Priorities for Strategic Project Execution in a Shifting Healthcare Landscape

Funding pressures in healthcare are reshaping the way capital decisions are made. Costs are climbing, reimbursements are flat, and policies keep shifting. Yet the push to modernize healthcare facilities is accelerating, fueled by dated facilities and the need to keep pace in a rapidly evolving market.

Across the country, infrastructure updates are being delayed – the average age of plant has risen over 10% in two years (AHA, 2024). At the same time, advances in technology are forcing organizations to think strategically to remain viable (JMIR Formative Research, 2022).

Healthcare leaders are moving projects forward in an environment where resources are limited and conditions shift overnight. Every decision you make now carries greater weight – shaping budgets, timelines, compliance, and ultimately, patient care. In this climate, the right decisions come from engaging the right experts early, following a process that adapts to change, and staying focused on the outcomes that matter most for your patients and communities.

The most effective capital projects start with the right people in the room. As a leader, that means getting project support involved early – before plans are too far along to change without pain. Those early conversations set the tone for everything: scope, budget, timelines, and how decisions will be made.

It’s not about having everyone at the table all at once; it’s about knowing who to bring in and when. Clinical leaders, architects, engineers, facilities, IT, and safety each have a role to play, but if their involvement is mistimed, it can create noise or bottlenecks.

Misaligned teams are one of the top reasons healthcare projects go over budget (Health Facilities Management, 2024), and the fix is surprisingly simple – sequence your stakeholder engagement so the right voices are heard at the right moments. Timing isn’t a detail. It’s the difference between momentum and meltdown.

But even with the best team, you need a process built for the real world – not the ideal one. In 2024, nearly 60% of hospitals reported delaying or scaling back projects because of rising costs and funding uncertainty (Health Facilities Management, 2024). That’s the reality leaders are navigating.

The projects that keep moving are the ones designed to bend without breaking. Scenario planning for potential shifts – funding changes, policy updates, new operational priorities – creates clarity on what to do when the unexpected happens.

Phasing the work so each milestone triggers the right conversations at the right time keeps decisions moving. And having a single point of coordination tracking dependencies and impacts across all disciplines means you can pivot without losing momentum.

A flexible process is about being visionary, not reactionary.

Then there’s the question of focus. As a leader, you can’t – and shouldn’t – be pulled into the daily grind of project execution. On a major healthcare build, seventy-plus people may be involved across internal teams and external partners. Without the right structure, burnout isn’t a risk. It’s a guarantee.

Partnering with a team that can act as an extension of your own lets you stay focused on what you do best: setting vision, prioritizing patient and community needs, and keeping the organization’s strategic goals front and center. With that support, resources go to changes that move the needle – boosting efficiency, improving patient experience, and delivering results for years to come.

Some things will never change. Policy debates will keep happening. The market will keep shifting. The need for adaptable, future-ready facilities will only grow. But what can change is how you approach the challenge. Choosing the right people, building a process that can pivot, and keeping your leadership energy focused where it matters most – that’s how you make smart, future-ready decisions under pressure.

Feeling the pressure? Nimble can help. Whether you’re starting a project or navigating a mid-course pivot, we can work as an extension of your team to help you deliver the kind of facility your community will thank you for, now and in the future.

In a moment when patients, families, and care teams are stretched thin, they deserve the strongest support possible. Keep your focus on the people you serve and allow us to focus on helping you.

Leah Sternhagen | Senior Director
leah@nimblepds.com
612-203-4657