Healthcare and life sciences facilities are long-term investments, yet the clinical, research, and technological demands placed on them are always evolving. Shifting patient volumes, changing research priorities, expanding service lines, and advances in medical and laboratory technology can all introduce new structural, electrical, mechanical, exhaust, and space requirements.

Effective healthcare facility planning must, therefore, extend beyond the needs of opening day. The objective is not to anticipate every future scenario or invest prematurely in capacity that may never be needed. Rather, it is to identify the decisions that will be most difficult or costly to reverse and preserve appropriate options for future growth and adaptation.

For owners, one question can help frame that discussion: What decisions are we making today that could make the next project easier, or significantly more difficult?

Plan Today’s Project with Future Growth in Mind

Healthcare campuses and life sciences facilities rarely remain static. Even when a project begins with a well-defined immediate need, owners should consider how today’s investment may support what comes next.

The Obici Patient Tower Addition for Sentara Healthcare illustrates the value of that approach. The three-story bed tower was designed with the structural capacity and infrastructure to support expansion to seven stories. Accommodating the possibility of vertical expansion in the original design preserved a viable path for future vertical growth without significant structural reinforcement later.

At the campus scale, the same principle applies to site and infrastructure planning. During master planning and predevelopment for Sentara’s Princess Anne Medical Complex, road alignment, utility routing, building placement, and phasing were considered across the 72-acre site to support multiple medical office buildings and an eventual hospital.

The inverse is also true. Existing facilities can demonstrate how decisions made decades earlier influence what is possible today. At the Sentara Leigh Hospital OR and ED Expansion [link to project page], the 36-year-old hospital’s horizontal configuration, existing infrastructure, and active operations contributed to a highly While that sequencing protected ongoing clinical operations, it also lengthened the project by requiring smaller work areas, repeated transitions, temporary conditions, and carefully coordinated shutdowns before each successive phase could proceed.

Thoughtful healthcare and life sciences planning means having an in-depth understanding of which decisions determine if growth or change remains practical later. For healthcare owners, that may mean protecting an expansion zone, preserving structural capacity, or planning a future utility connection. In life sciences facility planning, it may mean reserving space for additional process equipment, laboratory support functions, exhaust systems, or expanded utilities.

The goal is to preserve credible options without committing capital to every possible scenario.

Test Critical Decisions Early

Some of the most consequential facility decisions are made while the design is still evolving. At this stage, an option that appears straightforward on paper may have substantial implications for infrastructure, shutdowns, structural systems, equipment coordination, cost, or future expansion. Early involvement from builders, engineers, equipment vendors, and key trade partners gives owners the opportunity to test those implications before the design becomes costly to change. This is especially important in active healthcare and life sciences environments, where construction decisions must account for the work continuing around them.

The Bon Secours New Harbour View Hospital provides a clear example. The new surgical-focused hospital was constructed adjacent to an active healthcare facility, making uninterrupted access for patients, staff, and visitors a critical planning consideration. During preconstruction, the team evaluated site logistics and developed a temporary covered corridor, along with an alternate maintained entrance, to preserve safe circulation between the existing facility and the new construction.

The value of that planning extended beyond logistics. By resolving access and sequencing requirements early, the team could evaluate the operational impact of construction before those constraints became field problems.

For owners, this is where preconstruction planning and design-assist can provide value beyond estimating. Early technical input can help answer larger capital planning questions: Should infrastructure be installed now or extended later? Is targeted structural capacity worth preserving? Will a future expansion require a major shutdown? Can specialized equipment be replaced without affecting nearby operations? The earlier those questions are evaluated, the more flexibility an owner retains.

Plan Equipment as Infrastructure, Not Procurement

Medical and laboratory equipment planning cannot be separated from the building systems that support it. An MRI, linear accelerator, laboratory instrument, fume hood, or process equipment package can introduce requirements for structure, power, cooling, exhaust, shielding, vibration control, utilities, access, and even the building envelope. Equipment should, therefore, be considered as part of the facility planning process, not simply as an item to procure near the end of design.

At the Bon Secours Imaging Center for Radiation & Oncology, installing a LINAC and HDR/CT simulator required 3,400 square feet of new concrete vault construction within an existing outpatient building. The radiation shielding requirements made the surrounding structure integral to the equipment installation.

The same principle applies in life sciences environments. At an occupied biotech laboratory renovation for a Richmond-based pharmaceuticals company at the VA Bio+Tech Park in downtown Richmond , construction included a new electrical panel, transformer, fume hoods, and snorkel exhaust system. Accommodating those additions required ceiling demolition, MEP connections, and electrical upgrades throughout the active space.

What may appear to be an equipment change can quickly become a building systems project. For that reason, owners should consider replacement and expansion when planning initial installation. How will equipment eventually enter and leave the building? Can electrical, mechanical, and exhaust systems be modified without extensive demolition? Will the structure support foreseeable changes? How will future work affect adjacent operations?

No one can predict exactly what the next generation of medical or laboratory technology will require. Facilities can still be planned to accommodate change intelligently.

Plan for Continuity, Not Just Construction

A master plan may identify where a future addition or renovation will occur. It should also consider how that work can be executed while the organization continues to operate. That distinction is especially important in occupied healthcare facilities and active laboratory environments, where disruption can affect patient safety, clinical care, diagnostic services, research activity, or critical workflows.

The Nutrition Support Services Addition at Riverside Regional Medical Center in Newport News  was completed in 13 occupied phases adjacent to the hospital’s main entrance. Infection control, Interim Life Safety Measures, off-hour work, temporary services, and strict separation between construction and hospital traffic directly shaped the sequence of work.

A lab renovation for a military medical center provides a parallel example in an active laboratory setting. The 48,500-square-foot renovation included autopsy, histology, pathology, and microbiology spaces and was divided into 12 phases so critical laboratory functions could remain operational. Before interior demolition began, the first phase created an elevated exterior walkway and modular trailers to serve as swing space for staff. That temporary infrastructure allowed diagnostic and pathology operations to continue throughout the remaining phases

In both cases, the phasing plan was more than a construction schedule. It was a continuity plan for the owner’s mission. In healthcare construction, continuity may depend on patient safety, infection control, emergency access, and clinical operations. For laboratories and life sciences organizations, it may depend on controlled environments, research continuity, diagnostic services, equipment uptime, or critical processes. A future phase has limited value if it cannot be delivered without unacceptable operational disruption.

Plan Beyond Opening Day

Future-ready healthcare facility planning doesn’t prepare for every possible scenario. Healthcare and life sciences capital is finite. The more disciplined approach is to identify future needs that are reasonably plausible and especially difficult to accommodate later, then preserve those options at an appropriate level of investment.

Sometimes that means designing the structure for a future vertical expansion. In other cases, it may be as simple as protecting a utility corridor, reserving an equipment pathway, documenting a future connection, or positioning a building to preserve an expansion area. The goal is not to prepare for every possibility, but to preserve the options most likely to provide meaningful value as needs evolve.

I have spent most of my career in healthcare construction, and one of the most meaningful aspects of that work is seeing these facilities become part of the communities they serve. My own grandmother received care at an OrthoVirginia facility that Hourigan built, shortly after it opened. Experiences like that make the long-term significance of facility decisions tangible.

“The goal is not to prepare for every possibility, but to preserve the options most likely to provide meaningful value as needs evolve.”

A successful project must perform on opening day. Effective healthcare and life sciences facility planning should also provide a practical path to what comes next, whether that is a new service line, additional patient capacity, emerging laboratory technology, equipment replacement, or the next phase of a campus.

The future cannot be predicted with precision. It can, however, be considered thoughtfully enough that today’s decisions do not unnecessarily constrain it.