In the latest episode of Side Notes, the bite-sized version of Side of Design, BWBR’s Healthcare Practice Leader Ryan Johansen joins us for a quick but impactful discussion on the state of healthcare market. In less than 15 minutes, they explore how the industry is shifting from a model centered on treating illness to one focused on promoting wellness—and how design can support this transformation by addressing the needs of patients, families, and healthcare staff in holistic ways.
A Broader Definition of Health
When asked what excites him most about healthcare today, Ryan refers to the important evolution happening in care. “What excites me about the market itself is that shift from treating the sick to keeping people healthy. Physically, mentally, spiritually, it covers it all,” he says. “Physical health is going beyond just prevention and focusing on being well.”
He highlights the growing emphasis on lifestyle factors like exercise and nutrition, along with advancements in technology such as wearable fitness trackers, as empowering tools for people to take control over their own health. Mental health, he notes, has also become central to how we think about overall well-being. “The stigma is still there. We haven’t gotten over that yet, but the momentum towards openness, support, and innovation is stronger than ever,” he says.
And, as Ryan shares, spiritual health is increasingly being recognized as a social determinant of health—influencing resilience, motivation and emotional well-being. “So, what that means for me is that every project is a healthcare project. Because every project has a human interaction and can affect all three of those physical, mental and spiritual health.”
Pressures Amid Progress
While the shift toward holistic wellness is encouraging, healthcare organizations are still facing significant hurdles. “If you were to ask me to pick one challenge in healthcare—not possible,” he says. However, financial pressures are a difficulty Ryan consistently sees among clients.
Hospitals are operating under immense strain. Ryan explains that costs for staffing, materials, and construction continue to rise, while reimbursements often lag behind—creating a financial gap that many healthcare systems are struggling to bridge. “Hospitals run on razor-thin margins,” he says. “So, every change that happens requires a reaction from the organization, and there’s a lot of changes happening right now.”
Beyond finances, staffing shortages and burnout are major concerns. Healthcare workers are stretched thin, and many are facing emotional exhaustion. “The amount of change that’s coming at them at any one given time, plus those staffing shortages and burnout—that’s a big deal,” Ryan says.
Creating Spaces That Support
The current landscape demands resilience not just from healthcare leaders and staff, but from the systems and spaces designed to support them. For Ryan, it starts with a deep understanding of the healthcare market itself.
“At BWBR, we really try to understand how a business operates,” he says. This means looking closely at patient volumes, payer mixes, and department-specific reimbursement rates—factors that influence how an organization functions financially. “That really helps us design a facility that is not only sized appropriately to meet their community needs but also allows the facility to optimize those reimbursements that they do receive for providing care.”
But financial sustainability is just one piece of the equation. Ryan emphasizes that thoughtful design must also address the rapid evolution of technology, patient needs, care models, and more. “Change is constant, so if we build a static building, that’s not doing them any good,” he explains. “Designing resilient spaces that are flexible and easily adaptable—that’s where we can make a real difference,” he says.
And ultimately, design must prioritize the well-being of everyone who interacts with the space. “That’s from a patient to a family visitor to the staff that work there day in and day out,” Ryan notes. The right design can reduce stress, support better outcomes, and create a more human-centered experience for all.
Designing with Purpose
Healthcare environments touch everyone’s lives. “It’s not just the patient, it’s not just the family, it’s the staff, it’s everybody,” he shares.
That’s what makes great healthcare design so important to Ryan. He shares the story of his grandmother Laura, who suffered from Alzheimer’s at a time when treatment options were limited and healthcare environments were far less developed. He also remembers his grandmother Thelma, who experienced a brain aneurysm that dramatically altered her mobility for the rest of her life, as well as family members and close friends who have undergone cancer treatment, spending long hours and days in treatment rooms.
These weren’t just medical conditions, they were defining events that deeply impacted his loved ones’ lives. This is what inspires Ryan to create better spaces for healing. “Anything that we can do to make their experience more pleasant. To help them relieve stress, help them provide quality care and receive quality care,” he says. “To help improve their outcomes and help promote wellness to get them healthy—and to keep them healthy moving forward.”
