By Adam Hicks, Vice President – Account Manager, Skanska USA


COVID-19 has accelerated our need to consider how healthcare facilities in the future are physically and logistically designed, built and arranged. With the sudden onset of the pandemic, healthcare organizations are considering in real time what they must do to further prepare and evolve their existing facility. They are also rethinking what will be needed when building a new facility for the next generation of healthcare.

As a global company that has been building hospitals and other health-related facilities for more than 100 years, we have unique insights on these trends based on conversations with clients and partners. The pandemic exposed several areas where healthcare facilities can operate more efficiently when faced with a wide-scale health crisis like COVID-19. With changing regulations and a heightened focus on resiliency planning, the healthcare industry is finally ready to embrace a transformation.

Flexible spaces: Scalability in patient room designs. While this can have higher upfront incremental costs, it can also lead to greater bed utilization and a better return on investment. Hospitals of all sizes are struggling to provide enough intensive care units (ICUs) and isolation rooms to accommodate the influx of patients, so resiliency planning is at the forefront of every healthcare provider’s mind.

Technology integration: Creating clinical spaces that can accept rapidly changing technology and positively affect operations by reducing contact and exposure (touchless sensors, robotics, telehealth, etc.). Ultimately, building footprints could change as telehealth reimbursement structures become permanent and staff/patients feel more comfortable with this technology.

Infrastructure upgrades: Upgrading equipment to save on energy expenses – cost savings will be important across the board as some facilities increase telehealth capabilities. Improving infection prevention will be key in making staff and patients feel safer about the care delivered post-pandemic. Hospitals are exploring creating entire isolation floors or buildings, reconfiguring HVAC set ups, redesigning waiting rooms, and building separate entrances for patient rooms.

Future enabling of the built environment: Adopting comprehensive, forward-thinking strategies that enable advancements without having to significantly modify existing environments. Building a space knowing that future technology, for example, might require different infrastructure/capacity will keep facilities adaptable and future proof.

Specialty centers in communities: Moving specialty practices such as cardiovascular and breast centers closer to residential areas. More convenient locations with shorter commute times will encourage routine visits so people can stay better on top of their health.

Climate change and operational efficiency initiatives: Weighing material selections based on embodied carbon impacts and overall life-cycle costs, again ultimately creating cost savings. As we look at flexible spaces and resiliency planning in the future, how can we create spaces that meet both energy needs and emergency preparedness needs? For example, many owners and design firms are talking about creating negative floors or hospital units. This can have a huge impact on a facility’s energy consumption.

While the effects of the COVID-19 pandemic will have a lasting impact on the healthcare industry, in the short-term, we have helped several of our customers rapidly scale up capacity to support the predicted surge in COVID-19 patient volumes. From this experience, we see opportunities to increase bed capacity permanently and expand telehealth services as hospitals reevaluate their facility needs long-term.

For example, on our University of Virginia Health System University Hospital Expansion project, we expedited testing and balance, as well as the commissioning on 69 ICU rooms to bring them online two months early. Additionally, our team prepared them to be used as negative pressure rooms in the future. We also installed three large exhaust fans sized to support an Airborne Infection Isolation unit for the shell space floor of the tower for future fit-out and expansion. The facility is now better equipped for the pandemic and any future outbreaks.

COVID-19 has presented many challenges to the healthcare industry, but the lessons learned can be great opportunities for forward thinking.


Adam HicksAdam Hicks is a vice president with Skanska USA serving as account manager for the firm’s Middle Tennessee Operations. A graduate of the University of Tennessee Martin, Hicks began his tenure with Skanska as an intern while still in school. Complementing his two decades of project management experience, Hicks holds a healthcare construction certificate from the American Society for Health Care Engineering (ASHE). For more information go to



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