Children’s specialty hospitals generated $49.1 billion in revenue in 2024 as systems raced to modernize aging campuses and expand behavioral health capacity. With demand still rising, pediatric healthcare remains a critical and growing focus across the U.S.
At the same time, a growing body of research points to the measurable impact of environment on care quality. A recent study at a 370-bed tertiary-care children’s hospital in Canada used human-centered design to create a new procedure room with input from children, caregivers and clinicians. Their top priority was control over environmental conditions like lighting, temperature and sound to reduce pain, anxiety and distress. Researchers found that poorly designed spaces often led to longer procedures and more frequent use of sedation. Meanwhile, well-designed, controllable environments supported faster, less traumatic care and improved staff experience.
HOK teams are applying similar co-design strategies in their own work. At La Rabida Children’s Hospital in Chicago, designers developed patient avatars to help clinical leaders visualize future care scenarios and shape environments that better support emotional and developmental needs.
Designing for the Whole Child Without Feeling “Childish”
“In pediatrics, we’re designing for everyone from infants to young adults—sometimes even into their 40s for congenital conditions,” says Karen Freeman, AIA, ACHA, LEED AP BD+C, HOK’s Children’s Health practice leader. “At the same time, we’re speaking to their parents. The challenge is creating environments that meet kids where they are developmentally and emotionally, while reassuring families they’re receiving world-class care. I call it designing spaces that are childlike, not childish.”
To achieve that balance, HOK’s teams break down large departments into smaller, more manageable zones using scale, color and intuitive wayfinding. “We think about how to guide children through the space visually, before they even read a word,” Freeman says. “Color and layout become tools for emotional orientation, not just aesthetics.”
Creative play areas support emotional development and help children manage the stress of treatment.
This attention to developmental nuance helps young patients feel grounded from the moment they arrive. It improves experience and builds trust.
Spaces that support families by including private work areas, rest zones or dedicated lounges help foster healing and strengthen trust.
Balancing Digital Innovation with Human Connection
From voice-driven charting to predictive scheduling, AI is impacting pediatrics. But Freeman is clear about its role: “AI is an increasingly important part of the healthcare experience, but it really can’t replace that human connection,” she says. “We want to augment, not replace, that experience.”
Administrators weighing new technology investments can use this as a filter: does a device augment or interrupt face‑to‑face time? If it’s the latter, rethink placement or integration. Technology should be felt through smoother experiences, not seen in blinking boxes.
Comfort, Control and Calm at Room Scale
Senior interior designer Donald Cremers, IIDA, LEED AP, starts every project by asking how a clinical space can feel more personal. “No matter how much equipment is in the room, I try to make it as intimate as possible,” he says. “That means giving people control: moveable furniture, dimmable lights, adjustable temperature. The goal is to create as much calm as possible so patients and families can absorb what’s being communicated.”
Colleen Harrington, IIDA, LEED AP, adds that the visibility of medical equipment can disrupt the connection between caregiver and patient. “When you eliminate visual chaos, you eliminate a source of anxiety,” she says. Discreetly integrating technology and clarifying what truly needs to be in view helps the environment support human interaction.
For healthcare leaders focused on reducing length of stay or improving patient satisfaction, these design choices are more than aesthetic. They shape how care is delivered and received.
Making the Environment Part of the Healing Process
Virginia Pankey, AIA, LEED AP, EDAC, who leads HOK’s Behavioral Health practice, believes the environment should actively support healing. “You don’t want a space that’s too open or clinical,” she says. “That can be overwhelming. We use layers, warmth and natural materials to help people feel at home, let down their guard and connect with the care team.”
This focus on emotional regulation and connection aligns with a growing design emphasis on whole-person health, especially for children in distress.
Pankey stresses the importance of offering multiple ways for patients and staff to regulate sensory input. That might mean a view of nature, a place to pace, a calming room with minimal stimuli or even a simple rocking chair. “Different people regulate in different ways,” she explains. “Giving them options makes a big difference.”
These strategies informed the design of Kedren Children’s Village, a new behavioral health facility in South Los Angeles where HOK created a therapeutic environment for inpatient, outpatient and urgent pediatric care.
By supporting healing and reducing the need for medication or restraint, these spaces also protect clinicians. “When staff reach compassion fatigue, they need somewhere to pause and reset so they can bring their best selves to patient care,” Pankey says.
For healthcare systems, this translates into a capital-planning imperative: allocate square footage and FF&E investment for respite areas as intentionally as for exam rooms. It’s not just good design. It’s a workforce retention strategy.
Designing for Neurodiverse Experiences
A predictable and adjustable environment can make all the difference for neurodiverse children. Our teams design spaces that empower these young patients by giving them control. This includes creating a range of sensory rooms—from quiet retreats to areas for active engagement—along with flicker-free, tunable lighting and cozy enclosures that let each child find their comfort zone.
A 2025 Building Design + Construction survey lists “detailed design of neurodiverse environments” as the No. 1 trend in children’s hospital design. Embedding neuroinclusive criteria into design briefs communicates a commitment to inclusive care and reflects what HOK has made a firm-wide priority.
That commitment is explored in depth in Designing Neuroinclusive Workplaces, a new book by HOK Director of Thought Leadership for Interiors Kay Sargent, ASID, FIIDA, CID, LEED AP, MCR.w, WELL AP.
Drawing on decades of research, client work and lived experience, the book outlines strategies for sensory and cognitive inclusion across the built environment. The book is focused on the workplace. Its core principles, however—things like sensory zoning, environmental control and biophilic design—are universal and directly inform HOK’s design of children’s health settings.
A New Standard of Care
All these design strategies work together to support families, streamline care and create more calming environments. As pediatric facilities compete for the trust of families, the leaders will be those who thoughtfully combine smart technology with spaces that feel personal, flexible and safe.
Read more about HOK’s pediatric design practice in a feature story on the firm’s Children’s Health Center of Expertise. The ideas in the Designing for Neurodiverse Experiences section build on a previous article by HOK’s pediatric and interiors experts, which explored inclusive environments for neurodivergent children. For more, contact Children’s Health Practice Leaders Karen Freeman at karen.freeman@hok.com or Laura Poltronieri at laura.poltronieri@hok.com.
Note: Neurodiversity is a term used to describe a broad range of conditions, some of which likely will be unresponsive to design solutions. HOK’s approach to inclusive design is based on our experience as designers and architects with the objective of providing a wide range of options for users with different needs. Any attempt to address the needs of neurodiverse individuals should also include review of human resources policies, implementation of technology solutions and building operations among other considerations. HOK does not represent that any design solution discussed in this article is capable of achieving any specific outcome for an individual user.