Q+A with New Leaders in HKS’ Healthcare Practice

By Joey Kragelund, Phyllis Goetz on March 1, 2018

HKS’ new regional health group director for the Pacific region, Joey Kragelund, and chief development strategist, Phyllis Goetz, are pushing the boundaries of healthcare design thinking. In this interview, they share their ideas about where the industry’s been, where it’s going and what clients should look for in their facilities to keep them competitive, now and in the future.

How has the healthcare landscape evolved over your career, and what do you see happening over the next few years?

{P} I remember being at a conference and arguing about whether research has a place in healthcare design. Fortunately, we’ve made progress, which continues to accelerate like Moore’s Law. We have metrics, research and hospitals with patient centered care that encourage us to take control of our health situations through education and participation.

{J} When I started in healthcare, patient centered care and design research wasn’t there. Now we have conversations about how design affects not only the operations of a facility, but also how it supports clinical processes and how healthcare consumers respond. We’re more engaged with the intangible components behind operations in these facilities.

Looking ahead, what will you be working on and what will you be putting most of your energy into?

{J}  We’ll be looking at how we navigate uncertainty in the healthcare market. On the West Coast, there’s a layer of policy and politics from the local, regional and even national levels that influences the rising cost of capital investments. We’re assisting clients as project and solution partners.

{P} My greatest challenge is harnessing thought leadership that illustrates our unique value as an organization. I’m looking at who we are and what we do, and making sure that we’re matching this changing role that Joey is talking about.

What are the drivers that are pushing the healthcare industry forward?

{P} Reimbursements affect everything. Every healthcare organization struggles to be profitable, and as much as the ACA needs some work, it has changed healthcare behaviors in a dramatic way. Consumers are much more involved in their care, versus the traditionalist generation where doctors were godlike creatures, and patients did whatever they were told. We’ve moved into a participatory care model where all of us work together to care for the ill.

{J} It’s health outcomes. Looking at the cost of healthcare, capital investments are only one piece of a larger puzzle. The costs of administration, insurance, procedures and prescriptions put a lot of pressure on health outcomes. The focus on prevention and wellness has changed the discussion from cost to education. It’s the most comprehensive discourse I’ve seen in 25 years.

On staying ahead of the curve, what advice do you have for healthcare leaders considering new or updated facilities?

{J} Our clients have businesses to run and services to provide, so the uncertainty of finances and reimbursement policies offers up a lot of challenges. By looking for innovative and integrated solutions with built in flexibility and adaptability, facilities will be up to whatever challenges the future brings.

{P} Shy of having a crystal ball, the best we can do is create spaces that keep pace as regulations, illnesses and treatments evolve. Bringing your team together early and often, so everybody knows the vision and the mission, allows you to give them the freedom to innovate. The facilities will function better, and because they can adapt over time, they’ll be a better investment.

What kind of trends do you see in what clients are looking for in their designs?

{P} I think a lot of major systems are trying to find ways to provide care for all, and at the same time manage surge capacity. With all the horrible things that can happen, whether they’re acts of god or man, healthcare facilities must be prepared to deal with them. We’re helping them think through daily use, but also what happens in the extreme, and how spaces flex to support the community.

{J} We’re seeing small and large campuses integrating with the urban fabric. Clients want them to become community centers, rather than isolated medical facilities. On the flipside of that, there are aspects like safety and security, and healthcare facilities are looking for the balance between these concepts.

What attracted you to HKS?

{J} People who are inspired and energized by the challenges we’ve discussed. I’ve been thrilled by just how global our thinking and collaboration are.

{P} What I love about HKS is that we care more about the client’s message than our own. I can’t look at a building and say ‘oh, well HKS designed that building.’ That’s a positive, because that means that we’re demonstrating the values and branding of those we serve. The passion is there but the humility of knowing that it’s not just about us.


    • John, so great to hear from you, thanks for your kind words! Hope all is well with you, would love to grab a coffee sometime.

  • Robin Orr, MPH, Founding Member Board of Directors Center for Healthcare Design and Past Executive Director Planetree says:

    Congratulations Phyllis on your new position! A fan for years of your passion and expertise for creating environments and markets to enhance healing and wellness. All the best my friend!

    • Robin, as always, you honor me and touch my heart. Thanks for your kind words. Hope all is well, hugs to you and Sue!

  • Congratulations, Phyllis! I moved into healthcare real estate 2 years ago and would welcome a discussion with you.

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