As a healthcare architect in private practice, I remember redoing the same space for a healthcare customer three times in three years. And it’s not because it was bad design! Initially, the need in the space was a doctor’s lounge; then medical records; finally, the space was converted into a cardiac care unit for the Emergency Department. Each time, the space was gutted and rebuilt!
Functional needs just change too fast for healthcare providers to effectively predict their future needs. As architects and designers, we must own this problem for our customers, not be a part of the problem. Designs must be planned to accommodate continuous change with minimal downtime and capital costs. We can no longer believe that our design statement is the perfect solution to a program since the program will likely change at some level—even prior to occupancy.
A five-year usage of a space is a long time; imagining 50 years is only wishful thinking. How we plan, design, and construct spaces that can change gracefully is the new basic requirement for sustainable design.