladin’s company culture is deeply collaborative and rooted in listening rather than prescribing. The most meaningful innovations at Paladin rarely begin in a conference room. They begin in conversations with nurses, facilities teams, architects, and clinicians who understand the daily pressures of care delivery.
Listening is treated as a professional discipline. It informs design decisions, refines workflows, and shapes long-term strategy. Whether it is a nurse describing wasted motion during a night shift or a facilities manager navigating infection prevention protocols, Paladin takes those insights seriously. They are not anecdotal. They are foundational.
This culture of listening extends internally as well. Paladin is a team-driven organization where experience matters, curiosity is encouraged, and craftsmanship is valued. People are trusted to care deeply about the work they do because the work itself carries weight. When you are designing environments where life-altering moments occur, there is no room for indifference.
Built on Principles, Not Noise
The name Paladin speaks to the company’s moral center. Historically, paladins were protectors defined by loyalty, integrity, and service. That symbolism is not decorative. It is operational.
Paladin Healthcare does not chase trends or flood the market with excess. It does not lead with volume or spectacle. Instead, it operates with a disciplined restraint that reflects a deeper respect for healthcare environments. Every solution must earn its place. Every innovation must serve a purpose grounded in clinical reality.
This principle-driven approach is why Paladin’s presence in the industry is often quiet, but constant. It is why the company is trusted early in the design process, invited into complex projects, and relied upon long after installation. Leadership, in this context, is not about visibility. It is about reliability.
Paladin’s impact on the healthcare community is not abstract. It is measurable, lived, and experienced daily by the people inside the spaces it helps create.
Cleaner floors reduce infection risk. Elevated equipment minimizes clutter and trip hazards. Thoughtful layouts reduce wasted motion and cognitive fatigue. Flexible systems allow teams to respond quickly in moments when seconds matter.
These outcomes may not appear in marketing headlines, but they shape the quality of care in profound ways. They support healthcare workers navigating long shifts and high-pressure decisions. They create environments that feel calmer, safer, and more intuitive for staff and patients alike.
Paladin understands that supporting healthcare workers is one of the most direct ways to support patients. When a space works with the care team instead of against them, confidence grows. Efficiency improves. Burnout is reduced not through slogans, but through design that respects human limits.
Why No One Else Is Doing It Quite Like This
Many companies can manufacture components. Few can think systemically. Fewer still are willing to slow down, listen, and design for longevity in an industry often pressured by speed and cost.
What sets Paladin apart is its refusal to separate infrastructure from responsibility. The company does not see healthcare environments as static builds, but as living systems that must remain resilient over time. That perspective requires foresight, humility, and a willingness to prioritize long-term value over short-term gain.
Paladin’s independence allows it to hold that line. It allows the company to say yes to complexity, yes to collaboration, and yes to doing the work thoroughly, even when it would be easier not to.
As healthcare continues to evolve, Paladin Healthcare remains steady in its mission. Sustainability, adaptability, and human-centered design are not trends to follow, but commitments to uphold. The company will continue to learn from the field, refine its systems, and build infrastructure that supports care without ever overshadowing it.
There is a quiet confidence in knowing your work matters even when it goes unnoticed. That confidence defines Paladin.
Because when a hospital room works the way it should, when everything is exactly where it needs to be, care becomes clearer. Movement becomes easier. Outcomes improve.
And in those moments, Paladin Healthcare has done its job.
By Bill Ledger, AIA, ACHA, NCARB, EDAC, LEED AP, LSSGB Jessica Detweiler, AIA, ACHA, NCARB
Healthcare renovations are complex by nature.
They involve aging infrastructure, active patient care environments and regulatory oversight—all at the same time. Projects that perform well rarely do so because construction is easy. They perform well because the groundwork was thorough.
Success in renovation is largely determined before construction documents are complete. Seven principles consistently separate stable projects from reactive ones.
1. Define the Real Problem Before Defining the Solution
Renovations often begin with a stated need: more space, better flow, updated finishes. But the stated need and the actual operational issue are not always the same.
Careful workflow analysis—tracking patient movement, staff circulation, equipment staging, and material flow—often reveals whether the constraint is square footage or process. In some cases, expansion is necessary. In others, targeted reconfiguration or operational adjustments provide greater impact.
Establishing this clarity early prevents oversizing a solution—or underbuilding one.
2. Align Leadership and User Groups Early in the Process
Leadership establishes strategic goals, financial boundaries, and institutional priorities. User groups understand daily operations and workflow friction. Both perspectives are necessary.
When user input is delayed until later design phases, revisions often occur, sometimes increasing cost and almost always extending schedules.
A more stable process allows leadership to define parameters first, followed by structured engagement with user groups early enough to validate assumptions before design progresses too far.
3. Separate Feasibility from Full Design
Budget challenges frequently stem from premature cost commitments. When financial expectations are set before scope and infrastructure conditions are understood, projects become constrained by incomplete information.
A phased planning approach mitigates this risk by involving architects, engineers, and cost estimators early. With an initial feasibility study, the design team can gather appropriate information, test fit the needs, evaluate workflow and infrastructure, and create a schematic cost estimate based on current market trends and knowledge.
Once the feasibility study is complete, healthcare teams can move confidently forward into a full design effort.
This sequence allows decision-makers to approve projects based on informed data rather than preliminary assumptions.
In healthcare environments, infrastructure—mechanical systems, electrical capacity, medical gases, IT—often drives cost more significantly than visible architectural elements. Evaluating these systems early stabilizes financial planning.
Many healthcare facilities have experienced decades of modifications. In an ideal world, health systems will maintain a record of all of the renovations that have occurred to better inform the next one. Having a systematic approach to documentation and drawing storage is incredibly helpful in planning future work, especially when systems above ceilings and within walls may be nearing end-of-life or may not comply with current codes.
A proactive facility assessment identifies:
Infrastructure lifecycle status
Code compliance concerns
Structural limitations
Deferred maintenance liabilities
These findings can materially influence renovation strategy. In some cases, the cost of upgrading legacy systems outweighs the benefit of renovating certain spaces, prompting reconsideration of scope or approach.
5. Make Phasing a Core Design Consideration
Healthcare facilities rarely have the option to suspend operations during renovation. Surgical suites, laboratories, emergency departments, and inpatient units must remain functional.
Airflow control, infection prevention measures, egress continuity, and life safety compliance must be maintained throughout construction. Early coordination with construction managers or contractors improves phasing realism and helps ensure building systems remain operational during transitions.
Phasing plans may evolve as field conditions are discovered, but addressing them early reduces disruption and change orders.
6. Engage Regulatory Expertise Early
Healthcare renovations often trigger life safety, occupancy, and code compliance considerations that vary by jurisdiction. Interpretations from Authorities Having Jurisdiction (AHJs) can differ significantly.
Engaging regulatory consultants or initiating early discussions during study or schematic phases allows teams to confirm code strategies before documentation advances. Although not all jurisdictions accommodate early consultation, pursuing clarity early reduces the likelihood of redesign during review or after construction begins.
7. Plan Around Staff Productivity
Construction impacts operations beyond the physical footprint of renovation.
Temporary walls, modified circulation paths, and staging areas can unintentionally disrupt patient transport routes or staff workflows. Without understanding how clinicians and support staff move through a department, construction sequencing can introduce inefficiencies.
Collaborative phasing discussions that include clinical staff, designers, and construction teams allow operational realities to inform construction logistics.
Renovation Success Is Determined Before Construction
Healthcare renovation projects are inherently complex, but they are not inherently unstable. Stability emerges from disciplined planning.
When these seven elements are in place, construction becomes the execution of a well-tested plan rather than continuous adjustment.
By: Jen Worley, RID, EDAC, LSSYB, Interior Design Principal, BSA and Joe Sagen, RA, NCARB, RID, Senior Architect I, Architectural Lead – Indianapolis, BSA
As healthcare systems grapple with workforce burnout and increasing staff turnover, hospital administrators are recognizing that designing for staff wellness is no longer optional, it’s essential. The physical environment has a profound impact on the well-being of those who spend their days delivering care. Beyond creating healing spaces for patients, forward-thinking hospitals are investing in environments that promote the health, connection, and recovery of their own staff.
Designing for staff wellness means looking at the facility through a different lens, one that places equal priority on those who work in it. It involves embedding opportunities for rest, nourishment, collaboration, and restoration within the fabric of a healthcare campus. From daylighting strategies and lounges with views to outdoor access and nourishing food, the elements of design can make a real difference.
Natural Light: A Fundamental Wellness Tool
Numerous studies and WELL Building concepts affirm what caregivers already know intuitively: exposure to natural light boosts mood, reduces stress, and helps regulate circadian rhythms. For healthcare staff who may work 12-hour shifts or rotating schedules, consistent access to daylight is critical in supporting alertness and psychological well-being.
For years, hospital layouts have placed patient rooms along exterior windows, pushing staff spaces to the interior. Today’s designs are rethinking that approach. For instance, projects that incorporate light wells allow daylight to penetrate interior corridors, giving staff exposure to light even in the heart of a building. Likewise, some facilities are deliberately positioning nurse stations and break areas near windows or using glass walls to bring light deep into core staff zones.
Elongated nurse stations are used to open corridors, improving both visibility and the flow of natural light. This subtle shift in design not only supports wellness but enhances safety and team communication, especially during off-peak hours when staff may feel more isolated.
Importantly, these daylight strategies are being applied in both inpatient and outpatient settings, reinforcing a consistent message that staff wellness matters, no matter where care is delivered.
Respite Spaces That Feel Like a True Break
While every hospital has staff lounges, too often they are tucked away, windowless, and functionally sterile, more utility room than sanctuary. Designing for staff wellness demands more. Respite spaces should provide a visual and emotional contrast to the clinical environment, offering caregivers a chance to genuinely disconnect, even for a few moments.
At a recently completed facility, the look and feel of the staff lounge was intentionally designed to be softer and more residential. Warm tones, natural materials, and comfortable seating signal to staff that this is a space for restoration. These intentional visual cues help staff transition mentally, allowing a true break from the high-acuity zones where they work.
BSA took this concept further in a sports medicine clinic, offering framed views of the mountains from staff break rooms. This access to nature, even if it’s just through a window, helps reduce cognitive fatigue and provides a moment of calm in the midst of a demanding day. Where possible, staff should also have access to outdoor areas. The adjacent gym and café outdoor space allow staff to step outside, get fresh air, and return to being re-energized.
Encouraging Healthy Lifestyles
Supporting staff wellness extends beyond the shift. By integrating healthy lifestyle amenities into hospital design, administrators can encourage long-term staff resilience and retention.
The above-mentioned sports medicine clinic provides a dedicated gym, offering an on-site fitness option for employees before or after hours. Locker rooms and showers make this easy to access and discreet. When wellness is built into the environment, it becomes more accessible, more realistic, and more widely used.
Likewise, the provision of healthy food, available quickly and close to break areas, makes a tangible difference for caregivers working within the constraints of short break times. Food lockers, like those piloted locally at a hospital here in Indiana, allow for scheduled delivery of nutritious meals, reducing the time spent traveling to and from the cafeteria. Staff can eat better, faster, and with more intention, which supports both physical health and morale.
Designing for Connection and Collaboration
Wellness is not only physical, but also social. Hospital environments that promote collaboration, reduce isolation, and encourage team-based care contribute to staff satisfaction and engagement.
One key way this is being achieved is through wider-than-code corridors. At an orthopedic hospital, for example, the corridors were designed intentionally to allow for impromptu staff interaction and informal huddles. These spaces are not just for transport; they become dynamic areas for teamwork and human connection.
Shared lounges and break spaces can also be used to promote cross-pollination between departments. When different care teams intersect in these areas, it fosters a broader sense of community and opens the door for interdisciplinary collaboration.
Flexible care team stations can use modular furniture that can be easily reconfigured to suit team size, workflow, or even mood. This kind of adaptability in design gives staff more control over their environment, another contributor to wellness and professional satisfaction.
Designing with Intention
Designing for staff wellness is not about adding luxury; it’s about removing barriers to well-being. When architects and hospital leaders work together with intention, it’s possible to create spaces that nurture those who care for others.
Strategic shifts, such as placing a window by a break room or widening a corridor, can transform how staff experience their day. More strategic moves, like embedding daylight into core zones, adding gyms or healthy food lockers, or designing shared collaboration areas, can redefine what a hospital means to its workforce.
The message is clear: the healing environment must include the healers themselves. By investing in environments that support staff well-being, hospitals are investing in quality of care, workforce stability, and long-term organizational health.
Last month, I was in Houston for PDC, and once again I came home reminded of just how important it is to gather in person. PDC is always a great opportunity for me to reconnect with friends, board members, and Symposium speakers, and it also happens at just the right time of year. As we’re pulling together the conference program, I get to have deeper conversations about what’s happening across the industry and what kind of educational content will be most meaningful—and most helpful—for everyone this fall.
One of the unexpected highlights of the trip was a driving tour of the Texas Medical Center. Patrick Casey and Daina Pitzenberger generously took several of us around and shared their insight and experience as we moved through what is, quite honestly, an incredible concentration of healthcare, research, and academic institutions. Seeing hospital after hospital, research facility after research facility, all packed into such a relatively small area, was pretty awe‑inspiring. The level of innovation and life‑saving work happening side by side there has an impact that reaches far beyond Houston—and in many cases, far beyond the U.S.
The day continued with a visit to an active construction site: the new LBL tower at Harris Health. We started in the project trailer, where we got an overview of the site through drone footage, which immediately put the scale and complexity of the project into perspective. From there, we looked through boards of selected finishes, which really helped bring the future building to life.
Standing there, it was hard not to reflect on the significance of what’s being built. This project will have a profound impact on an underserved community—one that truly needs access to high‑quality, compassionate healthcare. While the Texas Medical Center represents world‑class facilities with global reach, the LBL tower represents something just as important: care delivered close to home, designed with intention, and rooted in service.
Experiencing both in the same day was powerful. Two very different places, each essential in its own way. One pushes the boundaries of research and innovation on a global scale; the other meets immediate, local needs with dignity and purpose. Seeing them up close wasn’t just informative—it was deeply moving.
It was truly an honor to see this work firsthand, to learn from those leading it, and to be reminded of the many ways our collective efforts—large and small—shape the health and well‑being of communities near and far.
With all the snow and ice piling up across New England—and freezing temperatures gripping so much of the country—it definitely feels like we’re in the thick of winter. And honestly, with everything else happening in the world, a lot of us are feeling that cold a little more than usual.
One thing that really helps? Talking to the people around us. A quick chat with a coworker. A check‑in with someone who looks like they might need it. A moment of real conversation can remind us we’re not carrying things alone.
That’s what I love most about the Symposium community. Every year, people from all different backgrounds—designers, clinicians, engineers, planners, and so many others—show up ready to learn, share, and lift each other up. It’s not just about building better healthcare spaces; it’s about building them together.
And our Advisory Board is the perfect example of that spirit. They met last month in Tampa, and as always, they brought their whole hearts to the table. It wasn’t just a meeting—it was a reminder of what can happen when passionate people gather with a shared purpose.
As we move through February, let’s keep leaning on each other. Talk to the people around you. Ask how they’re doing. Be that small spark of connection someone might really need.
Because if the Symposium community proves anything, it’s that we’re stronger—and more inspired—when we show up for one another.
Why lighting, air quality, cleanliness, and cross-functional collaboration matter more than ever—and how ARC Facilities supports the mission.
by ARC Facilities
Hospitals and clinics are built for healing—but creating environments that truly promote health goes beyond clinical care. Today’s Facilities Managers (FMs) are stepping into the role of patient experience champions, shaping spaces that impact outcomes, and support comfort, calm, and trust. Through intentional design, strategic maintenance, and cross-functional collaboration, they’re helping patients feel safer, more cared for, and more at ease.
Facilities decisions—from lighting and air quality to noise levels and cleanliness—carry emotional and physical weight. And with tools like ARC Facilities making it easier to access building documentation, manage preventive maintenance, and respond quickly to issues, FMs are better equipped than ever to make decisions that serve both regulatory needs and the patient experience.
From Gloom to Glow: Lighting That Heals
Lighting may seem like a background element, but it plays a front-line role in how patients perceive their care.
“One clinic I oversaw had been designed to outdated standards. The interior featured dark green walls and narrow hallways, which gave the space a gloomy, almost cave-like atmosphere. The lighting was inconsistent, with most bulbs casting a yellow hue that made the environment feel dim and dated. I initiated a refresh by repainting the space in a light, calming green and replacing all lighting with daylight-balanced LED bulbs to brighten and unify the space. After these changes, patient satisfaction scores related to the environment jumped dramatically, rising from consistent one-star responses to five stars on post-visit surveys. It was a powerful reminder of how much the physical environment can affect a patient’s experience,” said Jamie Duggins, Strategic Operations & Project Management Leader.
A brighter, more inviting environment improves mood, and reassures patients that they’re receiving quality care.
Having access to building plans and asset locations, via a mobile device makes upgrading lighting systems less disruptive and more efficient.
Designing for Comfort and Compliance
Facilities teams must create spaces that feel safe and restorative.
“Balancing compliance with comfort starts with understanding that both goals can be achieved with the right planning. I bring together design and operations to create spaces that meet all regulations while still feeling welcoming and supportive. For example, I selected smooth, durable wall coverings such as FRP in high-traffic areas. These met safety and durability expectations while also improving the appearance and cleanability of the space. I chose paint finishes that could be wiped down easily, reducing the need for constant touch-ups and helping clinics look cleaner and more professional,”
With ARC Facilities, these upgrades can be photographed and shared with team members through a centralized platform—ensuring nothing falls through the cracks and documentation is instantly accessible for inspections or updates.
Healing Spaces Start with Collaboration
Healing environments don’t happen in silos. FMs who collaborate with clinicians and designers early on create spaces that better reflect patient needs and staff workflows.
“In mental health settings, collaboration with clinical teams and design professionals is essential to creating environments that support emotional well-being and therapeutic care. I involve clinical staff early in the planning process so that decisions reflect their daily workflow and the needs of the patient population. Their feedback helps guide choices that go beyond function, focusing on comfort, privacy, and calm,”
ARC Facilities enhances this collaboration by making real-time building documentation and renovation history available to all stakeholders—so teams can make informed decisions faster.
What Patients Notice First
From the moment a patient walks in, their perception of care is shaped by the environment. Facilities teams must prioritize what matters most.
“Cleanliness and lighting are usually the first things patients notice. A bright, well-maintained space immediately communicates safety and care. Because of this, I prioritize strong custodial processes and updated lighting systems. In several facilities, we replaced outdated fixtures with daylight LED lights to make exam rooms and waiting areas feel more open and comfortable,”
“Noise also plays an important role, especially in behavioral health settings. Many clinics use white noise machines near counseling rooms to protect privacy and promote calm. Air quality can be more variable, depending on the age and condition of the building. In older facilities, I worked closely with HVAC vendors to resolve issues quickly and ensure a comfortable environment. Patient surveys helped identify which improvements to tackle first, always starting with the factors that had the biggest impact on how patients felt during their visits,”
By using ARC Facilities to proactively track equipment locations, FMs stay ahead of potential issues and respond more quickly to patient feedback.
Facilities and Clinical Care: A Vital Partnership
Respiratory health is one area where the connection between facilities and clinical outcomes is unmistakable.
“As a respiratory manager, I’ve seen firsthand how critical facilities teams are to patient care, especially when it comes to respiratory health. Their work goes far beyond compliance; it has a direct impact on patient outcomes, safety, and experience,” said Jacob Parker, Manager of Respiratory Care Services, Riverside Community Hospital.
“Air quality is obviously a big one for us. Proper ventilation, filtration, and negative pressure room maintenance are essential for protecting vulnerable patients, especially those on ventilators or with chronic lung conditions. I’ve seen how even minor HVAC issues can increase infection risk or delay recovery, so when our facilities team is proactive, it makes a huge difference,”.
“Noise control is another area that gets overlooked but affects respiratory patients significantly. When patients are in distress or struggling to breathe, a calm and quiet environment helps reduce anxiety and promotes better rest. We’ve worked with our facilities team on things like replacing loud equipment and adjusting alarm volumes, and it’s made a real impact,” Jacob said.
“I have seen HCAHPS scores improve after a targeted project with a previous facilities department I worked in enhanced air handling and reduce noise complaints in the ICU. It’s a great example of how facilities and clinical care are more connected than people think,”.
The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is a national, standardized, publicly reported survey of patients’ perspectives of hospital care.
Supporting the Mission with ARC Facilities
Facilities teams are evolving into essential drivers of the patient experience. With ARC Facilities, they’re empowered to work smarter—accessing critical documents instantly, managing maintenance more effectively, and planning improvements with clarity and speed.
From daylight LEDs to silent HVAC systems, the work of facilities managers leaves an indelible mark on patient care. And now, with better tools and stronger collaboration, they’re helping healthcare spaces heal more than just the body—they’re supporting emotional recovery and peace of mind, one thoughtful decision at a time.
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