It's impossible to spend any time covering the health care design, construction and operations field without noticing the profusion of alliances, consortia, initiatives and similarly named aggregations targeting many of the challenges facing hospitals today.

Focusing on specific areas within disciplines such as engineering, technology, operations and planning, these groups sometimes are assembled under the guidance of established membership associations and sometimes formed by other industry players.

In either case, they provide a clear indication of the dynamic cooperation and innovation under way in health care. In fact, prodded by reform uncertainties and financial realities, health care these days resembles a scrappy startup industry rife with entrepreneurial experimentation and technological cross-pollination rather than a mature and static behemoth, as it has often been portrayed.

In addition to our coverage of such established organizations as the American Society for Healthcare Engineering and the Association for the Healthcare Environment, Health Facilities Management strives to keep you updated on these newer, often under-the-radar groups. In fact, this month's Upfront section carries stories on two programs that are concentrating on environmental performance and energy management.

Whether you seek to become affiliated with such efforts is determined by your priorities. But to be unaware of their activities is to risk falling behind.