This is a post from Forsyth Director Shad Forsyth. For more from Shad, connect with him on LinkedIn.
If you flip through a set of hospital drawings, carts and storage usually show up as small rectangles and a line of text.
To a busy project team, those rectangles can look like a minor detail in a very complicated build. An afterthought, almost.
11 (!) years into Forsyth (and a heck of a lot longer than that in the medical carts and storage business), I no longer see a rectangle. I see clinical workflows, staffing levels, infection prevention, maintenance, budgets, and a lot of expectations that never quite fit on the drawing.
I wanted to mark our 11 year point by sharing a few lessons we have picked up along the way. These are not rules, more like patterns that show up across projects, big and small.
Lesson one: The earlier you bring in the people who will use the space, the fewer surprises you get
I have lost count of how many times an architectural layout looked fine until we sat down with the people who would actually live with it. Nurses, techs, porters, materials teams.
Often they saw issues in seconds that did not jump out to the rest of us.
A simple lack of capacity or room for growth. A potential collision with another item (what way a door swings on an adjacent cabinet or how far a door might swing in to a work space, for example). A blind corner where traffic always piles up. A frequently used item stored in a spot that requires a reach, a twist, and a prayer. Yet another reminder that a plan can look perfect on paper for square footage and clearances, while being completely wrong for how people actually move, share space, and do the work.
The pattern is simple. Projects that involve front line staff early tend to move more smoothly later. Projects that wait until the carts show up on site usually always pay for that delay in rework and frustration.
If the people who will push, stock, and clean the carts every day have not seen a mock up, a layout, or at least some photos of similar setups, the conversation is not early.
It’s late.
Lesson two: You cannot treat carts like a box on a price list
There is a natural push in large systems to treat carts as a commodity. The logic is understandable. If you can line up three quotes on similar products and drive the price down, that looks like good stewardship.
The problem is that carts don’t behave like a case of gloves or a pallet of paper.
They carry trays, supplies and devices that cost thousands of dollars.
They move through tight corridors and busy rooms.
They interact with cleaning processes, floors, door frames, and walls.
I have seen projects where a small change in material or design had six figure consequences over the life of the equipment. I have also seen teams stick with a “good enough” choice that quietly made life harder for staff every single shift.
Price matters. So does the way a cart rolls, cleans, reconfigures, and holds up under real use. If you only look at the line item on the quote, you miss most of the story.
Lesson three: Digital tools help, but they don’t replace walking the space
When I started, most of my work happened in person.
We drove out to sites, walked rooms, and sketched ideas on paper.
Today we do a lot more from behind a screen. We use configuration tools and digital plan review to support projects across the province without always standing in the room.
That change has allowed us to help more sites than we could have reached otherwise.
But there is still a lot you learn only by seeing how people move through a space. A dedicated walk through a department or even a few minutes watching a busy changeover space can reveal things that don’t show up on drawings.
For me, the right balance is to use digital tools to handle the heavy lifting of layout and documentation, and then rely on real conversations and real observations to pressure test those plans. The combination is much more powerful than either one alone.
Lesson four: The project isn’t done when the carts arrive
It can be tempting to treat delivery day as the finish line. The equipment is installed, the boxes are gone, and the photos look great.
In reality, that’s when the real test starts. The first few weeks after delivery and before go live are where we find out if the layout, the mix of carts, and the small design decisions are working for the people on the floor. People get into their spaces, they’ve stocked up the carts, and are running mock scenarios to see what works, and what doesn’t.
Similarly, some of the best improvements we have made on projects have come from listening carefully during the period right after go live. A nurse explaining that a cart always ends up parked in the same awkward doorway. A manager noticing that restocking takes twice as long as expected in one area. A tech pointing out that a drawer design is collecting dust and making cleaning harder.Staff turnover and changes in procedures over the course of a redevelopment project are also very real things.
We try to treat those early weeks as part of the project, not a warranty period. If we listen, adjust, and document what we learn, the next project benefits as well.
Lesson five: There is no substitute for being honest when things go sideways
Not every project goes smoothly.
Construction schedules shift.
Scopes change.
Human beings, including me and my team, make mistakes.
Over 11 years, one pattern has held up. When we’re honest about what went wrong, clear about what we are doing to fix it, and willing to take ownership, relationships get stronger, not weaker.
That doesn’t mean those moments are fun. They are not.
But they are where trust is built.
I have sat in difficult conversations with project leads who were rightly frustrated. The turning point is almost always the same. We stop talking about blame and start talking about what needs to happen next to make their opening or their go live as smooth as possible.
A note to the next generation of project leads
If you are early in your career as a capital planner, project manager, or clinical leader, you are going to inherit a lot of rectangles on drawings. Some will represent carts and storage. Others will represent equipment, rooms, or temporary spaces that have been “good enough” for a long time.
My encouragement is simple. Treat those rectangles as invitations to ask better questions.
- Who will use this?
- When will they use it?
- What will be happening around them at the time?
- What would make this feel easy on a bad day, not just on a good one?
The work you do to get those details right will not always show up in press releases or speeches. But it’ll show up in how a nurse feels halfway through a busy night, or how a materials team feels at the end of a long shift.
If any of these lessons raise questions about a project you are working on now, I am always happy to talk it through. Sometimes a short conversation about carts and storage can unlock a much bigger win for the people who keep your hospital running, one shift at a time.
