A major theme in Health Facilities Management's coverage has been the increased emphasis on community health and its effects on health care design, construction and operations.

One only needs to look at HFM's annual Hospital Construction Survey to note the number of hospitals considering neighborhood-based projects such as primary care clinics, ambulatory surgery locations, urgent care centers and even senior care environments in response to health care reform.

The transition presents many challenges to health facilities professionals as they adapt their talents from complicated but familiar hospital facilities to a mix of buildings that must be planned, built and maintained under different sets of assumptions and varying codes.

Running the gamut from custom-built freestanding structures to repurposed retail spaces to inherited physicians' offices, these facilities have the exterior aesthetic challenge of clearly signifying their purposes while unobtrusively fitting into their environments. Interior designs can vary from warm and welcoming to stark and clinical.

Likewise, space-efficiency requirements can range from the fast-paced flow of emergency medicine to the sedate tempo of long-term care and everything in between. The emergence of care teams, moreover, puts a premium on collaborative space.

Finally, perhaps nowhere are these challenges more apparent than in infrastructure design and operations. As centrally established utilities and technologies give way to linked or remotely monitored systems, many concepts will be reconsidered.

The growth of these facilities will signal a major shift for HFM's readers, as they incorporate disparate elements into a new delivery system that moves off campus and into the community.