Healthcare Is Evolving: What’s Changing and What’s Staying the Same

Healthcare continues to evolve, and the spaces where care is provided are changing with it. From large-scale hospital expansions to the growing role of ambulatory care, healthcare facilities are being designed to support more than just treatment. In 2023, we spoke with Dustin about the trends shaping healthcare design. We caught up with him again to see what has changed, what has stayed consistent, and what he expects to influence healthcare facilities in the years ahead.

When we last talked about healthcare in 2023, you mentioned several trends shaping the industry. Looking back, what has changed most, and what has stayed consistent?

“Telemedicine is here to stay, but it doesn’t really appear to have had a significant impact on the healthcare built environment. The same can be said for small, local clinics. They are prevalent and likely aren’t going anywhere, but they don’t seem to have diverted resources away from the construction of main hospital campuses. Lately, we have seen a pivot back to large, sometimes very large, healthcare projects entering the market. That’s despite very high construction costs. Another shift from the traditional acute-care hospital is a greater emphasis on being a community hub for wellness, not just a place to go when you’re sick. While the latter is still true, many new hospitals are positioning themselves as more inviting and welcoming spaces where people can go to help maintain good health, not just be healed.

Lastly, with advancements in treatments and techniques, increasingly significant procedures can be performed in an ambulatory setting that doesn’t require overnight stays. Patients can often receive the treatment they need and leave the same day, whereas the same treatment in the past may have required a multi-day stay in the hospital.”

What makes healthcare renovations particularly challenging?

“There are two things. First is often age. Hospitals are institutions that hold on to their existing buildings for long periods of time. Often, renovations are in buildings that were constructed based on very old building codes that are no longer applicable. Bringing existing structures like this into compliance with current building code can be challenging.

Second is unforeseen conditions. Because some of these buildings have been around for a long time, there have often been modifications to the existing structure that are either not documented or we don’t have accurate documents to review. It is not uncommon to uncover structural modifications that are no longer applicable and are often problematic for the job at hand.”

How does keeping a facility operational during construction affect engineering?

“This is a significant challenge for hospital renovations. We have to give special attention to materials, construction types, sequencing, and more. It’s not always the space you are working in. Sometimes you have to consider how your work affects spaces either on the floor above or below the one you’re actually working in.”

Can you share an example of a unique healthcare challenge RLG helped solve?

“We had a hospital project where the owner wanted to build a vertical expansion at a location where there was existing rooftop mechanical equipment. We phased the design and construction so they could keep the mechanical equipment running and servicing the existing spaces while they built the shell of the expansion around the existing equipment.

Then they could install new rooftop mechanical equipment on top of the new expansion and get that equipment operational before taking the existing equipment offline. After that, they came back and built out the interior floors of the new expansion space.”

 

What do you think will have the biggest impact on healthcare facility design over the next five to 10 years?

“In the DFW area, the largest and most obvious impact is the continued growth and expansion of the area. Hospital systems are continuing to increase their footprint into areas further and further from the city centers of Dallas and Fort Worth. 'Follow the rooftops.' "

Healthcare design will continue to respond to changing communities, advances in treatment and the evolving ways patients receive care. For engineering teams, that means designing facilities that can support today’s needs while remaining adaptable for what comes next.