9 May - 2022of decades now), there has been a nursing shortage. However, our current labor shortage is different and sobering. There are just not enough people in nursing schools or interested in working the required hours in a hospital. This context will require hospital leaders to create new ways of delivering patient care with different roles working to the top of their license. The bottom line, the built environment in healthcare will need to be redesigned to meet these new approaches to labor realignment.Because "form follows function" designing care spaces for new work flows and available staffing will produce new design for hospital architecture. Many organizations are beginning to see real impact by utilizing Lean design methodologies where optimal placement of equipment and supplies supports the different staffing mix and care requirements. Integrated Facility Delivery (IFD) utilizes the Toyota Lean methods that result in efficient work flows, and optimal staff and patient experiences. Our architect colleagues will need to be innovative and partner with us to re-design patient care areas in our hospitals and ambulatory care facilities to support the radically different staffing ratios or models of care we will have for the foreseeable future. The next pandemic is on its way (or you should be ready for it). Most health systems by now have added temporary renovation measures to meet the care needs of very sick and very contagious patients presenting during the pandemic. However, we must be pro-active in the design and construction of care spaces in preparation for the next crisis, whether it is this year or the next decade. As an example, the design of our waiting rooms, which were once designed to promote gathering in close spaces need to be re-designed for flexibility allowing optimal infection prevention. A paradigm shift is required in the planning and design of care spaces. Rethinking the planning for Heating, Ventilation, and Air Conditioning (HVAC) systems as a core element of strategic operational planning. Design that supports patient care flows with maximum infection prevention and safety practices will need to be hardwired to meet the needs of the future.Reinventing the approach to facility design and construction is more than an opportunity, it is necessary in the brave new world of pandemic readiness, shrinking capital, and innovative workforce redevelopment. We are at the edge....of bold new innovative solutions to meet the needs of our communities and reinvent ­ join us! Karin Henderson
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