Choose a hospital architect by starting with the care the facility must support, then testing whether the proposed team can translate the owner’s operational requirements into a coordinated design. Define the project before soliciting proposals, decide how the architect will be engaged, compare the people and process each firm is actually offering, and confirm which codes and local rules apply. A healthcare portfolio or professional credential can be relevant evidence, but neither by itself establishes that a team is right for your project.
Start with the hospital’s purpose, not the firms’ portfolios
Before inviting architects to compete, the owner’s governing body and project leadership should agree on why the project is needed and what it must accomplish. A hospital project is not defined only by its floor area or building type: its care services, operating model, users, constraints, and supporting systems all shape the brief an architect must respond to.
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Develop or refine an owner’s functional program and use it as the common basis for planning and proposal review. The Center for Health Design’s functional program guide describes a five-step process intended to help providers create a program for planning, design, and construction. It explains that the program communicates owner intent to designers and provides a basis for design. The guide quotes the FGI Guidelines’ purpose this way: “The primary purpose of the functional program shall be to communicate the owner’s intent for the project to the designers of record as a basis for design at the initiation of the project”.
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Put the owner’s requirements in one shared brief
At a minimum, describe:
- Purpose and care model: why the project is being undertaken and what care the hospital will provide.
- Services and spaces: which departments, functions, and project components are in scope, and what needs to be accommodated.
- Operations: relevant workflows, facilities and maintenance needs, operational constraints, and any conditions that affect how the hospital must function during or after the work.
- Systems and scope: relevant building systems and the project boundaries the owner expects the architect to address.
- Assumptions and governance: budget and schedule assumptions, decision-makers, and the process for resolving choices or changing requirements.
These are briefing topics, not a substitute for project-specific programming. The owner’s team should determine what detail is appropriate for its facility, services, and delivery arrangement. A clear account of what is known, what remains to be decided, and who owns each decision helps firms propose a meaningful approach rather than a generic service description.
Bring clinical and operational voices in early
FGI’s application guidance treats the functional program and safety risk assessment as owner-driven planning tools. The functional program identifies types of care and the spaces needed to support them; safety risk assessment helps determine appropriate design responses. That makes clinician and infection-prevention input part of forming the project requirements, not merely a final review after major design choices have been made.
Include the relevant clinicians, infection preventionists, facilities staff, and other care providers early enough that their operational knowledge can shape the program. The architect should be able to explain how the team will gather that input, document decisions, and carry requirements into design. The owner remains responsible for establishing priorities and governance; stakeholder engagement does not mean every participant has identical authority or that every request can be accommodated.
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Decide how the architect will be engaged
Know the project’s delivery structure before evaluating proposals, because it affects who contracts with whom and how the owner will coordinate design and construction. In the conventional arrangement described by the American Institute of Architects, the architect is hired by and reports to the owner, with the owner, architect, and builder as the primary project-development players. In design-build, the architect and builder are part of one firm hired by the owner.
| Delivery arrangement | Relationship to understand | Owner’s selection question |
|---|---|---|
| Conventional arrangement | The architect is hired by and reports to the owner; the owner, architect, and builder are the primary project-development players. | How will the architect work with the owner and coordinate with the builder as the project develops? |
| Design-build | The architect and builder are in one firm hired by the owner. | Who is the owner’s lead project contact, and how will design decisions be managed within the integrated team? |
Neither structure removes the need for owner governance. Before comparing firms, identify the intended delivery relationship, the owner’s project lead, decision rights, and how design decisions will be tracked. If the delivery method is not settled, say so and ask candidates to explain the assumptions behind their proposed role; do not compare an architect-only proposal with an integrated proposal as though the responsibilities were automatically equivalent.
Look for relevant healthcare experience and the right people
Healthcare-facility experience is a core qualification to examine, but experience should be relevant to the project rather than reduced to a count of buildings or attractive photographs. The Center for Health Design’s healthcare development guide recommends seeking healthcare-facility experience and checking recommendations from peers. For a health-center project, it advises looking for health-center experience where possible. That is useful selection guidance, not a universal procurement rule or a guarantee of success on a hospital project.
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Ask firms to identify comparable projects and explain what their proposed team actually did on them. A firm’s organization-wide portfolio does not establish that the people named in your proposal worked on those projects, nor that those people will be available for your work. Focus on the named team, its relevant roles, and its proposed involvement.
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Questions that reveal how experience transfers
- Which members of the proposed team worked on each cited project, and what were their specific responsibilities?
- How did the team translate the owner’s functional program into design options and decisions?
- How were clinicians, infection prevention, facilities operations, and other users engaged and their input recorded?
- What role did the team play in safety-risk discussions and in coordinating with engineering and construction partners?
- Can the owner speak with references whose facility type, scale, operational constraints, or delivery method resemble this project?
- Who will be available if the project’s needs change or a key proposed team member becomes unavailable?
These questions distinguish relevant project evidence from marketing claims. A portfolio image rarely shows how a team managed user engagement, phasing, safety risk, or the connection between the program and design. Ask for explanations and verify references with comparable owners instead of treating a list of project names as proof.
Compare proposals against the same owner-led criteria
Give each candidate the same project brief and consistent questions. Compare the substance of the proposed work, the people who will perform it, and the clarity of assumptions. The criteria below are a practical owner-oriented framework derived from the roles of owners, architects, and planning stakeholders; they are not a published scoring standard. No universal weighting or procurement formula for choosing a hospital architect is established by the cited guidance.
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| Decision area | What to examine | Useful evidence to request |
|---|---|---|
| Healthcare relevance | Experience with healthcare facilities and projects comparable in facility type, scale, operations, constraints, or delivery method. | Project descriptions identifying the firm’s role, proposed team members’ roles, and an owner reference. |
| Proposed team | Whether the named people have the relevant experience and whether their roles and availability are clear. | A team organization and a clear account of who leads, participates, and makes decisions in the proposed process. |
| Program-to-design approach | How the firm will understand and document owner requirements and develop design options from them. | An explanation of how requirements, alternatives, and owner decisions will be carried forward. |
| Clinical and operational engagement | How the process will involve clinicians, infection preventionists, facilities staff, and other relevant users. | A proposed engagement and decision-recording approach tied to the project brief. |
| Coordination and delivery | How the architect will coordinate with engineers and construction partners under the owner’s chosen delivery structure. | A description of responsibilities, communication channels, and how design decisions will be managed. |
| Codes, risk, and jurisdiction | Whether the proposal recognizes that applicable requirements depend on the project’s location and authority having jurisdiction. | A plan for confirming governing requirements with qualified project professionals and the relevant authority. |
| Scope, fee, and communication | Whether assumptions, scope boundaries, communication expectations, and fee structure are understandable and comparable. | A proposal that makes included work, exclusions, decision points, and communication approach clear. |
| References | Whether prior owners can speak to the candidate’s work in circumstances relevant to this project. | Peer references from comparable facility types, operational conditions, or delivery arrangements. |
Use the comparison to identify trade-offs and follow-up questions, not to disguise uncertainty behind a falsely precise score. If the owner chooses to score proposals, it should define the criteria and any weighting before reviewing submissions, apply them consistently, and comply with applicable procurement rules. The cited sources do not prescribe numeric weights, and this article does not assign them.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Confirm the applicable codes and local requirements
Do not assume that the newest published edition automatically governs a project. FGI says its guidelines are widely recognized and that states use them to varying degrees to inform or articulate regulation. Its 2026 series distinguishes the codes, which provide enforceable requirements, from the handbooks, which add commentary, technical guidance, and practices. The edition and requirements applicable to an individual project depend on adoption and local rules.
Ask the project team to confirm the governing edition, applicable local amendments, licensing and procurement requirements, and the authority having jurisdiction for the project’s actual location. Involve qualified project professionals and the authority having jurisdiction as appropriate. A candidate’s familiarity with a particular FGI edition may be worth discussing, but it does not establish that edition as legally applicable or replace location-specific verification.
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Run a disciplined selection process
- Align the owner’s leadership. Agree on project purpose, care services, scope, constraints, assumptions, and who is authorized to decide.
- Develop the functional program. Document the care and operational requirements that will inform planning and design; bring relevant clinical, infection-prevention, and facilities perspectives into the work.
- Set the delivery and procurement approach. Clarify the expected architect relationship, owner lead, decision process, and any applicable procurement requirements before inviting proposals.
- Issue one common brief. Give all candidates the same requirements and request comparable information about experience, team, process, coordination, scope, fee, and references.
- Evaluate the proposed team and method. Test claims against project roles, user-engagement plans, program-to-design approach, and clarity about assumptions.
- Check references and resolve uncertainties. Speak with owners whose projects offer useful comparisons and ask follow-up questions where proposal assumptions differ.
- Verify local requirements before relying on a code claim. Confirm the governing edition, amendments, procurement and licensing rules, and authority having jurisdiction for the actual project location.
Keep the final decision tied to the owner’s documented needs and the proposed team’s demonstrated ability to address them. If a candidate’s experience is strong but its named team or availability is unclear, resolve that before selection. If proposals use different scope assumptions, clarify them before comparing fees. If the jurisdictional path is uncertain, treat that as an open project issue to verify rather than a reason to assume a particular edition applies.
Common selection mistakes to avoid
- Starting with aesthetics alone: visual work matters, but it does not show whether a team can understand clinical operations, engage users, or carry an owner’s program through design.
- Assuming a credential guarantees fit: no credential alone establishes project success; examine relevant work, the actual team, process, and references.
- Leaving users until late review: late comments may expose needs that could have shaped the program and design earlier. Plan appropriate engagement during planning.
- Comparing unlike proposals: different scopes, delivery assumptions, or named personnel make a simple fee comparison unreliable. Ask firms to make their assumptions and responsibilities explicit.
- Treating guidance as a universal rule: the cited healthcare development guidance is useful, but it is not a universal hospital procurement formula. Follow the rules applicable to the owner and jurisdiction.
- Assuming a published code edition applies everywhere: adoption and local requirements vary; confirm them for the specific location with the project team and authority having jurisdiction.
A careful choice does not eliminate the complexity of a hospital project. It gives the owner a better basis for appointing a team whose relevant experience, proposed people, planning method, and delivery relationship fit the facility’s actual requirements.
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