Flexibility and Employee-Centered Design

Craig Passey: Healthcare is evolving rapidly—financial pressures, staffing shortages, and shifting care models are reshaping everything. Are traditional design approaches keeping up, or does adaptability require a fundamental rethink?

Lance Ferguson: One thing that has remained consistent over the past decade is the need for flexibility of intent. We now aim to design spaces that are as universal as possible. For instance, we don’t want an OR that’s only suited for orthopedic or neurosurgery—we want a robust, standardized operating room that can support a wide range of procedures. The same applies to ICU rooms. The need for that kind of flexibility isn’t going away, and I’m glad we’ve prioritized it in our recent builds.

There’s another big shift happening. We’ve always said design should center around the patient—and that has to hold true. But we’re increasingly recognizing that to truly support patients, we first need to support staff. Their needs are complex, but creating environments that foster connection, respite, and team cohesion is essential to attracting and retaining top talent and combating burnout.

Craig Passey: I think we now realize that caregivers spend much more time in these spaces than patients do, and their wellbeing directly impacts the quality of care. Designing spaces to support staff begins with a balance of operational efficiency and emotional resilience.

Lance Ferguson: Right—it’s not necessarily about building an employee gym, but about creating spaces for connection and respite—collaborative environments, gathering areas, places where staff can cohort and decompress. A physical space must foster creativity, innovation, and teaching.

Resilience and Sustainability

Jennifer Youssef: What does resilience mean to you in the context of your healthcare facilities?

Lance Ferguson: Resiliency has many definitions. Staff resiliency is one. Operational resiliency is another, especially in regions like ours that are prone to natural disasters. It’s critical to ensure that the space in which we do our work functions reliably, not just on a typical day, but also in these events where we may scale staffing up quickly and ride out an event for four or five days.

It also applies to product selection. We sometimes value-engineer materials to meet budgets, but that can lead to early wear and replacement. Resilient design means choosing materials that last. I also don’t think we’ve done enough as an industry from a green standpoint.

Craig Passey: That’s a great point. Sustainability and resilience go hand in hand—especially when it comes to long-term costs and environmental impact.

Lance Ferguson: With 10,000 people on campus, we need to build responsibly. Even if we can’t create new green spaces on this fully built-out campus, we should still reduce our footprint through better materials, construction practices, and energy use.

Craig Passey: At its core, sustainability is about responsible resource use. Hospitals are massive consumers of utilities and reducing that footprint creates better environments and lowers costs. We see more systems pursue sustainability not for the points or the plaque, but because it’s a smart investment—one that can be redirected into patient care, staffing, and recruitment.

Lance Ferguson: That’s exactly how I see it.

Craig Passey: How do we design environments that prioritize staff resilience, especially staff safety?

Lance Ferguson: We must draw more attention to workplace violence in healthcare. From a design standpoint, it’s about line of sight, proximity to teammates, the ability to call for help. If staff are isolated in rows of rooms without support, that’s a problem. We need to bring in experts and put more energy into this conversation. It’s a growing and real concern, especially for staff in emergency centers across the country.

Technology and Infrastructure

Jennifer Youssef: Given the uncertainty and constant change in healthcare, how are you approaching flexibility? Are there spaces where that need is growing?

Lance Ferguson: Absolutely. Everything is becoming data-driven, and the volume of devices and storage needs is exploding. In our new ORs, we doubled the storage capacity and still need more space. We’re constantly balancing space for staff versus infrastructure—servers, cables, IDF closets.

Jennifer Youssef: And code is pushing those rooms to get bigger, which adds complexity.

Craig Passey: Exactly. The infrastructure is driving facility scale. These decisions need to be made early to ensure we’re accommodating the technology so that it can support care delivery, especially as AI becomes more integrated.

In the next installment of this conversation, we explore how adaptive design principles extend beyond the walls of the hospital. From community engagement and equitable care delivery to lessons learned during the pandemic and the evolving role of data and AI, Memorial Hermann–TMC shares how design continues to shape strategy, operations, and long-term impact across the healthcare system.