Today, we are seeing an unprecedented global boom in healthcare facilities development fueled by a wide variety of economic and social factors:

• The Private Finance Initiative that is spawning significant new development in the United Kingdom.
• The creation of free zones giving rise to entire healthcare "cities" in the Middle East
• China's transformation from a monolithic public system to a hybrid public/private model of care delivery, which is necessitating a complete rethinking of their healthcare infrastructure
• Privately held companies leading the way in building new hospitals in India
• Public outcry in Australia forcing policymakers and developers to work together to provide improved quality and access to care
• The realization that massive rebuilding of decaying infrastructure will be essential to the future of Eastern Europe's healthcare system.

Significant numbers of qualified design professionals will be required to meet these demands and yet, in most regions of the world, healthcare facilities planning has not evolved into an area of specialization.

Healthcare planning is perhaps the most demanding of all building types. It requires designers to stretch across all scales of design, from urban planning to campus site development to detailed room and furniture design. Planners will play a unique and crucial role in shaping the healthcare landscape of the future. But healthcare planning is much more than simply creating wrappers around high-tech equipment. It is intertwined not only with the design of buildings, but with the design of care, with the clinical program serving as the first critical blueprint in the development of any physical structure. Healthcare planners must work in close collaboration with doctors, nurses, quality experts, and administrative leaders, all of whom bring a unique perspective on their field. Architects, in particular, are uniquely positioned to assist healthcare practitioners in analyzing their practice patterns and giving shape to new models for delivering care to their patients. Through the design process, architects take abstract ideas and translate them into concrete models that care teams may then analyze, discuss and refine. It is through this collaborative process that healthcare designers evolve new models uniquely tailored to meet the needs of the communities they serve.

Healthcare facilities must continue to be designed to respond to local context and needs, but increasingly, design teams who seek to remain current in healthcare advances must look far beyond their immediate community. Not very long ago, the US academic medical centers stood alone as examples of state-of-the-art facility design. Today, innovations in healthcare facilities are taking place in all corners of the globe. In response to the catastrophic SARS outbreak of 2003, Chinese architects and engineers are creating new models for control of airborne infection. In Australia, design teams are working closely with government officials to better serve lower density populations in rural areas. To achieve that goal, they are developing more distributed, community-based models of care that will rely on highly advanced IT systems. In the UK, some design firms are exploring modular prefabricated systems in an effort to build ambulatory clinics quickly and cost-effectively to meet demand for greater access to care. These are just a few examples of the kinds of innovation that will define healthcare environments of the future. We have much to learn from each other but to begin that dialogue we need a common frame of reference.

In The Art of Medical Equipment & Furniture Planning, Awni Kopty and his colleagues have given us that frame of reference. Through their rigorous documentation of every corner of a prototypical hospital we now have a common baseline from which to begin our work. The Art of Medical Equipment & Furniture Planning is not a cookbook or an endpoint. Rather, it is a substantial and well considered starting place from which to begin a dialogue with practitioners about how they work today and how they might deliver better care in the future. Through this type of collaborative process we will continue to learn and grow as professionals and be better positioned to create new and forward looking designs in response to the dynamic and ever-changing needs of healthcare providers world-wide.

Judith D. Mitchell, AIA

Director of Planning

Harvard Medical International