Perspectives February 24, 2025

Building Blocks of Adaptable Hospitals

By Jeffrey Keilman and Kenneth Webb

University of Virginia, University Hospital Expansion

When the COVID-19 pandemic surged during construction, our design team helped retrofit 84 patient rooms to support critical needs and prevent infectious disease spread.

Inpatient hospital environments are undergoing a profound transformation. As advancements in healthcare migrate significant care to outpatient settings, hospitals are increasingly serving the “sickest of the sick”, patients with the highest acuity and ICU-level care needs. The COVID-19 pandemic further revealed the limitations of existing and aging hospital infrastructure, as many facilities struggled to adapt to surging critical care demands.

Adaptable design isn’t just a practical necessity; it’s a long-term investment that minimizes costly renovations, enhances staff workflows, and elevates patient experience. By incorporating scalable principles, these flexible strategies extend from patient rooms and nursing units to procedural platforms, and even future vertical expansions. With smart planning today, we lay the groundwork for more efficient design solutions and effective care in the future.

Universal Patient Rooms

Universal patient rooms are the foundation of future-ready hospitals. Designed with intentional sizing and configuration, these rooms can scale to accommodate a range of acuities, from critical care to recovery, without requiring structural changes. By integrating essential ICU functions with recovery needs such as private bathrooms and visitor areas, universal rooms ensure that hospitals can flexibly respond to changing patient demands.

With these types of rooms, hospitals can adapt incrementally or manage sudden surges in patient needs without building new facilities or undertaking expensive retrofits. While universal rooms often require a higher upfront investment, this cost is significantly outweighed by the savings associated with frequent renovations.

room floor plan diagrams of patient room layouts

Universal Patient Room Layouts

In master planning efforts, we are seeing clients like MaineHealth Maine Medical Center and Hartford Health adopt a future-forward approach, prioritizing universal patient rooms for future capital projects. They recognize that the demand for ICU-level beds and the need to design for unforeseen challenges will only continue to grow.

patient room n hospital with nurse and visitors sitting

Maine Medical Center, Coulombe Family Tower Expansion

Design of acuity-adaptable patient rooms proved critical when this 64-bed surgical / medical oncology unit was able to convert to a COVID-19 care unit during the pandemic surge.

patient room in hospital with patient in bed and nurse helping

Maine Medical Center, Malone Family Tower

As the next major modernization project for the hospital campus, the Malone Family Tower builds upon success, providing 96 highly-adaptable universal patient rooms adjacent to surgical and procedural suites.

Equally vital as patient rooms are the surrounding staff areas. Nursing units must evolve to meet the needs of an increasingly acute patient population. Effective design enhances staff visibility, allowing for close monitoring and swift responses to critical situations. These units should also flex between acute and intensive care, adapting seamlessly to changing patient conditions.

nurse station in hospital with nurse sitting

Newton-Wellesley Hospital, 5 East Unit

A central, collocated nursing station improves visibility, boosts collaboration, and strengthens safety for both patients and staff.

Universal Procedural Platforms

As the complexities of interventional procedures evolve, hospitals are increasingly adopting universal procedural platforms. These spaces integrate surgeries, interventional imaging, electrophysiology labs, and cardiac catheterization into a single flexible environment. By organizing activities around a unified clean core with a restricted circulating corridor, these platforms enable flexibility while optimizing workflows.

The modular design of procedural rooms ensures that they can adapt to shifting volumes and technological advances. For example, a room designed for operating procedures today can be converted for interventional imaging without closing an entire department, all while maintaining patient care in adjacent spaces. Universal platforms also centralize care delivery, eliminating the inefficiencies of moving patients between disparate areas and improving the flow and collaboration of staff.

nurse at computer station, looking through window to operating room

Maine Medical Center, Malone Family Tower

As a teaching hospital, Maine Medical Center’s Malone Family Tower needed to be on the front edge of delivery and technology. Procedure room layouts can support either Operating Rooms or Interventional Labs with easy equipment replacements and integration of the latest technology.

Baystate Medical Center, Surgical Platform

Each procedure room is designed around a standard room size to allow for flexible, adaptable use over time. This allows each service line to perform surgery in any given room as the census grows or contracts on the given day, week or year.

Capacity for Vertical Expansion

Hospitals often operate within tightly constrained sites, where outward expansion can be complex and costly. Thoughtful planning for future vertical growth allows hospitals to maximize their existing footprint and reduce future construction costs. Key preparations during new construction, such as reinforcing foundations, optimizing structural loads, and designing flexible MEP systems, help avoid costly retrofits or structural adjustments needed for future expansion.

This forward-thinking approach supports scalable growth, enabling the addition of floors as patient demand increases. The ability to expand incrementally also spreads costs across multiple phases and minimizes disruptions to hospital operations.

exterior view of hospital with a lay over of a future expansion

Maine Medical Center, Malone Family Tower

The new tower’s structural design allows for vertical expansion without requiring additional land. With the ability to add seven more floors, each with dedicated mechanical systems, the future build-out will not interfere with hospital operations, ensuring seamless growth in the years to come.

Takeaways for Success

Outside of inpatient environments, the healthcare industry as a whole is increasingly embracing adaptable and flexible design, especially through standardized clinical modules, exam rooms, and procedural spaces. This approach is reshaping the efficiency of outpatient facilities, allowing for streamlined operations and maximizing throughput across multiple procedural specialties. By standardizing elements like exam rooms and operating rooms, health systems can better utilize their space, optimize scheduling, and reduce the overall need for clinical space. These efficiencies not only improve day-to-day operations but also provide significant long-term value, offering more flexibility in care delivery and reducing operational costs across the board.

Looking ahead, the need for resilience in hospital design will only grow. As we work with our clients, we focus on maximizing the value of each project—balancing energy efficiency, operational costs, and long-term flexibility. The design decisions made today are investments in the healthcare systems of tomorrow, ensuring that facilities remain equipped to provide high-quality care, no matter what the future holds.

Building Blocks of Adaptable Hospitals

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