An economic meltdown followed by a bitterly fought health care reform battle are hardly the most favorable conditions under which to design, build or operate a hospital. Thus, it's not surprising that health facilities professionals now find themselves at something of a loss when asked to detail their future projects.

Early results from Health Facilities Management's annual Hospital Building Report show construction and renovation plans to be a mixed bag as we move into the new year. Indeed, more than half of the 570 respondents to our 2010 Hospital Construction Survey believe that this year will be similar to 2009 in terms of previously planned building projects and about 29 percent indicate that health reform discussions have impacted their future development plans.

The article, which will appear as next month's cover story, also found that the percent of capital budgets spent on construction in 2009 and allocated for construction in 2010 is substantially less than those spent and planned in 2008 and 2009, respectively. And, not surprising in our currently credit-dry environment, about half of the respondents now report using existing cash reserves to finance construction projects, a noticeable increase over previous years.

In the face of such daunting numbers, however, health facilities professionals appear to be making great strides in controlling their project costs. For instance, the survey indicated that 65 percent of respondents' projects were "on or under budget/on or ahead of schedule."

Indeed, if there's any silver lining to the past year's dark cloud, it is that the health facilities professional's already sharp pencil appears to have grown ever more exacting in the current environment—a skill that will prove useful even when the industry sees better days.