The Designer Will See You Now: Building the Future of Healthcare

Great health care doesn’t happen by accident. It’s the result of dedication and innovation — and that necessitates more than knowledge and compassion. It also demands the right tools, systems, and infrastructure. BWBR is operating at the leading edge of health care design, creating spaces that are thoughtful and inspired, catering to the principles of the IHI Triple Aim. The IHI Triple AIM addresses three elements imperative to a successful health care system:

  1. Population health
  2. Experience of care
  3. Per capita cost

If only two sides of the equation are intact, the system begins to fail. And right now, the system is struggling to maintain optimal functionality. Design and the design process are powerful tools capable of increasing efficiency, controlling costs, improving patient outcomes and patient, family, and staff experiences, and addressing the complex and shifting needs of the population.

Design Matters

It’s difficult to overstate the importance of design in the health care system. While it doesn’t grab all the headlines, design is immersive and omnipresent. It’s in the number of patient rooms available, compared to how many people are on staff. It’s in how much light each room gets and at what time of day. It’s in the distance from the patient’s bed to the bathroom, and from patient rooms to the nurses’ station and the elevators. It’s in the way the space sounds, looks, and feels.

And while there’s nothing basic about the work that goes into these nuances, these are just the basics. There’s so much more that goes into design, and the future of health care depends on the decisions made next. Trends in health care design are about innovating to deliver on the Triple Aim in new and groundbreaking ways.

Power in the Pods

Health care pods are one great example of where the industry could be heading. These compact pods enable efficient delivery of general services (e.g., “primary care plus”), including temperature checks, skin checks, nasal swabs, vital checks, and potentially even X-rays and other minor procedures. Health care pods are cropping up on college campuses, as well as other locations where populations may not have the knowledge, resources, interest, or comfort level to access legacy health care services. Health care pods have tremendous implications for individuals experiencing homelessness and those in rural areas.

Pods can help reduce the number of people seeking primary care services from urgent care clinics and emergency rooms, which frees up these spaces for urgent and emergent medical needs. Pods can also cut down on the number of symptomatic people crowded in a medical facility, which can help mitigate the spread of disease and provide a more comfortable setting for those who are apprehensive about crowds and/or contagion. The design of and strategy behind these pods is critical, because they should be cost-effective to build and maintain; equipped with the right resources to support providers and enable care; and an accessible, pleasant setting for patients.

In Value Veritas

Health care pods support another emerging trend: the shift toward value-based care. How much time are providers spending with patients? What decisions are they making? What resources are they using? What value are they providing? Smart design can help facilitate value-based care to help control costs while enhancing outcomes and experiences. It means designing for group care or so that providers can easily see virtual patients in a day. It means making it easier to care for patients before they are in your building. People born in 1960 have seen health care costs as a percentage of GDP rise dramatically over their lifetimes, from around 5% in 1960 to close to 18% in recent years. Meanwhile, the health care industry continues to face a serious staffing challenge. Additional costs and fewer staff combine with a third factor — an aging and increasingly sick population — to pose a serious threat to the IHI Triple Aim.

The design process creates opportunities to ask questions and build with intent. What are room utilization rates? Can patients check in from the parking lot and follow a line on the floor to their room without needing interaction with multiple staff members? How big of a check-in space is needed? Are we creating space simply for the sake of creating space, or can it be strategic and value-added? Where can we infuse virtual reality so providers can keep their skills sharp and patients can see models of what they should anticipate?

Post-Pandemic and Beyond

Health care design met a significant curve in the road during the pandemic. Hospitals have been overflowing, while at the same time many outpatient visits were delayed or cancelled or moved to telemedicine. Some patients declined to receive care, choosing to delay or go without care. Health care technology companies were able to rapidly innovate to provide telemedicine as fast as clinicians were providing the care. Now, the industry is trying to figure out how to plan for the next significant factor in care. Do we build to accommodate another or different pandemic? Or do we embrace a permanent shift toward telehealth? How do we do both?

There’s no one-size-fits-all solution. The best designers cater their work not to the industry as a whole but to the specific needs and objectives of a client and that client’s specific patient population while staying true to industry trends. Some are highly tolerant of virtual care, while others prefer to interact face-to-face. Some locations necessitate large medical facilities–others would benefit from a higher percentage of strategically located health care pods.

Achieving the Triple Aim means considering these factors at once, as well as considering not only what’s needed now but what may be needed tomorrow, and years down the road.

BWBR Welcomes New Principal Brian Zabloudil

BWBR is thrilled to announce that Brian Zabloudil, AIA, ACHA, LEED AP BD+C is joining the firm as our newest principal. He will be based out our Omaha office as a Senior Medical Planner. With his experience and thought leadership, Brian will lead our health planning group and will play a key role in mentorship and the overall strategic direction of BWBR’s healthcare practice.

BWBR President and CEO Stephanie McDaniel, AIA, LEED® AP says, “We are so excited to add Brian’s depth and breadth of planning experience to our already amazing healthcare team, expanding our capacity to continue powerfully serving our clients in Nebraska and nationwide.”

Brian is a native of Hastings, Nebraska and a graduate of the University of Nebraska in Lincoln. Before joining BWBR, he spent nearly 20 years at HDR as a Health Principal and Pediatric Health Practice Leader. Brian has devoted his entire to career to healthcare design and has led the planning of projects with Mayo Clinic in Rochester, Minnesota; Children’s Minnesota in Saint Paul, Minnesota; Monument Health in Rapid City, South Dakota; Children’s Hospital and Medical Center in Omaha, Nebraska; Boys Town National Research Hospital in Omaha, Nebraska; Grand Island Regional Medical Center in Grand Island, Nebraska; Methodist Hospital in Omaha, Nebraska; Lurie Children’s Hospital in Chicago, Illinois; Sentara Health in Norfolk, Virginia; and Children’s of Mississippi in Jackson, Mississippi. Brian brings a deep level of leadership and guidance in strategic healthcare programming, planning, advocacy for his clients, and will be an integral part of BWBR’s healthcare team.

“I am deeply passionate about creating healing and comforting environments for patients, their families, and care providers. At my core, I find it incredibly fulfilling to know that our work inspires and offers hope to those that are experiencing one of the most stressful events of their lives. In the end, what we do is about helping people.” Brian says. “BWBR offers a unique blend of strategic planning expertise and hands-on, personal project delivery. I am really looking forward to being a part of a practice and a team with such a rock-solid foundation and culture.”

Welcome, Brian!

Navigating Hybrid Work When Your Field is all about Place

Hybrid and remote work are now the norm across a wide range of industries, and while the shift was a long time coming, it was clearly accelerated by the pandemic.

But what happens when you work in an industry where place is everything? At BWBR, we literally design spaces for people to connect and collaborate. How do we reconcile that with our own work policies? BWBR project manager and architect Jarett Anderson hosted a conversation with senior project manager Mallory Furlong and principal and operations director Stefnee Trzpuc to talk about it.


BWBR embraces a flexible hybrid work approach that we call FLEXForward. It allows employees to decide how they best do their work. The three flex options are resident (on-site), hybrid, and distant (remote). Stefnee explains that hybrid is the dominant model chosen by current BWBR staff, who come in to the office somewhere between one and four days per week. “Individual work styles are really important to how we design the future of our work,” she says. “As a hybrid organization, we need to understand what it means to thrive as hybrid in our design processes, our operations, our teams, our tools, how we serve our clients, and how we use our physical and virtual space.”

Indeed, hybrid is arguably the most challenging of the three options within the Flex Forward approach. When a team is in the office full-time, it’s easy to plan for that. It’s also easy to plan for a fully remote team. The hybrid approach demands a workspace that’s flexible, that provides enough desks for people to get work done and enough meeting space for people to have sessions together, and space to accommodate small cohort brainstorming all the way to large team gatherings.

Fortunately, creatively and strategically designed spaces are something we know a thing or two about.

Creating Space

When considering a structure like FLEXForward, Stefnee recommends that organizations pursue team agreements. Team agreements involve a group agreeing to standards of how to approach a project, when people are going to be available, what tasks need to get done, how often they’re going to gather in person, where they’ll gather, and so on. Establishing these standards up front paves the way for fewer roadblocks and miscommunication down the road — and can also help a team consider the physical spaces they’ll need to support their agreements.

Mallory adds that even the most well thought out agreements demand room for flexibility. Perhaps initially, a group thought it was realistic to all get together on Tuesdays and meet for half-days on Thursdays, but that doesn’t turn out to be practical. Other workload creeps up, or there’s an illness, or family obligations get in the way. For Mallory, transparency is key in instances like this: “We’re all people, and even when we have a plan, those plans can be interrupted. Open the door for conversations with your teams and be transparent about what’s happening and what you need.”

Having flexible physical spaces can help teams navigate uncertainty in hybrid schedules, too. It might not make sense to dedicate a large office space to one function, but what if it can flex and be a brainstorming room, extra workspace, a place to cater in lunch, or whatever the moment calls for? For this to work, design is key. Nobody wants to do their best creative work in a place that’s clearly meant to be a cafeteria, or vice-versa.

Collaboration Above All

Regardless of whether the BWBR team is on Zoom or in the office together — or some of both — collaboration must be at the heart of everything. BWBR’s culture is built on collaboration and mentoring and sharing ideas. Distinct perspectives and the inherent tensions that spring from those distinctions are fundamental to creating exceptional environments that transform lives. That means we need to be intentional about how we connect, even if we’re not in the same room.

We want that for our clients, too. Around the world, organizations are reimagining their professional spaces and wondering how they can create the best path forward. How can they cater to flexible work structures? How can they best serve their clientele in inspiring spaces when the future is uncertain?

Hybrid work is a major design challenge, but it also opens up new possibilities to redesign spaces to facilitate the flow of knowledge throughout an organization, within and beyond its walls. The world now knows that collaboration doesn’t always require physical presence, but at the same time, having occasions to get together make those opportunities even more impactful — and demand spaces that can harness the moment.

Better For All

Mallory and Stefnee agree that a major plus of the FLEXForward structure is that it invites people to bring their best selves to work, giving everyone agency to decide how and where they work best. Says Stefnee, “if we can all bring our best selves to work and build deep relationships, balancing team needs and employee needs, we’ll not only have better experiences as an organization, but we’ll also come up with better design solutions for our clients.”