With healthcare construction booming, architecture firms are hiring from an unexpected talent pool—registered nurses.

Architect, December 2007

Marion Fraser and Alison Wesley-James are in remarkably good spirits, considering what they have to accomplish over the next several hours: squeezing 27 surgical beds, six operating rooms, labs, CT scanners, and support areas into 30,000 or so square feet of planned hospital space.

Sitting with healthcare architects in a meeting room at the Omaha, Neb., headquarters of the firm HDR, Fraser and Wesley-James—the CFO and planning manager, respectively, of the Ottawa Heart Institute in Canada—study CAD drawings and stacks of spreadsheets as they weigh all the factors. These include work hours (If the ORs were used more hours per day, wonders Fraser, could they make do with five?) and hospital politics (Where is the best spot to put the CT scanners, so as many doctors as possible can have them close by?).

Most tortuous of all is phasing, the logistics of which can be paradoxical: “You have to build new, to take out the old, to be able to refurbish, to build new,” says Fraser, who wears the sensible clothes of an accountant but a ready smile.

The planned cardiac unit might be new construction or an existing facility that’s been renovated—or a combination of both. It’s too early to say, since ground won’t be broken on the project, a major expansion of the Ottawa Hospital, for another decade. And some of the changes that Fraser and Wesley-James foresee won’t take effect until 2031.

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Photograph by William Anthony