To staff groups, "we realized we needed to segregate operational and strategic models, the intent being to acquire the best thinking regardless of where it was located," Bergmann says. Hence, the decision to headquarter groups in different geographic markets rather than consolidate leadership in Grand Island.

Groups boast wide-ranging experience and skill sets. Corporate/commercial, for instance, not only is staffed with architects and interior designers but with former facility managers, real estate brokers and landlords, says group executive director Meg Osman.

For their part, Osman and other group leaders remain abreast of key market and client trends, which they disseminate to practices in other regions. Likewise, information they gather from those practices enhances their perspective on regional trends.

"The leaders are the drivers, and we're their wheels in this and other regions," says Bergmann.

Training, in many cases, is ongoing. For the Chicago-based health group, senior managers engage in executive workshops to reintroduce them to the medical marketplace, providing the perspective required to better serve client needs. In one exercise, the group perused 2009's Affordable Health Care for America Act to learn how its tactical and philosophical underpinnings could impact the practice of medicine and—by extension—facilities where medicine is practiced.

The approach has led to ongoing collaborations with clients, including Roche Diagnostics, for which CannonDesign initially developed a campus plan intended to enhance employee efficiency. Among other services, CannonDesign addressed suboptimal adjacencies among key business groups, developed strategies for implementing flexible work environments and created architectural and site standards to inform future building and site development.

CannonDesign continues to broaden its range of services, particularly in the urban arena.

Prior to designing the Malcolm X College School of Health, CannonDesign's newly formed city design group, based in Chicago, assisted City Colleges of Chicago in conceiving the project by identifying local industries most in need of a skilled work force. Health care, as it happens, was one of them.

Malcolm X, due to open next year, marks a sea change for City Colleges of Chicago's community college system, providing a more hands-on approach to selected curricula. Accordingly, the facility will house simulated hospital spaces and patient rooms, with room dimensions, beds, headboards and finishes matching those of nearby health care operators, including Rush University Medical Center and John Stroger Jr. Hospital of Cook County.

As Tim Swanson, CannonDesign's associate vice president of urban strategy, has noted, "We looked at the entire pedagogy of the school and began to understand how to transform it from an unfocused two-year program to an incredibly focused program."