North Big Horn Hospital (NBHH) in Lovell, Wyoming was ready to update its 10-year-old facility plan. Hospital leaders were navigating new challenges during the COVID-19 pandemic, and they wanted to develop a strategic vision that would address facility needs and project priorities now and in the future.


Eric Connell, CEO of North Big Horn Hospital, had worked with Stroudwater Associates on a successful project at his previous hospital and was impressed by Stroudwater’s professionalism and rural healthcare expertise. NBHH engaged Stroudwater’s strategic master facility planning services to provide a flexible, data-driven plan that would be sustainable in the short and long term.

“Our partnership with Stroudwater accelerated conversations with the board and community by at least a year and a half,” said Connell. “Bringing Stroudwater in at the moment we did allowed us to find common ground and get to a decision point much quicker — which is especially important in the environment we’re in with the pandemic and financing opportunities that may no longer be available in 18 months. It’s enabled us to think two steps ahead on the future of our facilities.”

Stroudwater worked with NBBH to:

  • Involve multidisciplinary stakeholders in a rapid process
  • Identify priorities
  • Understand the market needs – current and future
  • Evaluate options
  • Fast-track immediate projects
  • Develop a long-range facility framework with phased investment

The data acquisition and analysis phase was completed in one month, followed by a one-week intensive on-site session that covered scenario building, volume modeling, facility solutions, and financial feasibility. At the end of the week, Stroudwater had a clear understanding of the scope, scale, and cost of different projects and delivered a semi-final report. The final report was completed two weeks later.


By collaborating with diverse stakeholders and evaluating the current and future market needs, Stroudwater helped NBHH leaders identify potential revenue sources, develop a financially sustainable plan, outline immediate action steps for priority projects, and create a long-term facility framework.

NBHH’s identified priorities included:

  • Improving the space and flow of the emergency department (ED) for a better patient, family, and provider experience
  • Building upon recent investments in clinic/outpatient services
  • Creating an improved inpatient/ outpatient traffic flow across a public spine
  • Developing a long-term plan for improving the inefficient layout of separate patient wings
  • Using time-sensitive funding for the initial ED improvement project

Stroudwater worked with NBHH to analyze options and create phased investment plans. The ED project used CARES Act funding and quickly moved forward into the design and pricing phases. NBHH is also planning to execute short-term modifications to flex space, long-term building additions as necessary (to clinic and inpatient spaces), and short- and long-term improvements to traffic in public corridors. NBHH is well-equipped to ensure a financially sustainable plan to support future growth.