What Drives Healthcare Design Decisions Today: LIVE from HCD in KC

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1:36Would you rather have a partner that spots problems before they happen or have a partner that crushes crises in the moment? From my experience, you can't spot all the problems. And so I'd rather have someone that's quick thinking when there's a moment that happens that we aren't planning than constantly think that we have everything but not. We have contractors that we've worked with that have come to us ahead of time and like, hey, we see this coming. But I really appreciate the ones in the moment. They're like, oh, we have to pivot like now and we have to fix this now. And they're not trying to fix it for us.

2:09They're saying, how can we help you fix it? Yes. So I think this is more of a cultural thing of if you have a team that can spot problems before they happen, even if you don't catch all of them, you are going to be better equipped in those crises in the moment. You can't really have one without the other in a really good team environment.

2:29What you just heard is a clip from the opening exercise of our second in a series of live events, where I spoke to a room of over 60 healthcare end users, designers, manufacturers, and dealers as part of the Healthcare Design Expo in Kansas City. Now, nearly 95 % of the room said that they would rather have a partner that spots problems before they happen, while only 5 % said that they'd prefer a partner who crushes crises in the moment. So what does that tell us? That even in a sector built on constant complexity, the teams shaping healthcare spaces aren't looking for heroes. They're looking for partners who help avoid the crises altogether.

3:15Welcome to Season 9 of Design Nerds Anonymous. I'm your host, Amanda Schneider, founder and president at ThinkLab and speaker now featured on TED.com. In this episode, we're going to take you live inside our experiential research event at the 2025 Healthcare Design Conference. We call it a hackathon. It's where we bring together leaders from across the design ecosystem to unpack how decisions for the built environment are evolving. Now, 63 people RSVP'd and 61 showed up on a Sunday morning in the rain. That level of turnout reminds us why these conversations matter. Because when the people shaping healthcare spaces come together, ideas move faster, and even the toughest challenges start to feel solvable.

4:09So as you listen in, remember, you can get a half CEU credit just by listening to this podcast and taking a quick quiz. You'll find a link to that quiz in the show notes. Here are the four learning objectives for this episode. Number one, why decision-making for healthcare projects feels more complex and harder to align. Number two, what healthcare end users actually need from their design, construction, and product partners. Number three, you'll hear the practical ideas generated from our cross-functional table discussions that help create clear starts and smoother handoffs in the process. And finally, number four, you'll learn simple shifts that you can bring back to your own teams to strengthen alignment, improve communication, and help healthcare projects move forward with more confidence.

5:06Now, in case you didn't catch last week's episode from our corporate event in Chicago, This one will follow a similar arc, but with insights unique to the healthcare sector. First, we'll start with voices as our participants arrived. Real-time snapshots of what healthcare leaders, designers, and product partners were thinking about before the session even began. Then you'll hear what followed that Would You Rather warm up, which led into my keynote on the top five challenges shaping healthcare projects today. Next, you'll hear highlights from our end user panel, where two healthcare leaders brought those challenges to life through their own lived experiences.

5:48After that, you'll step inside our cross-functional brainstorming session, where nearly 60 participants work together to reimagine practical ways to solve our industry's challenges. And finally, you'll hear real-time reactions from our on-site podcast confessional. Let's begin with a few of those pre-session voices. I am Charmi Deepak, work with UC Davis Health from Sacramento, and I am a project development program manager. What would you say is the biggest challenge facing people in your role today? People. You know, at the end of the day, we work with people for people. Everyone is unique in on ideas, identity requirements, and priorities, and how do you align all of that to streamline a project or among the plethora of needs in projects, like how do you prioritize something?

6:44That's a challenge. What would you love to see from your partners as you think about all the people that you are trying to corral internally to get to a decision? What advice or requests would you have for your external partners? Don't afraid to speak up if you have a better idea than your clients, because the clients rely on, you know, vendor partners as much as vendor partner needs clients. And I think that relationship needs to be more open, transparent. You know, if you messed up a project, raise your hand today, not tomorrow, not, you know, after five weeks of trying to fix it. You want to round up the trips, help them.

7:23So I think the relationship and raising the escalations earlier on, being open, transparent, and working as a team, essentially, and not as, you know, a vendor. I'm going to give you a magic wand. Fix anything about our industry, the industry that you work in, that helps make your projects more successful. What would you do with that magic wand? Transfer all the historical knowledge that retiring industry leaders have to the young leaders. And I think you will start to see this amazing transformation happen because the new leaders have new ideas, new ways, new technology, and the elder leaders or the retiring leaders have a ton of knowledge and wealth about people and how to make it, that will be a success.

8:14I'm Michelle Ribbentrop. I'm with Leo A. Daly, a new addition to the firm, and I joined their Minneapolis studio. An industry that is so complex like ours, our internal champions have to translate up a bit more. Whether you're a design firm, how you visualize, whether you're a product manufacturer, how you position things, how you speak to those folks that are in the room. So can you talk to that a little bit? Yes, absolutely. Design is communication. The simplest form design is communication. And even if we are designing in 2D, 3D, no matter how we want to present that, we need to make sure we're communicating to our clients in a method that they understand.

8:48At the very simplest core, they're going to understand a process. And so if you can communicate your design through their process efficiencies, they're probably going to get on board with you and they're going to make more efficient and faster decisions. And do you find most designers at any firm you work with, do you feel like you're trained in that communication level, in that connection level, or do you feel like that is an opportunity for our industry to up-level and maybe learn a little bit more about how to fit into their business and process mind versus our creative minds? I think that's an opportunity for everyone.

9:20no matter where you are at the start or the end, because every client, you're meeting them where they are in their journey. And it is also an opportunity that I think was missed within our mentorship within the industry, is you have to have these strong leaders that understand how and why it works. You have to be able to self-reflect and define your own process. And with that, you can then lead the next generation in that process. And so if we as senior leaders understand how to to get clients to move forward in an efficient manner, then we can also train the next generation in. And that means that our voices are being represented even when we're not in the room, or when they're not in the room, that we're getting that moving forward on a continual basis.

10:03Really well said. Okay, I'm giving you a magic wand. You can fix one thing about our industry that makes your job getting your projects moved through the system faster. How would you use that magic wand? Critical thinking skills. It is not only in interior design and architecture and engineering. It is how we need our leaders on the other side to also communicate with us, whether they're CEO management, security, in charge of nursing, doctors. No matter what that segment is, is we need critical thinking. Part of that is that when we hit go on a project, we're expecting some of that process to have already started.

10:40And so the background, the kickoff, the information that's needed at step one, if it's not there within your internal team and within your client team, then you do need to slow down. You do need to ask them all those questions and allow them to think about it. You do need to allow your client, their leadership, to go back to their people and say, how do we want this to look? Because if they have not had those conversations and they didn't have anybody leading those conversations, you can't expect the process to move along because you do have to pause then. And so that critical start of every project having the necessary information is going to be what drives the future and drives the quickness of your process, I would say, throughout the entire project.

11:22What you just heard were conversations before the session even started, and they were already circling around the same pressure point. Healthcare projects don't fall apart in the middle. They struggle at the start. People, priorities, communication styles, leadership changes, everyone's moving fast, but not always together. And when the why isn't clear, the how gets really messy. So that's exactly where we began our session. In my opening keynote, we shared new ThinkLab research uncovering the five biggest challenges shaping healthcare decision-making today. The systemic forces behind the very issue these participants were already naming out loud.

12:06So whether you design, build, or support spaces that heal, join us for a front row seat inside the future of healthcare decision-making. Here are just a few of the five challenges I shared in my opening keynote that happened to resonate most in the room. First, cost management is in a phase. It's now the entire project. In healthcare, even small changes can snowball. What used to be one round of value engineering has become an ongoing balancing act of cost, scope, and schedule. As one private research participant told us, we spend a lot of time just trying to anticipate cost escalation. Finance wants tighter estimates up front, but everything still changes anyway.

12:52Second, more people, less alignment. Healthcare projects now have more stakeholders than ever, from compliance and IT to outside consultants and third-party operators. that means decisions take longer and communication gets murkier. One voice summed it up perfectly. So many people are part of the project now. I'm not always sure who's actually making the call. And third, projects are moving faster, but with less clarity. As leadership turnover accelerates and priorities shift, teams are feeling the pressure to move quickly, sometimes too quickly. One research participant shared, it feels like we're building the plane while we're flying it every time.

13:42Speed is essential, as we know, but not if it replaces strategy. Now, of course, those were just three of the five that we explored in the interest of keeping this brief. You can find the full list and deeper dive in the link in our show notes. Now, let's turn it over to Standout Design Group's very own A.J. Perrone, who hosted a fantastic live panel with two of our healthcare decision makers. You'll get to experience what our audience did in the room. ThinkLab data coming to life through real stories from these leaders navigating the complex projects inside their own healthcare systems. You'll hear them introduce themselves, then respond to a diagram of a heat map showing where the most pain surfaced in our research for healthcare projects today.

14:28Now, the first voice you'll hear is our end-user panelists, Miranda. Here's Miranda.

14:37So I'm Miranda Morgan. I'm currently at UT Southwestern Medical Center down in Dallas. I'm an architect and medical planner by trade. I'm assistant director of facilities, planning, design, and construction. But everything I say is from my experience, not the vantage point of the university. What's one word to describe how your project process has changed in the last five years? Evolving, ever evolving, and nowadays even more so. With leadership changing at the medical center, we have three pillars. We have a business center, academic, and then healthcare. So it depends on who's on first that month.

15:12It evolves constantly. The priority is shifting, so we have to shift our targets, our projects, and everything that goes along with it. Lauren, up to you. I was saying earlier, I need a disclaimer to add in front of my spiel as well. My name is Lauren Cole. I'm System Director of Design Strategy at Providence Health, based primarily on the West Coast. And my background is in interior design and environmental psychology. And what is your word that has described how your project process has changed in the last five years? Yeah, I thought a lot about this. And I settled on radical because if we think about the past five years, like life has changed so much.

15:54And I think there's a collective realization that the way that health care is built and delivered in the United States isn't really working the way that we need it to. And so there needs to be some radical thought in order to get us back on track. Okay. As we look at this heat map and where we were feeling the pain all the way across, what surprised you? That it's not more red? Not more red. Is there something down here that doesn't surprise you that you're like, yeah, this is the part where the rubber really meets the road and this is where we have a lot of challenges? No, I think it's spot on.

16:28We are our own worst enemy. The front end being the most red is very true. We have high expectations, high lofty goals, and things that we want, and you can't get 60 things out of a bag with only$30 in it. If we can meet our own expectations in the beginning, the project starts out better. If we aren't over-challenging our design teams and our construction managers and everyone else that's involved at the end of the process, we get a better product. But when we walk in the door with unrealistic expectations for the finances, is unrealistic expectations for the space, unrealistic expectations for the users.

17:11That's where we're going to make the mistake. We have to rein ourselves in half the time. When I look at data like this, I tell our vendors, and regardless of if it's service or product or whatever, you have to teach us how to be good customers. So all the frustrations that everybody has in the room about the decision-making process is really hard and why does it take you so long to create a PO and whatever anybody says. A lot of times we don't know how to be good customers and we need partners that teach us because we're going to have a whole bunch of people in the room who will work on one construction project their entire career.

17:51And so their lens on it is not the same as those of us who work on some type of design and construction all day, every day. So I keep preaching to our vendors, like, we need you to teach us to be good customers because we don't know how. What's your best word of advice to help you keep this decision-making process aligned and going as smooth as possible? I think it's really important in the state of the industry right now to be able to connect the dots both to the future and then back to the metrics that the health system is tracking. So people ask me, how do I sell better to the healthcare system?

18:28Well, we don't buy things based on pretty. You need to connect the dots for me. And you have to take it much further forward than what I'm thinking. So if you can tell me that this thing I'm going to purchase from you, this widget, will last me not only the 10 years that manufacturers like to give us as a warranty, but if you tell me it's really going to last 25 or 30, which is the more realistic lifetime of this project, awesome. I'm in. because we're always trying to figure that out. And it's really hard for institutions to stay up on some of that. Your expertise, really bring it forward. That's what we're looking for.

19:03I'd add one more thing to that too. And that is the healthcare industry in particular, owners, we have done ourselves a disservice by getting so standardized that now we are treating design partners, different vendors across the ecosystem. We treat you guys like order takers. We need you to come back and be designers again. We don't just want the room. I appreciate when I have it, and this may only be me, so correct me if I'm wrong. I want a design firm to challenge me. If we're doing something that's crazy or that somebody else did and it didn't work, tell me about it. I don't want to repeat somebody else's mistakes.

19:44Same with, you know, we have a lot of the furniture vendors that we work with will come to us and say, like, what's the chair? I don't know what the chair is. You tell me what the chair is. We don't have that standards program. That's not our goal. We're never going to get 52 hospitals to agree on a paint color. Come to the table showing me some solutions and make the decision making easy. We had a vendor one time ship 80 textile samples to our office to a person who's a medical planner and really doesn't care. Do you really think they're going to go through those 80 textiles and make a decision?

20:22a smart decision and then make it quickly like no you have to set us up to make those good decisions yes now we are the system that does have those standards yay for us okay but we do expect our a's and our a and d partners to challenge those decisions you know we do have the 30 chairs you know we do have a special colorway we have all those things but we still expect you know for for you to look at it. We really don't recommend that you go there. Let's help you revamp it. Let's help you update it. Let's help you pivot at this point. We're always looking for that as well. Well, Lauren and Miranda, thank you so much.

21:02Were they not great?

21:06And that was the close of our end user panel. Now, if that panel showed us anything, it's that healthcare teams don't need more options. They need clear guidance, stronger partnerships, and help connecting decisions back to what truly matters. Because we know that behind everything Lab Data Point are these real people, project champions, facility planners, designers, and even caregivers. This panel gave us a window of empathy into their world. We got to hear their reality in their own words before shifting into problem solving mode. So from there, we turned the tables. Literally. Each group chose one of those top challenges we uncovered, from cost management to stakeholder alignment, and asked a single question.

21:53So what do we do about it? The next hour was fast, messy, and full of ideas from end users, designers, and manufacturers alike thinking out loud together about how to make healthcare projects not just faster, but smarter and more human. What you'll hear next are highlights from that shareback session. Each table will start by naming the challenge they tackled and then share the spark of insight their conversation ignited.

22:25I have been christened as the spokesperson for this. Okay, so our choice was to do projects are moving faster with less clarity. I will say we kind of dipped into number four a little bit in our discussions as well. And so we had a lot of discussions about different points in the process. And what we were trying to do is get back to, okay, how do we better manage it? So it's not necessarily all questions. It's a little bit thinking about process as well. So we talked a lot about the fact that through the project, there can be a lot of miscommunication that happens because people are saying words, but having different interpretations of it.

23:01But so, you know, what can we as practitioners do to help them understand that language and what we're asking them? And, you know, maybe introduce yourself as a translator for them to be able to help them through the process so that that doesn't exist. And then in that discussion to really set up the fact that, you know, there's an openness to new ideas. you know maybe starting starting point for some people that were mentioned is starting with some templates of this is what we do and this is kind of a standard way of thinking now let's talk about how that's going to work for you and adapt it and then really bring to the table that it all ideas are open it's it's just a matter of they need to understand that there are major ripple effects in the process and really starting a dialogue using words like trade-offs right so that that can be part of the whole project process amazing okay we're going to come to table two next tell us by saying which question you chose and what what maybe one idea was i'm going to use the we word because that was our keynote and we all decided on question five projects are moving faster with less clarity we actually have sort of a trifold timeline that looks at the timeline of the project the standards and the cost all along the continuum of the project.

24:22We wanted to understand that this is a system level, Emily is our client, and that, but you still have to localize it to the geographic region, the population, the way that you, the way you do things in your neighborhood. We wanted to make sure that the operational leader was at the table. Visualization was critical, not just for the actual project but for the process and that led us into talking about Miro and Miro boards especially with the new narration capability of the Miro board where you can actually talk through the board and leave a note and why that's important because the people at the beginning of the project the legacy people are not there when the new CNO comes along or the new CFO so we want to make sure that we have a archival history that doesn't require a lot of scrolling because you know if it's more than two clicks no one's looking.

25:19All right table six who's our spokesperson at table six? I'm Jillian with Lurie Children's. We found in our discussion we were struggling with a topic and found that we kept circling back to cost management so number one and starting at the beginning with trade-offs, pros and cons for material specking and what that means in terms of downtime or maintenance in the future, communication, which I heard a lot in number five, identifying your stakeholders, full range, anybody who you think might be in the project and then who they think should also be in the project, documentation and organization.

26:02So AI and meeting minutes was brought up, having AI just record the meetings so that that documentation is there. Good. I love that that group got into AI. Good job. Okay. Our table also did the first one talking about cost management and how to be a little more proactive. And so we identified through the process how really Revit and BIM management has changed the industry over the last few decades and that we're now needing information earlier on to make our models and our documents more accurate up front. And with that, our clients are not always having the right leadership in the room to make those decisions.

26:43And so it's kind of back to your point of who's not represented in this room, why aren't they represented? Also talking about decision fatigue with leaders that aren't maybe at that executive leadership point, and we need to make sure that they are confident in making those decisions early on. As the process goes through, we also discussed that we need to be better at educating our clients about the process and where costs can be changed and associated with the different phases. So if it best behooves them to say, yes, we are going to bid this project with technology or furniture making these assumptions.