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SEPTEMBER 24-26, 2024
Austin Convention Center - Austin, Texas

The Leaflet

How to design a hospital in 10 days and live to tell the tale

August 19, 2021

By Jennifer Voigt, AIA, LEED AP, BD+C, EDAC, Project Leader, Associate Principal

What happens when a generation-defining global pandemic meets the immovable object that is a state’s certificate-of-need calendar? Throw the traditional linear design process in the waste bin, and rethink.


With an already-approved Certificate of Public Need (COPN) in hand for a greenfield hospital, the leadership of this health system made a bold decision. Due to a recent merger, they needed their facility strategy to respond to their organizational realignment – which meant submitting a COPN for a larger program, including more beds and expanded service line offerings. The caveat? The state’s COPN deadline meant they only had two weeks to complete the design.

How We Responded

Eager for a fresh perspective, the health system entrusted Kahler Slater to drive a process to not only provide the COPN deliverables in two weeks, but also set the project up for success. Since this was Kahler Slater’s first project with the client, we did a deep dive into the organization’s mission, strategic vision, and decision-making structure.

Kahler Slater responded with a two-pronged process that aligned with the client’s internal structure. The leadership at the local market guided strategic vision and value, building design, and clinical decisions. Simultaneously, the system’s planning, design, and construction leadership team directed real estate, site design, and jurisdictional concerns.

Rapid Response Tools

An every-other-day virtual workshop cadence provided structure, allowing the team to build and refine from one to the next. The key to success was an arsenal of Kahler Slater rapid-response tools:

Days 1 & 2

Stakeholder Alignment and “Data In”— Kahler Slater developed online surveys for metrics of project success, guiding principles, and key volumes/space drivers and sent to stakeholders in advance; results were reviewed for consensus and fresh eyes.

Days 3 & 4

Space Programming Automation — By providing just a few key space drivers, our automation tool instantly produced full, room-by-room space programs with about 90% accuracy. Our team of expert planners took it the rest of the way, accounting for market uniqueness. We took a programming process that typically takes four weeks and did it in two days.

Day 5

Rapid Prototyping and Scenario Planning — Did we mention we designed not only one project in the two weeks, but three? Since the outcome of both the COPN process and the internal capital allocation request was unknown, we devised a scalable project. We developed three scenarios to the building design, with full detail for each version of the project.

Many designers start with a base project and devise “growth zones” for the future. We did the opposite; we started with the 30-year end game as a fully realized project and scaled back to two fully functional milestone projects from there.

Days 6 & 7

Aesthetic Stakeholder Alignment — Historically (pre-2020, that is), before developing a campus identity, we engaged our clients together in an in-person Image Survey activity to gather aesthetic preferences in real-time. Since the pandemic restricted us to a virtual-only engagement, we needed to do it differently. Our in-house web developers and graphic designers created a virtual image survey activity. Easily accessible via phone, computer, or tablet, it guided stakeholders through a series of images to discern their tastes, with an emphasis on simple comments on each picture. As we reflected on the success of the tool, we realized the previous in-person approach had perhaps silenced all but the loudest voices in the room. The virtual tool gave users the freedom to provide feedback at their convenience and pace and encouraged more input from a wider sampling of stakeholders.

Days 8 & 9

Design Iterations — Using visualization tools such as virtual reality, flythroughs, and sketches, we quickly built upon the aesthetic preferences from the image survey responses. With multiple brand identity options for the client’s consideration, one option rose to the top – leadership agreed it elevated their brand identity to represent the multi-faceted, high-tech, modern provider their community recognizes them as.

Day 10

Button it Up — We used this final workshop to finalize all the COPN deliverables which included full space program, operational narrative, renderings, site plan, and full schematic floor plans (at a room-by-room level). We revisited the guiding principles set at the beginning – and ensured these deliverables were aligned.

Key Takeaways

Build flexibility and convenience into the design process for greater stakeholder engagement. The pandemic has opened eyes to how virtual engagement can sometimes be superior to in-person, in terms of expanding stakeholder engagement in the design process. It can be difficult for a busy surgeon to break away from practice to attend a twice-monthly design meeting, sometimes across campus. By moving the platform online, we have seen a significant increase in provider participation.

Speed to market is critical in these times of unprecedented change in healthcare. In the last year of the pandemic, among widespread upheaval, the one certainty was that all our clients needed to implement solutions quickly. An arsenal of rapid response design tools can help test more scenarios and quicker than traditional design delivery.

Plan the plan. When moving quickly, it is tempting to immediately dive in and start ticking boxes. By creating a workshop schedule with a singular focus at each touch point, we were able to keep the decisions in sequence from big picture down to small. Shared buy-in between ownership and the design team meant everyone knew what needed to be accomplished with every precious hour.

Statement of Success

We took a 12-week Concept Design process and synthesized it into 10 days. Along the way we established a new partnership, and rapidly created and deployed new automated design tools, breathing innovation into the process. Simultaneously, we provided a design solution that best reflects the client’s evolving brand identity and provides them with two fully alternate planned future growth scenarios.

Necessity is the mother of invention – and innovation. This experience left us armed with the right tools and a reinvigorated process that brings more flexibility to our clients.

Author: Jennifer Voigt, AIA, LEED AP, BD+C, EDAC, Project Leader, Associate Principal

About Kahler Slater

Kahler Slater designs to enrich life and achieve powerful results. Through architecture, interior design, strategic advisory, and environmental branding, Kahler Slater’s dynamic collective of marketplace experts and creative thinkers harness the power of design to move boldly forward. With clients in the United States, Canada, and Singapore, Kahler Slater designs for civic and cultural, healthcare, higher education, corporate workplace, residential, hospitality, and sports, recreation, and wellness sectors. Kahler Slater is known for leveraging design to help clients achieve their strategic goals for advancing their organizations. They operate offices in Milwaukee, Madison, Chicago, Richmond and Singapore. Follow Kahler Slater at, on LinkedIn, Facebookand Instagram.