Sustainability must be a consideration for the design of all health care facilities. Many sustainable design features can be incorporated into health care facility design, including daylighting, energy and water conservation, non-toxic materials and finishes, and sustainable operations and maintenance. Flexibility must be a basic feature of any new health care facility to keep it from rapid obsolescence in the face of changing needs and technologies. Health care facility needs are evolving rapidly, and the direction of that evolution is difficult to forecast with any certainty. New equipment technologies, new treatment methodologies, changes in diseases, and changes in the patient population base all impact the facilities that house them. Inpatient care is steadily being reduced while outpatient services are growing. There is increasing emphasis on special-care units and smaller satellite facilities rather than large, centralized facilities.