In this episode, we sit down with Associate Principal Architect Joe Copley to explore what it truly takes to master the healthcare design experience. From leveraging natural light and optimizing circulation to advocating for caregiver well-being and managing complex operational disruptions, Joe shares deep insights on how thoughtful architectural choices directly impact patient healing and facility efficiency. Whether you're a healthcare leader, facilities manager, or simply curious about medical design, tune in to discover how small design shifts make a massive difference in modern healthcare environments.
(Skyler Gorsett): Welcome, everybody, to another episode of the Laying the Foundation podcast. My name is Skyler, and I'm your host. Joining me today for this phenomenal episode is Joe Copley, an Associate Principal from our Des Moines office. Joe, welcome to the show.
(Joe Copley): Hey, Skyler! How's it going?
(Skyler Gorsett): It's going great! We're excited to have you here to dive into the depths and complexities of healthcare design.
(Joe Copley): I'm really excited to talk about it.
(Skyler Gorsett): Absolutely. Healthcare design is one of our primary practice areas at CMBA Architects. When designing a hospital or medical facility, getting it right is crucial. While every building type is important, healthcare is an exceptionally technical field. Today, as our episode title suggests, we are discussing "Mastering the Healthcare Experience." To kick things off, Joe, what is our overarching philosophy when approaching healthcare design? What core principles guide your work in this sector?
(Joe Copley): Broadly speaking, we all instinctively understand how a physical space makes us feel. There are spaces where we love to spend time, and others we want to exit as quickly as possible. In healthcare, you are specifically designing a healing environment. It is extra important to create a space that actively promotes recovery—a place that feels safe, calm, and comfortable for patients and families.
(Skyler Gorsett): That makes total sense. If a space is conducive to healing, it fulfills its primary purpose. What specific design factors contribute to creating a supportive healthcare environment?
(Joe Copley): There are many factors, and they vary significantly depending on the facility type. For example, when evaluating an emergency department, you walk through to assess how the space feels operationally. Unfortunately, many existing emergency departments are overcrowded and lack adequate patient rooms, forcing patients into hallways. That compromises both caregiver workflow and patient dignity. By contrast, a outpatient specialty clinic has very different operational goals. Across all project types, our goal is to empower clinical staff to perform at their highest level while providing patients with an exceptional, stress-free healing environment. Because CMBA handles everything from small rural clinics to major hospital emergency departments, our approach is always tailored specifically to the project.
(Skyler Gorsett): We certainly cover a wide spectrum—from small family practices and dental offices all the way to full-scale regional hospitals and emergency departments. Each brings very different spatial requirements. Looking at high-density hospital environments, we know how vital natural light is for psychological well-being and physical recovery. How do we bring natural daylight deep into dense, landlocked hospital floor plans?
(Joe Copley): It's a classic architectural challenge. Hospitals tend to expand inward over time as additions are built around original structures, turning former exterior walls into landlocked interior rooms. That makes capturing daylight difficult. However, because natural light is essential for healing and regulating circadian rhythms, we use several strategies to introduce it. Where possible, we use interior glass partitions to borrow light from perimeter windows deep into central work areas. If a space is entirely landlocked or underground, we collaborate with specialized lighting designers to simulate natural daylight through tunable color temperatures and indirect fixtures. In areas where exterior views are unsightly—such as a tight rooftop well—we place windows higher up on the wall to harvest daylight while obscuring the view. Every solution is customized to the facility's existing constraints.
(Skyler Gorsett): It's amazing how advanced lighting strategies allow us to simulate natural daylight even when physical windows aren't an option. Now, going back to caregiver workflow and crowded corridors: while patient care is the priority, what design strategies do we use to support the doctors, nurses, and staff administering that care?
(Joe Copley): Caregivers are inherently selfless. They almost always prioritize patient amenities over their own physical needs, often agreeing to sacrifice staff break rooms or work centers if it means adding extra patient capacity. As architects, we have to advocate for the staff. We evaluate the bigger picture to ensure the environment supports their endurance and focus. We do this by asking detailed operational questions, reviewing workflows, and shadowing caregivers directly on shift. Following a nurse through a shift reveals subtle friction points and travel inefficiencies that rarely show up during a boardroom meeting. Designing a space that reduces physical strain on staff directly improves downstream patient outcomes.
(Skyler Gorsett): What does that shadowing process look like in practice? What specific details are you watching for on the floor?
(Joe Copley): Shadowing provides insights you can't capture in a questionnaire. By walking alongside a clinician, we observe exact spatial adjacencies—such as how far their desk is from supply rooms, medication stations, or patient bays, and what visual sightlines they need. Observing what works well and where bottlenecks occur allows us to refine the layout for maximum efficiency in the new design.
(Skyler Gorsett): It's fascinating how architects step into the role of behavioral analysts to observe how people move through a space, translating those observations into better physical environments. That connects directly to line-of-sight. In healthcare, how do you balance patient privacy with the staff's need for direct visual oversight?
(Joe Copley): It requires a delicate balance on every project. For example, we recently renovated an emergency department triage intake area. Their existing setup relied on small, enclosed triage rooms that created severe waiting room bottlenecks. They wanted an open, flexible intake area with curtained bays for privacy and a central nurse station with direct oversight. By converting underutilized administrative space into flexible curtained bays with an integrated workstation, we increased patient throughput, reduced waiting times, and maintained caregiver line-of-sight. Post-occupancy feedback confirmed the layout significantly improved their operational flow. Every facility requires a tailored balance between privacy and oversight based on patient acuity.
(Skyler Gorsett): That reinforces why standardized, cookie-cutter designs don't work in healthcare.
(Joe Copley): Exactly. Even two facilities within the exact same health system often operate differently based on local patient volumes and staffing models. Listening to the specific user group at each location is essential.
(Skyler Gorsett): Unlike schools that have summer breaks, major hospital departments operate 24/7/365. How do we manage the complex puzzle of constructing new additions or renovating existing spaces without interrupting active medical care?
(Joe Copley): Phasing construction in an active hospital is a major undertaking. When working adjacent to 24/7 clinical areas like emergency departments, architects must develop rigorous construction phasing plans. We evaluate potential disruptions to plumbing, medical gas, and electrical systems, scheduling necessary shut-offs during low-impact hours. Infection Control Risk Assessment (ICRA) protocols are critical—we design dust barriers, negative air pressure systems, and isolated material transport routes to ensure construction debris never enters patient care zones. This requires extensive coordination with facility leaders, maintenance teams, IT personnel, and clinical supervisors. Having a clear, well-vetted phasing plan in place prior to bidding ensures the general contractor executes the project smoothly without unexpected operational downtime or costly change orders.
(Skyler Gorsett): It's like solving two complex puzzles at once: designing the physical building and mapping out a non-disruptive construction process.
(Joe Copley): Absolutely. It requires balancing operational safety with project cost. While shifting all construction to night shifts minimizes daytime disruption, it dramatically increases labor costs due to overtime rates. Strategic upfront planning and constant communication across all hospital stakeholders ensure there are no surprises once construction begins.
(Skyler Gorsett): To wrap things up, if a healthcare executive or facility director is preparing for an expansion or renovation, what key advice or mindset shift would you offer them as they begin the process?
(Joe Copley): Prioritize transparent communication right from the start. Assemble all internal stakeholders early, clearly define your operational goals, and collaborate with your design team to establish a realistic project framework. Understanding all design and construction parameters upfront empowers leadership to set clear objectives and partner effectively with their architectural team to execute them.
(Skyler Gorsett): That is fantastic advice. While we can't cover every nuance of healthcare design in a single podcast episode, this offers a great overview of how CMBA Architects approaches medical facilities. Joe, thank you for sitting down and sharing your expertise with us.
(Joe Copley): Thanks, Skyler! I appreciate the opportunity to share our work, and I hope it gives our listeners valuable insights.
(Skyler Gorsett): Absolutely! We'll see you next time.
(Narrator): If you'd like to find out more about the Laying the Foundation podcast, you can head over to any podcast streaming platform such as Spotify, iTunes, Google Podcasts, and others. You can also find out more about CMBA Architects through social media such as Facebook, LinkedIn, Twitter, and Instagram. Additionally, you can head over to the CMBA website at cmbaarchitects.com. If you're an architecture or design professional or an intern looking for an internship within those fields, please be sure to check out our website and click on the careers tab to find out more about what opportunities we offer. This has been another episode of the Laying the Foundation podcast. We'll see you next time!