How to build for the unplanned in healthcare

By

Travis Escoffery

and Tara Cohn

Last Updated May 4, 2026

By

Travis Escoffery

and Tara Cohn

Unexpected disruptions and evolving conditions are a given at every step of a healthcare construction project, from conceptualization to ongoing capital improvements. Leaders need to be ready to pivot thoughtfully rather than react in the moment.

While you may not be able to control external forces, you can still shape the outcome of your healthcare construction projects by being willing and able to adapt when plans and reality collide.

In fact, the difference between being adaptable — thinking on your feet, adjusting strategies when new information emerges, and navigating shifting priorities — and stationary can often be measured in millions of dollars on the budget and months on the schedule. 

How can you adjust as conditions change, without losing sight of project intent, care delivery, clinical priorities, or long-term performance?

Let data drive how you pivot.

Real-world conditions are always in motion, and data will always be the starting point for understanding options to continuously refine how work is prioritized, sequenced, and staffed as a response.

The real challenge in using data to adapt.

Healthcare systems rarely, if ever, lack data. Instead, they lack information and the ability to act based on what their data tells them.

Tara Cohn

Director

Wipfli LLP

For you and your team to use data to adapt, the right people must have access to the right information at the right time across financial, operational, clinical, construction, and real estate teams. In other words, each function needs clarity and ownership over information so they can act on their own data while also sharing it in a way that supports how others across the organization will use it.  

For example, information about project performance, real-time spend and schedule status, capital forecasts, and operational constraints should be visible in one place, not trapped in disparate tools, spreadsheets, and email chains. 

Creating this single source of truth allows healthcare construction leaders to:

• Use forecasting and scenario modeling to evaluate how different options affect budgets and ROI 
• Make informed decisions about which projects to advance or delay
• Strategically re-phase work as needed
• Pinpoint who is overextended and where capacity still exists
• Adjust contingency and cash flow as realities shift

What integrated insights look like in practice

Tampa General Hospital Construction Services Manager Chris Lucas’ experience with healthcare construction illustrates how information integration enables adaptability.

As his organization expanded from a single hospital to a system with nearly 200 locations, project volume climbed alongside the number of variables that had to be managed simultaneously: different sites, risk profiles, stakeholder needs, etc. 

To monitor status and workload in real time during this period of growth, his team integrated their construction tools with their accounting systems. This allows healthcare finance leaders to answer questions about purchase orders, payments, and project capacity without waiting for information from other departments. It also ensures consistency in terms of how stakeholders operate and report.

Finally, it makes it easier for construction and facilities leaders to rebalance projects and resources as needs change.

Tampa General Hospital used to be a stand-alone hospital with few ambulatory facilities. Now we’re a healthcare system with almost 200 locations, and we’re growing exponentially. Being resilient means being able to scale our processes and operations.

Chris Lucas

Director of Construction

Tampa General Hospital

Adding external signals to internal numbers

While internal data is essential to adaptability, external data rounds out the picture. Without it, adapting in the wrong direction becomes too easy.

Pairing internal data with external market and community signals — such as demographic trends, utilization patterns, and competitor presence — helps leaders adapt to where demand currently exists and where it could emerge next. These insights can reshape which projects move forward and how aggressively to invest.

Finally, layering internal and external data with perspectives from all stakeholders — clinicians, operators, compliance, construction, and finance team members — helps organizations validate and refine how they interpret data and adjust plans to support all priorities, from clinical workflows and regulatory requirements to capacity planning and financial health.

For instance, a proposed expansion might look unnecessary when you view internal numbers. When clinicians surface access issues and community data confirms unmet demand in that service area, however, leaders may adapt and reconsider the project as a strategic priority.

How one hospital adapted spending to better reflect project timelines

Adaptability doesn’t always mean changing what or how you build. Sometimes it’s about rethinking how you plan and spend as new information comes to light. 

Case in point: Boston Children’s Hospital. There, healthcare construction leaders manage a large, complex portfolio of more than 400 active projects in various stages. But they were constrained by capital spend forecasts with a high margin of error. Inaccuracies meant that funding was often tied up in stalled projects, while other critical needs went underfunded or delayed. 

Rather than accepting this as reality, the Boston Children’s Hospital team adapted its construction approach and spending habits to match how work was progressing. 

The change started by looking at how and where money was being spent. Facilities and finance teams used the analytics in their construction management platform to analyze historical spending patterns across projects and compare forecasts with reality.

That analysis made it clear where forecasts routinely overshot or lagged actual spend. It also revealed a pattern: Capital was being requested and released based on habits and assumptions rather than on how work unfolded in the field. 

After analyzing those patterns, the team was able to reset forecasting assumptions and rebuild spending plans. Now, purchases align with schedules, allowing resources to be used more efficiently. One example is their allocation of furniture and equipment costs to project timelines rather than committing to those expenses too early. This reduces the risk of paying for assets long before they’re needed, which historically tied up capital and caused those assets to depreciate before they were ever used by patients or staff.

By grounding decisions in real performance data, Boston Children’s Hospital is optimizing its investments. Adjusting when and how funds are committed lets capital flow in step with design and construction progress. This has improved forecasting accuracy and financial foresight, giving executives more confidence that approved projects will move forward as planned (and that resources won’t sit idle). It also frees up capital, which can be redirected to other priorities to support care delivery.

Where adaptability will lead

The ability to adapt effectively to change allows healthcare construction leaders to protect capital investments, support delivery timelines, and make sure every facility they build or upgrade continues to advance their organization’s mission of care well into the future.

Treating adaptability as a deliberate, data-informed practice enables healthcare construction leaders to deliver projects that are ready for everything that comes next.

Written by

Travis Escoffery

Senior Product Marketing Manager | Procore Technologies

Travis Escoffery is an experienced Product Insights and Strategy leader with a proven record of transforming complex technical capabilities into value-based, measurable business results. Travis plays a leading role in advancing Procore’s product and technology vision, helping organizations adopt solutions that deliver stronger performance and accountability across their capital programs.

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Tara Cohn

Director | Wipfli LLP

13 articles

Tara Cohn is a director with over 15 years of experience in providing healthcare data analytics services. She helps leaders improve decision-making and achieve success with the use of data analytics. Tara’s experience includes provider practice, hospital/health system and healthcare startup/technology. She is a healthcare subject matter expert and has supported initiatives across operations, clinical care, quality, compliance, patient experience, population health, marketing, strategic planning, finance, revenue cycle and human resources. Tara’s passion is in leveraging data analytics to help organizations achieve their full potential with a focus on transparency, optimization and automation via the power of data storytelling.

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