Modernization efforts – while not always ideal – allow designers to be creative with the spaces and the budget that they are allotted. Healthcare Facilities Today recently spoke with Christy Lindsey, global health of healthcare advisory for SJ Group and Nico Kienzl, senior executive director for Atelier Ten on what strategies hospitals can use during modernization projects.

HFT: What cost-effective strategies can hospitals use to modernize without massive capital campaigns?

Lindsey: To modernize without massive capital campaigns, hospitals should prioritize targeted modernization over full replacement. Shifting low-acuity care to ambulatory and community sites, leveraging modular or prefabricated components, and pursuing energy performance contracts or public–private partnerships can significantly reduce capital burden. Federal and state grants, such as the Rural Health Transformation Program, can also bridge funding gaps. A data-driven Long-Range Capital Plan - a 10–15-year roadmap that allocates capital across growth, renewal, technology, and equipment needs - sequences quick-payback projects first while aligning long-term investments with mission and market demand.

HFT: What compliance or regulatory requirements must hospitals keep top of mind during upgrades?

Kienzl: When considering compliance and regulatory requirements during upgrades, facilities must adhere to evolving codes and standards — not just for safety, but for seismic resilience, energy efficiency, and climate readiness. Forward-thinking organizations go beyond compliance to plan for future regulatory shifts, such as carbon reporting or grid modernization requirements. Modeling future climate and energy risks early prevents costly retrofits later, ensures long-term operational continuity, and positions facilities to meet evolving regulatory requirements.

HFT: How do you prioritize modernization needs when resources are limited?

Lindsey: When resources are limited, prioritizing modernization needs should balance clinical impact, regulatory risk, and financial performance. Using a Clinical Delivery System Plan combined with a Capital Asset Renewal assessment allows decision makers to objectively score projects. Scenario-based long-range planning then helps compare options — such as deferred versus accelerated investment — to sequence modernization in a way that maximizes both mission alignment and return on investment.

Very sound advice! Plan ahead and adhere to codes. I’m curious to learn more about the Rural Health Transformation Program.