Constructing with Care

Capital Planning Under Pressure: Data, Decisions & Building with Conviction

Healthcare capital planning has never been simple. But with financial pressures, shifting reimbursement, rising construction costs and increasing demands for flexibility, health systems are being forced to make difficult decisions about where—and when—to invest.

In this special compilation episode of Constructing With Care, we revisit some of the most compelling insights from conversations with healthcare leaders and advisors across several previous episodes. Together, these perspectives explore how health systems can make smarter capital decisions when the path forward isn't always clear.

From prioritizing the "critical few" to using data without becoming overwhelmed by it, the conversation examines what it takes to move from analysis to action—and how today's capital investments can create flexibility for tomorrow.

The episode also explores the financial and operational value of prefabrication, including speed to market, standardization, cash flow, risk mitigation and the ability to adapt facilities as healthcare needs evolve.

In this episode, you'll hear insights on:

• How financial pressure is changing the way health systems prioritize capital investments

• The opportunity cost of not building—and why waiting can carry its own risk

• How leaders can distill complex data into the information needed to make decisions

• Why stakeholder engagement and active listening are essential to effective capital planning

• Using BIM and other technologies as data-driven decision-making tools—not simply documentation

• How health systems can test assumptions and continuously evaluate financial risk

• Avoiding analysis paralysis and knowing when it's time to make the decision

• Building flexibility into longterm capital strategies rather than relying on rigid plans

• The financial and operational value of prefabrication and standardization

• Why speed, adaptability and operational resiliency are becoming increasingly important measures of capital value

• How leadership culture can create the confidence to challenge conventional approaches

Featured voices

• Curtis Skolnick — CommonSpirit Health
• Jonathan Bykowski — Array Advisors
• Sarah Francis — Advocate Health
• Jeff Schroder — Atrium Health

Editor's Note: This episode is part of our Constructing With Care Highlights series, featuring curated insights from previous conversations on timely issues shaping healthcare design, construction and capital investment.

Healthcare workers are five times more likely to experience workplace violence than employees in other industries, making safety a critical consideration from the earliest stages of facility planning.

In this special compilation episode of Constructing With Care, we've curated some of the most valuable conversations from our interviews with Jay Farhat, Executive Director of Protective Services at Baptist Health and Deb Sheehan of DPR Construction. Drawing on more than 30 years of law enforcement and healthcare security experience, Jay shares practical insights into how healthcare organizations can design facilities that are both welcoming and secure.

From Crime Prevention Through Environmental Design (CPTED) principles to advanced weapons detection technology and security planning for high-risk clinical spaces, this episode highlights how thoughtful design decisions can improve safety for patients, visitors and caregivers alike.

Featured topics

• Why workplace violence has become one of healthcare's biggest challenges
• Designing to reduce risk through CPTED principles
• Creating secure, welcoming spaces in sensitive care environments like the NICU
• Lessons learned implementing advanced weapons detection technology
• Building effective healthcare security teams through specialized training
• Balancing hospitality with protection in modern healthcare facilities

Today, we're sharing a conversation from the Healthcare Facilities Network podcast featuring DPR Construction's Healthcare Core Market Leader, Hamilton Espinosa. In this discussion, Hamilton joins Patrick Murphy, Regional President at CREF, and podcast host Peter Martin to explore the challenges and opportunities shaping the future of healthcare facilities.

From workforce shortages and evolving career paths to artificial intelligence and emerging construction technologies, this conversation examines how healthcare organizations, facility leaders, and builders can adapt to a rapidly changing landscape while keeping people at the center of every decision.

In This Episode

• Why labor shortages continue to impact healthcare facilities and construction alike
• How data centers and other industries are competing for the same skilled workforce
• The growing role of AI in healthcare, construction, and facility operations
• How prefabrication and off-site manufacturing are transforming healthcare construction
• Why mentorship, apprenticeships, and hands-on learning are critical for the next generation
• The importance of creating workplaces that attract and retain skilled talent
• How healthcare organizations can rethink hiring requirements to expand their talent pool
• Why mission-driven work remains one of healthcare's greatest strengths

Key Takeaways The Workforce Challenge Isn't Going Away

Healthcare facilities are facing a perfect storm of aging infrastructure, aging employees, and growing demand for services. At the same time, industries such as data centers are attracting skilled tradespeople with higher wages, making recruitment and retention increasingly difficult.

AI Is Changing How We Work

Rather than replacing people, AI is creating opportunities to automate routine tasks, improve decision-making, enhance safety, and allow professionals to focus on higher-value work. The conversation explores both the promise and the practical realities of AI adoption across healthcare and construction.

Alternative Career Paths Matter

The panel discusses the growing acceptance of vocational training, apprenticeships, and hands-on career development. As labor shortages continue, organizations must broaden how they recruit and develop talent rather than relying solely on traditional degree requirements.

Construction Is Becoming More Industrialized

Prefabricated building components, robotics, automated layout tools, and data-driven workflows are helping construction teams improve efficiency and address labor shortages while maintaining quality and safety.

Culture Is a Competitive Advantage

Creating better work environments—from mentorship programs to improved jobsite conditions—plays a critical role in attracting and retaining talent. Investing in people is no longer optional; it's essential.

Featured Guests

Hamilton Espinosa National Healthcare Core Market Leader, DPR Construction

Patrick Murphy Regional President, CREF

Hosted by: Peter Martin, Healthcare Facilities Network

Connect With Us

If you enjoyed this conversation, subscribe to Constructing with Care for more discussions on healthcare construction, facilities, leadership, innovation, and the people shaping the future of the built environment.

Artificial intelligence is everywhere in healthcare conversations, but where is it actually delivering value?

In this highlight episode of Constructing With Care, we move beyond the hype to explore how AI and digital innovation are actively reshaping healthcare infrastructure, operations, and patient outcomes. Drawing from past episodes with leaders across health systems and industry partners, this conversation connects strategy to real-world application, highlighting where AI is working today and what it takes to scale it responsibly.

• How AI is evolving from concept to operational necessity in healthcare systems
• Where digital innovation is directly impacting patient outcomes
• Why cybersecurity and infrastructure resilience are now clinical priorities
• How health systems are prioritizing capital investments across AI, EHR modernization, and analytics
• The unique challenges, and opportunities, of designing AI for pediatric care
• Real-world examples of AI in action, from virtual care to autonomous security systems

Building with Intention: How the Healthcare Fellowship Is Shaping Better Outcomes

Recorded live from the DPR Healthcare Fellowship Summit in Scottsdale, Arizona

As healthcare systems demand faster delivery, greater coordination, and measurable value, one thing is becoming clear: technical expertise alone isn't enough. In this episode of Constructing With Care, host Leslie Tulio explores how DPR Construction's Healthcare Fellowship is redefining what it means to build healthcare facilities — by grounding project delivery in clinical insight, empathy, and patient-centered thinking.

Recorded at the DPR Healthcare Fellowship Summit, this episode features perspectives from fellowship leaders and participants who share how deeper understanding of clinical workflows, patient flow, and hospital operations is leading to more predictable outcomes and stronger collaboration.

In This Episode, You'll Learn:

• Why the Healthcare Fellowship was created to address the "why" behind healthcare spaces — not just the "what"

• How clinical operations, funding models, and patient-centered care are integrated into the fellowship curriculum

• Why empathy and early engagement reduce risk and improve project predictability

• How fellowship-trained builders are changing job site culture by connecting trades to patient outcomes

• What "go slow to go fast" really means in healthcare construction

Episode Timeline Highlights:

• 00:00 – 01:10: Introduction & purpose of the Healthcare Fellowship

• 01:10 – 04:30: Why the fellowship was created and how it bridges gaps between builders and healthcare leaders

• 04:30 – 06:50: Fellowship impact on project teams and job site culture

• 06:50 – 08:10: Integrated delivery, early engagement, and complex healthcare challenges

• 08:10 – 10:40: "Go slow to go fast" — designing and building with intention

• 10:40 – End: Fellowship outcomes and closing reflections

Learn More

Explore more healthcare construction insights and episodes at: constructingwithcare.com

Subscribe to Constructing With Care on your favorite podcast platform, and follow DPR Construction on LinkedIn and YouTube for featured content.

This special highlight episode brings together the most impactful moments from every Constructing with Care conversation released in 2025. Through a curated set of clips—no narration needed—we revisit the insights that shaped this year's themes across capital planning and prefabrication.

In This Episode: *Aligning capital investments with long-term clinical vision *Using data to bring clarity and confidence to decisions *Closing the gaps between strategy, design, and implementation

*Tangible benefits and early-stage predictability *How prefab improves workflow, care delivery, and patient experience *Achieving cost certainty and mitigating risk in complex healthcare projects

These guest-driven highlights reflect the evolving approaches healthcare organizations are using to build smarter, more resilient facilities.

Tune in for a concise review of the ideas that shaped 2025.

In the third episode of this Constructing With Care, short series, host Leslie Tullio from DPR Construction is once again joined by Curtis Skolnik of CommonSpirit Health and Jonathan Bykowski of Array Advisors. Throughout Episode 21 the team explores how healthcare organizations can execute with confidence, from lean construction and technology integration to data-driven decision-making. The conversation dives into the challenges of bridging gaps between strategy, operations, and clinical realities, the role of AI in modeling patient care, mitigating bias in decision-making, and the power of Lean and Six Sigma processes to streamline implementation.

Key Topics

01:20 – Emerging Technologies & Process Enablement Curtis and Jonathan discuss promising technologies and the potential for AI to optimize planning and operational decisions, including modeling patient flow and bed utilization.

02:18 – Bridging Strategy, Data, and Clinical Operations The discussion highlights the disconnects between hospital strategy teams, clinical operations, and patient care realities. AI is seen as a tool to bridge these "chasms," helping identify opportunities like step-down care vs. ICU placement.

04:14 – Entrepreneurial Opportunities in Chasm Bridging The panel identifies gaps in healthcare data utilization and how new ventures could address them.

05:23 – Managing Data Overload Conversation on balancing the abundance of data with actionable insights, ensuring decision-makers aren't overwhelmed.

06:39 – Future-State Planning & Flexibility Jonathan emphasizes that long-term plans need built-in flexibility—"back roads maps"—to accommodate changing inputs and dynamic healthcare environments.

10:42 – Human Complexity in Implementation The panel explores how humans and bias affect project execution and the importance of structuring implementation to account for these complexities.

13:26 – Advocating for Equitable Participation Jonathan shares strategies for ensuring all voices are heard in planning sessions, emphasizing equity over equality to combat power dynamics and bias.

17:08 – Lean Six Sigma for Implementation The conversation pivots to Lean and Six Sigma principles, demonstrating how a systems-based approach improves project execution and reduces downstream inefficiencies.

21:13 – Lean Philosophy & Process Accountability The episode closes by reinforcing that errors and inefficiencies are always a reflection of the process, not individuals, and that continuous improvement depends on fixing the system rather than assigning blame.

Quote

• Jonathan Bykowski, Array Advisors

"We need to stop chasing perfect data and start trusting the patterns we see in real-time."

In episode 20 of Constructing With Care, host Leslie Tullio from DPR Construction continues the conversation with Curtis Skolnik of CommonSpirit Health and Jonathan Bykowski of Array Advisors. Building on their earlier discussion about vision, stakeholder alignment, and data-driven strategy, they now dive into how organizations execute with confidence—exploring the role of lean construction, BIM/VDC, technology integration, and leadership in navigating capital projects.

Host, Leslie Tullio is joined by:

• Curtis Skolnick, CommonSpirit Health

• Jonathan Bykowski, Array Advisors

Episode Highlights

• 01:30 – The role of BIM and VDC Curtis discusses how early-stage planning tools accelerate implementation, but also the challenge of how far to push them in upfront planning.

• 02:59 – Industry gaps in technology adoption Jonathan challenges the AEC industry's slow progress, explaining why BIM is really data and how outdated paradigms still hold projects back.

• 05:42 – Balancing innovation with value Curtis emphasizes that innovation must have practical value, not just novelty.

• 06:17 – Creating room for experimentation Jonathan highlights the lack of a "safe space" to test new approaches and how integrated project delivery helps create room for experimentation.

• 07:35 – Financial risk and uncertainty Curtis explains how CommonSpirit uses constant data modeling to mitigate financial risk in a volatile environment.

• 09:14 – Resource allocation challenges A look at how health systems manage limited human resources and prioritize projects.

• 10:53 – Rethinking ROI Jonathan describes how clients are focusing more on long-term flexibility and adaptability, not just immediate cost-benefit.

• 13:02 – Building a leadership bench Curtis shares how CommonSpirit fosters a culture of collaboration, innovation, and change through leadership development.

• 15:40 – Working with different client cultures Jonathan explains how Array Advisors adapts its role to support diverse organizational cultures, sometimes even using creative tactics like removing titles in meetings.

• 17:53 – Building trust and relationships Both guests reflect on the importance of trust and relationship-building in driving project success.

• 19:25 – What the future holds Predictions for the next 5–10 years: the emergence of a two-tier healthcare system and the need for faster decision-making.

• 21:13 – Advice for navigating uncertainty Curtis: Understand your risk tolerance and the risk/reward equation. Jonathan: Be brave and do no harm.

Quotes

Curtis Skolnick

"Not all ROI is financial—sometimes it's access, equity, or the human impact that matters most."

In episode 19 of Solving What's Missing in Healthcare, we continue our Constructing With Care series with an in-depth conversation on how health systems can strategically plan capital investments amid today's challenging environment. From rising labor and material costs to suppressed patient volumes and volatile supply chains, healthcare leaders are being forced to rethink how they prioritize, phase, and finance projects.

Host, Leslie Tullio is joined by:

• Curtis Skolnick, CommonSpirit Health

• Jonathan Bykowski, Array Advisors

01:10 – Market Pressures & Capital Planning How rising costs, suppressed volumes, and community needs are reshaping capital investment strategies.

04:07 – Aligning Projects to Strategy Balancing opportunity costs, phasing investments, and ensuring long-term alignment with vision.

05:19 – A Disciplined Process A structured approach to project evaluation—balancing ROI, infrastructure, and mission-driven goals.

06:26 – Consultant Perspective The role of consultants: distilling complexity, simplifying data, and focusing leadership conversations.

08:33 – Stakeholder Engagement The outline for a collaborative, non-dictatorial approach that balances leadership, end users, and external partners.

10:42 – Culture, Politics & Listening The reality of political dynamics in hospitals, the role of active listening, and facilitating C-suite dialogue.

13:35 – Objectivity & Empathy Leading with dispassion, objectivity, and understanding frontline realities.

14:22 – The Role of Data How predictive modeling and simplified synthesis help health systems solve root problems, not symptoms.

18:07 – From Data to Predictive Tools Efforts to triangulate data, search for "single sources of truth," and explore AI-driven decision support.

21:01 – Closing & Takeaways The future of predictive analytics in healthcare capital planning—and the search for tools to balance strategy, ROI, and patient care.

Quotes:

Curtis Skolnick

"We're making decisions about how to care for the next 100 years of patients. That takes strategy, not speed."

Jonathan Bykowski

"If hospitals are the trauma bays for community health, then strategic investment is the triage."

In Episode 18 of Constructing With Care, host Leslie Tullio welcomes back Sarah Francis (Enterprise AVP of Standards and Activation at Advocate Health), Jeff Schroder (AVP of Planning, Design & Construction at Atrium Health), and Sean Ashcroft (Healthcare Core Market Leader at DPR Construction). Together, they explore how prefabrication and standardization in healthcare environments drive cost certainty, boost efficiencies, reduce risk, and still allow for innovation. This episodes highlights:

• The importance of robust pre‑construction collaboration: by bringing decision‑makers onboard sooner, teams can identify schedule savings and cost efficiencies early.

• How knowing handoffs between trades in advance enables reducing two weeks of work from scopes, enhancing efficiency on-site.

• The 80/20 rule: 80% standardized design ensures efficiency; 20% flexibility supports unique needs.

• How standardization frees time to focus on innovation—like implementing AI, new tools, and future‑proofed master planning.

• Why prefabrication enhances cost certainty, expedites schedules, elevates quality, and reduces risk.

• Tips to influence stakeholders, demonstrating community benefit, clinical engagement, proven partners, and breaking traditional paradigms.