Director of Healthcare Design Finds Flexibility Is Key for Rural Healthcare Providers

Connected closely to the health of their communities and the local economy, improvements to rural healthcare facilities can have a lasting, positive impact on residents and staff. For many years, our Heal Studio has supported these providers with forward-thinking, flexible designs. We recently interviewed our Director of Healthcare Design, Bob Bosley, about his experience working with critical access and rural hospitals.

In this article, he shares insights from his career. Spanning over two decades, his work encompasses everything from full replacement hospitals to additions and remodels. Discover the trends he’s seeing and learn more about what makes these projects unique below.

TELL ME ABOUT YOUR HISTORY DESIGNING NEW OR RENOVATED SPACES FOR RURAL AND/OR CRITICAL ACCESS HOSPITALS.

I grew up in a small town, and most of my family still lives in small towns. As an architect, I’ve had the chance to work with organizations that serve my family directly. So, for me, it’s energizing to be able to support healthcare in places that feel like home.

WHAT KINDS OF UNIQUE CHALLENGES DO YOU HELP THEM SOLVE THROUGH DESIGN AND PROGRAMMING?

Efficiency and flexibility are key in a community hospital. I enjoy listening to the client and sharing ideas with them about what is the right mix of services for their area. We consider how to combine uses, allow for and anticipate new models of care, and right-size projects. It is the most fun.

WHAT DO YOU ENJOY MOST ABOUT WORKING WITH THESE ORGANIZATIONS?

The people. The leadership and staff are members of their communities and close to the families they serve. These are their friends and neighbors. A patient centered approach to healthcare is very real to them, because they interact with these people daily and may have known them for years.

RURAL AND/OR CRITICAL ACCESS HOSPITALS PLAY AN IMPORTANT ROLE IN THEIR COMMUNITIES. HOW DO YOU ENGAGE WITH THE PUBLIC ON THESE PROJECTS?

It’s an important part of our process. We hold visioning sessions early in our projects. These help us understand the community’s purpose, vision, and goals for the projects. We invite a combination of administrators, board members, staff, and key members of the public. As the project’s design develops, we continue the discussion through participation in public meetings that keep the community engaged and aware of how a project is progressing.

HOW DOES YOUR APPROACH DIFFER WHEN WORKING WITH HEALTHCARE ORGANIZATIONS IN THESE AREAS?

From a process or steps perspective, it doesn’t change. We continue to use the same, tested approach, whether it’s an equipment replacement project or a 12-story tower. It’s just a matter of degree or scale.

One of the most significant differences is that these organizations typically tackle construction projects less frequently. They may not have the same infrastructure in-house to manage the work. When working with large, regional providers, we may be adapting to meet their systems. However, for these efforts, we act as a guide, walking them through the design and construction process, while they educate us on the specific needs of their community and staff.

A rewarding aspect of this is work is seeing the large economic impact rural hospitals have on their community. We’ve seen how these projects can generate jobs and improve the health of an area.

WHICH TRENDS ARE YOU SEEING AT THESE SMALLER FACILITIES? ARE THERE DESIGN ELEMENTS OR NEW SERVICES THAT MANY ARE BEGINNING TO OFFER?

Everyone in healthcare is expanding outpatient services. For rural hospitals, this typically means expanding the variety/frequency of specialty clinic services. Some other interesting trends are:

Refitting or expanding surgical services to accommodate robotic operations.
Growing and increasing behavioral/mental health services.
Offering space for patients to come to the hospital for telehealth services with larger health systems.

We are also seeing hospital leadership reach beyond traditional healthcare services. They are:

Expanding physical therapy to include sports training for local schools or competitive teams.
Offering housing through local partnerships to assist in recruiting physicians and/or staff recruitment.
Partnering with school districts to provide school nurses.

WHAT’S AHEAD FOR THESE ORGANIZATIONS? HOW CAN ARCHITECTURE SUPPORT THOSE CHANGES?

There will always be financial challenges in rural healthcare. By providing designs that are flexible, efficient, and expandable, the buildings can better respond to changes in reimbursement and community needs.