On a recent webinar with Corazon, HCM principals Rhonda Malone Wyskiel, RN, MSN and Jamie Norwood, AIA, EDAC, LEED AP BD+C, gave a presentation on staying ahead of the curve in healthcare and how to adapt to changes in the field.

Rhonda spoke about how healthcare providers might reimagine care outside of a hospital setting with the rise of ambulatory care. She mentioned a quote she used often in her work as a registered nurse, “if a patient is staying the same from hour to hour and day to day– they are getting worse.” Likewise, if healthcare institutions do not adapt and only maintain the status quo, they are not keeping up with the latest evidence and innovation in order to provide forward thinking care delivery models to their patients. She stressed that healthcare leadership must be willing to seek feedback from their workforce and teams, and to challenge their own assumptions to move beyond the obvious. Safety should always be at the core of all ambulatory care design. Four ways to ensure this include:

  1. Standardizing care wherever is possible 
  2. Creating independent checks 
  3. Learning when things go not as planned  
  4. Reverse engineer what went correctly 


Patients and families should be heavily involved in the design process, how might we ensure we have a way to gain input and insights from them?

Do we administer a standardized survey to measure patient safety and, if so, how those results are used? Are there intentional efforts to make improvements?

Jamie then spoke on the best ways to reimagine care outside of a hospital setting and how to overcome challenges. Some of those unforeseen challenges to moving surgical care from inpatient to outpatient care can include finding the correct space to house necessary equipment and employees, not having access to the same support services as the hospital, and not having access to hospital building and support management.

While inpatient care has everything needed on site, outpatient care is dependent on a landlord that may not understand healthcare needs.

However, an advantage that outpatient care provides is the ability to focus on the smaller scale. The providers do not need to worry about brand standards of the overall hospital or the standards of a neighboring department. For example, a waiting room for a younger, healthier population can bring a lot of elements of hospitality and funds can be spent where it will matter the most.

Other opportunities with outpatient care centers include:

  • Determining how to pull everything together to one location. Will patients, doctors, and staff benefit from having all services consolidated at one location or having a suite to transfer onsite patients?  
  • Will pre-admission testing be done at the hospital or onsite? One advantage of conducting testing away from the hospital is having the patient avoid what can often be a convoluted process.  
  • How will administration be handled? Having your administration run a lot of different departments can be expensive and time-consuming. Determining what type of HR/administration you need and how much space they need can save money in the long run 
  • A healthier patient population allows creative use of space. If care providers don’t need to worry about having enough beds for patients, then they can focus on vertical recovery in a different way than the hospital. 
  • Telemedicine can help solve the issue of having access to ancillary support services. Yes, outpatient care won’t have every healthcare professional on site, but support can be simply a phone call or video chat away.  
  • Additional amenities can help differentiate the outpatient care facility from other facilities when patients are electing to receive care there 

As the healthcare sector continues to grow, healthcare providers and designers will need to get creative to provide more and more care outside of a traditional hospital setting.


Meet The Experts

Rhonda Malone Wyskiel, RN, MSN, joins HCM from the Greater Baltimore Medical Center (GBMC) where she served as the Senior Director, Performance Improvement & Innovation. Additionally, she previously served as the Patient Safety and Healthcare Innovation Lead at the Johns Hopkins Armstrong Institute for Patient Safety & Quality. She brings over twenty-five years of experience in the healthcare field to HCM, with sixteen years as a clinical care nurse at Johns Hopkins Hospital. She was also instrumental in the development of The Promise Project at GBMC, a $110 million, three-level 60 bed building designed to meet the needs of patients, families, and staff with larger rooms equipped with smarter technology.


Jamie Norwood is a leader of the Healthcare team at Hord Coplan Macht, and is actively engaged in a number of design and construction projects running the full spectrum of healing environments. Jamie has committed his career to health and wellness, with a focus on improving the places and processes for the continuum of care. He is an award winning healthcare architect, and his experience includes a wide range of both new and renovated inpatient and outpatient projects that support his clients’ strategic goals, operational objectives, and clinical outcomes. One of Jamie’s biggest motivators is finding innovative and effective ways to improve human-centered design and make healing spaces that promote better outcomes.

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