Hospitals aren’t just Buildings: Deb Sheehan says they are Part of Care
By Arunima Rajan
In an interview with Arunima Rajan, Deb Sheehan, health care market strategy leader at DPR Construction, talks about the challenges she faced as a woman health care leader. Sheehan has spent more than 30 years influencing health care planning, design, construction and business strategy. At DPR, she helps health systems across the country think through their facilities in a more strategic way, using data and collaboration to support better outcomes.
You've spent over 30 years at the intersection of healthcare and the built environment — a space where few women have led. When you look back at the trajectory of your career, what was the defining moment that made you realise the physical design of healthcare facilities could be just as transformative for patient outcomes as the clinical care delivered inside them?
I feel very blessed that, very early in my career, I had a clarifying moment that really shaped my focus and helped me realize the impact that real estate has on patient outcomes.
Deb Sheehan, Health Care Market Strategy Leader, DPR Construction
When I was fresh out of school and working at the Cleveland Clinic, I was touring the neonatal intensive care unit with a nurse manager who was guiding me on infection control protocols. The NICU was busy with activity and congested with equipment, staff and isolettes crowded close to one another with barely room for the parents gathered tightly around them. In the middle of the room, I noticed one couple holding their baby outside the isolette without gloves. Based on the protocols I had learned, I immediately thought it was a mistake. The nurse explained that the infant was failing to thrive and nearing the end of life, and that in those final moments, skin-to-skin contact of the baby with their parents was permitted.
I will never forget standing there, hearing the din of alarms and witnessing the chaos caused by the congestion in the space. I was overwhelmed by the experience that family was having in such a sacred moment. That was when it crystallised for me that the built environment is not separate from care delivery. It directly shapes how those moments are supported and experienced.
Working in healthcare real estate means you are present for both the celebration of life and the transition at the end of it, as well as key moments of healing between those milestones. Instilling dignity in those moments has fueled my passion ever since. I remain committed to finding ways to never lose that sense of empathy and understanding for the perspectives of the users in the spaces we create and how those moments will transform lives over time.
The construction industry remains overwhelmingly male, women hold only a small fraction of leadership roles. As a woman who has risen to the top of healthcare construction strategy, what barriers did you encounter that were unique to being a woman in this field, and how did navigating those challenges shape the kind of leader you are today?
The biggest lesson I learned early in my career was how to be a chameleon. When I started my career in 1989, construction was a tough industry for women. I was often discounted on job sites just by my gender and heard my share of comments like “I see you brought the skirt”. I developed thick skin quickly and learned to let petty comments roll off my back.
But the deeper lesson was realising that success in this industry requires an understanding of your audience and adapting how you communicate. Being a chameleon does not mean losing who you are; it means adjusting your approach so your message can be heard.
That realisation put the onus on me to educate myself beyond design and construction. I needed to understand the challenges and value systems my audience carried so that I could see things through their lens. So, I made it a habit to spend time learning how healthcare leaders think about the pressures they face, how they define value and what success looks like from their perspective. When you can get into someone else’s head space and frame ideas through their lens, your message is far more likely to resonate.
At DPR, we apply the same principle through what we call True North sessions, which are designed to help capital project development teams understand how each stakeholder defines value and success. Tuning into that early in the engagement, keeps everyone aligned on the outcomes that matter most. It requires stepping outside what we are traditionally taught in engineering, architecture or construction management. We invest in understanding our audiences so that we can be more effective in supporting them and delivering meaningful results.
You're known for championing an evidence-based approach to healthcare facility planning and construction. Can you walk us through a specific example where data fundamentally changed how a health system thought about its physical footprint, and what that meant for clinical or financial performance?
One example that stands out was our early-phase capital planning work with Providence on a new heart center. They brought us in early to support assessment and feasibility planning, and as part of the program analysis, we looked at something they had not fully examined before: workforce capacity over time. We studied the cardiologist workforce in that market and developed a 10-year forecast that examined expected retirements and the pipeline of new providers entering the field. This was happening in the post-COVID environment, when burnout and workforce erosion were already top of mind across healthcare.
What became clear through the analysis was that the region was heading toward a significant shortage of providers – a gap that was expected to grow over the next decade. Once they saw that data, it started to reshape how they thought about the program. It placed pressure on workflows and on how technology would be used to support care delivery. They realised the traditional model would not be sustainable if fewer providers were available in the future. That insight ultimately led them to consider a different solution set, one designed to adapt to the workforce realities they knew were coming.
Another example comes from work with a healthcare organisation facing significant reimbursement cuts tied to Medicaid funding. The leadership team had envisioned a program that exceeded the capital they ultimately had available. As they worked to close that gap, they began reducing elements of the program without benefit of fully reconciling the impact on their financial proforma.
Using our dynamic cost modeling tools, we introduced a way to evaluate those decisions in real time. The tool cost loads the program assumptions with capital investment cost as well as anticipated service revenue predicated conservatively at CMS reimbursement rates linked to the organizations’ data. Modeling with this tool allowed the team to see how program changes would affect both the capital budget and the business case. We worked rapidly through scenarios in a matter of hours, not days or weeks, with their executive leadership team. The ability to quickly test and assess impacts of various program reduction strategies in real time empowered the chief nursing officer, chief operating officer and chief financial officer to actively sculpt the best solution outcome tuned to their financial limitations. The analysis provided quick clarity and greater conviction in decision making. Instead of discovering unintended consequences months later, the team was able to test different scenarios and find the right balance between diagnostics, bed capacity and the support systems needed to make the program viable.
Healthcare systems across the country are rapidly shifting care from hospital-based settings to lower-cost ambulatory and outpatient sites. You've advocated for modular construction and prototyping as ways to meet this demand faster and at lower cost. What does this transformation look like in practice, and why should health system CEOs be thinking about their construction strategy as a competitive advantage?
A relevant example is our work in support of a national healthcare system to scale ambulatory care delivery across its regions. As a national system operating coast to coast, they were looking for a way to create consistency for their members while also improving speed to market and cost certainty. They leaned into modular construction and prototyping to standardize how their ambulatory facilities function and how they represent their brand.
Much like retail environments with familiar and predictable layouts, the health system has developed a sophisticated template for ambulatory clinics seated within regional hubs for care, that unify diagnostic and treatment services for their members. Their clinical expert panels define the core program and design criteria, ensuring the spaces support the workflows their providers rely on every day. From there, the model can be applied consistently across regions while still adapting to local service area needs. Where it becomes particularly powerful is how the health system paired that design strategy with purchasing agreements across their supply chain.
By establishing memorandums of understanding with key partners, they were able to bring greater predictability to labor and commodity pricing and mitigate supply chain volatility. The result is a model that helps them address three priorities at once. It accelerates occupancy dates for care delivery because the prototype continues to evolve rather than starting from scratch each time. It creates greater cost certainty through standardized purchasing and repeatable delivery. And it reinforces a branded, consistent experience for both their members and caregivers across their system.
Our role has been helping the health system operationalize that strategy. Together we developed a playbook that allows teams across the country to implement the templates consistently while continuing to refine them with each new project. Each iteration builds upon the lessons learned from the last one, which allows the model to keep improving as they scale it across their network.
You've chaired the Women Health Executives Network and the Health Executives Forum. Through those roles, you've had a front-row seat to the progress — and remaining gaps — in women's leadership in healthcare. What do you see as the most important thing established women leaders can do right now to accelerate the pipeline of women into senior roles, especially in the less visible but critical parts of the healthcare ecosystem like planning, design, and construction?
For me, it starts with mentorship and being accessible. I was fortunate to have great mentors early in my career, and I try to pay that forward whenever I can. If someone reaches out and asks how I got where I am or wants advice navigating this industry, I make the time. Being generous and transparent about your experiences matters.
One of my early mentors told me that you cannot walk the journey for someone else, but you can give them the space to test, learn and build their confidence. Failure is part of the process. It is how people develop judgment and find their own voice.
I saw this play out a few years ago when I worked closely with a young professional who had just relocated to a new office and stepped into a role that was well outside her comfort zone. I told her I had her back and we would navigate it together. Rather than telling her exactly what to do, I gave her guidance and the room to experiment. When women are supported that way, you see them grow into leaders in their own right. And that, to me, is the most rewarding part of mentorship.
I’m also encouraged by how much more support exists for women today than when I started in the industry. Networks and advocacy groups have grown significantly. At DPR, the scale and impact of our Women in Construction Week is a great example. It highlights not only women in leadership roles, but also the growing presence of women across the trades, which historically had very closed doors.
Climate disasters, pandemics, and technological disruption are putting unprecedented pressure on healthcare infrastructure. How should health systems be thinking differently about the resilience and adaptability of their physical facilities, and what role does construction strategy play in ensuring continuity of care during a crisis?
Healthcare leaders are thinking about resilience differently today, largely because capital budgets no longer have the same room for full redundancy that they once did. In the past, critical facilities were often designed with complete backup systems, whether that meant multiple power feeds or redundant infrastructure, in case something went offline. That level of duplication is much harder to afford today.
As a result, organizations are becoming much more intentional about how they plan and distribute services. Rather than focusing on resilience at a single facility, many leaders are thinking about resilience across their entire network. That means asking questions such as whether another location within the system can absorb demand if one facility is offline or overwhelmed, or whether key services like imaging or diagnostics can be accessed within a reasonable distance by patients. It’s a more holistic approach that looks at the interdependence between facilities rather than treating each building as a standalone asset. In many ways, it reflects a broader shift toward system thinking. Healthcare leaders are evaluating how their entire portfolio of facilities works together to maintain access and continuity of care, even when unexpected disruptions occur.
Your career has taken you from architecture and design to consulting to construction — and you've consistently worked alongside clinicians, policy leaders, and health system executives. What do most healthcare leaders get wrong about the relationship between their clinical strategy and their facilities strategy, and what does truly integrated planning look like?
One of the challenges I’ve seen is that clinical strategy and facility strategy were often developed on separate tracks. Clinical leaders would define the model of care they wanted to deliver, and facilities would then try to design a building around it. The problem is that by the time those conversations came together, the physical environment was already limiting what the clinical strategy could become.
What we are seeing now is a shift toward much tighter integration between those two conversations. Healthcare leaders recognize that clinical models are evolving rapidly due to digital platforms and interoperability, AI-enabled clinical and operational decision support, remote/virtual care, new treatment protocols and changes in reimbursement that reward value, access and throughput. If the facility is too customized or rigid, it can struggle to accommodate new technology footprints and evolving staffing models, quickly becoming obsolete.
A good example is the operating room. In the past, ORs were often designed very specifically around a particular type of procedure or specialty. Today, many systems are moving toward more universal platforms. More adaptable rooms can accommodate new technologies and allow care teams to shift how those spaces are used over time as clinical practices evolve.
Truly integrated planning starts by bringing clinical leaders, designers, builders and technical experts together much earlier in the process. When those voices are aligned from the beginning, the facility strategy becomes an enabler of the clinical strategy rather than something that has to catch up to it later. That early collaboration is where the most innovative solutions tend to emerge. It allows organizations to create spaces that meet today’s clinical needs while remaining flexible enough to support how care will be delivered in the future.
If you could go back and give advice to the young woman who started her career in healthcare planning more than 30 years ago, what would you tell her? And what would you say to a young woman today who is considering a career in the healthcare built environment — a field she may not even know exists?
I would tell her it is okay not to have all the answers. Early in my career, I put a lot of pressure on myself to show up prepared for every question and every possible scenario. What I’ve learned over time is that it is perfectly acceptable to say, “I don’t know, but I will find out.” That mindset takes a lot of pressure off, especially for young professionals who sometimes hesitate to step forward and share their ideas because they think they need to know everything first.
I would also remind myself that failure is a necessary part of the growth journey. When I started, I saw failure as something to avoid at all costs. Over the years, I’ve come to see that it’s often how we learn that matters most. You test ideas, you refine them and you try again. That process is how you grow.
Finally, surround yourself with people who are smarter than you. Having a strong team dynamic, where people complement each other’s strengths and can challenge each other to advance ideas, makes all the difference. When you build that kind of environment, we are all better because of it.
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