By Mackenna Moralez, Associate Editor

While the call for new and modern hospitals and other healthcare facilities is being heard loud and clear, this is significant costs associated with these types of projects. A lot goes into determining whether or not healthcare facilities should move forward with a new building or renovations, and the leading factor tends to be the expense.  

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. 

Mackenna Moralez is the associate editor of the facilities market and the host of the Facilities in Focus podcast.