The average hospital is 20 to 30 years old. Yet in that time, game-changing technologies have emerged—smartphones, AI, telemedicine, advanced immunothearpy—all with implications for the design of healthcare buildings.
Combined with growing operational demands, these advancements push healthcare real estate to evolve faster than ever. Yet many existing facilities are not designed to adapt at this pace, let alone stay relevant for generations.
Instead of the static structures of old, hospital buildings can now routinely make it to the century mark through integration of a hyperflexible Universal Platform—a resilient, cost-effective design solution.
Typically, hospital lifespans are short because of...
Static Infrastructure
Evolving Service
Lines
Limited Space
Unlike hospitals constructed to meet the needs of a specific healthcare service or provider, a Universal Platform creates a flexible framework that supports multiple clinical space types, even as they change. It places core elements, such as columns, elevator shafts and stairs in consistent areas across every level, leaving the rest of each floor’s real estate free for reconfigurations.
While the term “universal” in healthcare design is traditionally used on a micro scale, a Universal Platform extends throughout an entire hospital’s design. This includes built-in infrastructure that anticipates future programs, tests how spaces flow and function, and then targets how to efficiently convert them over time.
With a Universal Platform, an outpatient floor that features staff support along the edges and exam rooms at the core...
A Universal Platform uses a consistent column grid on every hospital floor, benefiting both interior flexibility and exterior efficiency. This regularized structure supports modular, prefabricated systems that transform the hospital into a kit of parts assembled onsite. It also enables a rhythmic, repeatable facade and streamlines interior layouts for factory-built components like bathroom pods, headwalls and MEP systems.
A Universal Platform also enables standardized layouts, promoting convenience and familiarity. For example, consistent room features like same-handedness streamline clinician workflows, while universal inpatient rooms offer flexibility for varying acuity and surge capacity needs. This standardization enhances operational efficiency and patient care by helping staff adapt easily without sacrificing functionality.
Interested in learning more about a Universal Platform and if it is the right choice? Meet with NBBJ’s clinical planning team to evaluate your options.
could transform into an inpatient floor, with patient rooms along the perimeter and clinical support at the center.
A Universal Platform can be designed, built and renovated over time, utilizing components that are more permanent and others that are temporary to accommodate future uses. Like a go-to family recipe, a Universal Platform hosts the “essential” ingredients, while allowing other elements to shift as needs evolve.
The core ingredients of a Universal Platform are a structural steel grid, offset cores and higher ceiling heights. By keeping these three elements consistent, it allows interior floors to accommodate more seamless future renovations between outpatient and inpatient spaces.
Together, these factors allow flexible interior elements, such as walls, doors and flooring, to adapt in future renovations. This creates opportunities to evolve patient, staff, support and amenity spaces to meet changing service lines or needs.
Core Element 1:
Structural Steel Grid
Core Element 2:
Offset Core
Core Element 3:
Higher Ceiling Heights
With a Universal Platform, a structural system with 31–32 feet by 31–32 feet column bays offers greater flexibility. This all-purpose dimension can fit multiple programs: three exam rooms or two patient rooms or one operating room.
Another strategy is to place key elements like stairs and elevator shafts in a dedicated “offset core” zone on each hospital level. This frees the rest of the floor for reconfiguration and ensures consistent locations for electrical and technology rooms, supporting future needs. It also improves navigation for clinicians, patients and robots.
Incorporating standardized floor-to-floor heights of 15 or 16 feet facilitates future conversions between outpatient and inpatient floors, which require higher ceilings for systems. Surgical floors, or floors which could become surgical in the future, typically need 18+ feet due to extensive MEP requirements and increased weight capacities for medical equipment.
Image Credit: Adobe Stock / Wild Awake
Cindy Hecker
CEO, University of Washington Medical Center
“
The direction today may not be the direction in five years. We want to be able to maximally utilize space, and the reality is we’ll have to watch the market to see exactly what we need.”
The Universal Platform: A Smarter Approach to Flexibility
With a Universal Platform, an outpatient floor can convert to a procedural floor, placing prep/recovery along windows and support spaces centrally.
The Triple Advantage
Flexibility
A Universal Platform enables easier conversions between outpatient, inpatient and procedural spaces to support growth, consolidation and emerging technologies. Structurally efficient designs simplify column spacing, reducing costly transfers and streamlining both design and construction by allowing columns to be “extruded up” through the building.
Efficiency
Consistency
A Foundation for Flexibility
...
A Universal Platform can save time and money. To assess its suitability, consider projected growth, potential for additional service lines and site constraints. For example, an urban academic teaching hospital may benefit from the Universal Platform due to higher patient volumes, diverse specialties and evolving clinical needs, while a smaller hospital outside an urban center with fewer specialties may not.
Inpatient
Procedural
Public (primary)
Public (secondary)
Surgery (primary 1)
Surgery (primary 2)
Surgery (secondary)
Surgery Circulation (restricted)
Surgery Circulation
Vertical Circulation
Public (primary)
Public (secondary)
Inpatient (primary)
Inpatient (secondary)
Inpatient Circulation
Vertical Circulation
Public (primary)
Public (secondary)
Outpatient (primary)
Outpatient (secondary)
Outpatient Circulation
Vertical Circulation
1
2
3
Inpatient Rooms
Surgery
ICU Situation
Everyday Situation
31' 0"
Core Shifts to Perimeter
31' 0"
31' 0"
31' 0"
15–16' 0"
15–16' 0"
Patient Room Accommodation
Double Bed Situation
Hospital lifespans are short because of...
yet the needs of healthcare systems are always in flux.
...
Outpatient Exam Rooms
Circulation
Circulation
yet the needs of healthcare systems are always in flux.
31–32' 0"
Core Shifts to Perimeter
15–16' 0"
15–16' 0"
Please note that these are illustrative diagrams that have omitted key areas like stairs for visual clarity.
Outpatient
Outpatient Exam Rooms
Circulation
Outpatient Exam Rooms
Circulation
Circulation
31' 0"
6' 0"
8' 0"
8' 0"
8' 0"
31–32' 0"
31–32' 0"
31–32' 0"
31–32' 0"
31–32' 0"
31–32' 0"