October 2026 33

As Yale New Haven Health continues to invest in and modernize its facilities across the system, Clayton Mitchell is helping shape how those spaces support the organization’ s long-term needs. Mitchell, senior vice president of corporate facilities and Real Estate and chief systems design officer, spoke with High-Profile’ s Anastasia Barnes about aging infrastructure, sustainability, emerging technology, his experience in the U. S. Navy, and the role strong industry partnerships play in delivering complex healthcare projects.

Clayton Mitchell

Anastasia Barnes: You’ ve now been at Yale New Haven Health for more than a year. What have you identified as the biggest priorities for the system’ s facilities and real estate portfolio, and where do you see the greatest opportunities?

Clayton Mitchell: The greatest opportunity for us, I believe, is the continued effort to align our real estate and facilities portfolio with our business imperatives. One of the big imperatives is really to address our deferred maintenance backlog. That’ s an industry-wide issue. We have what I call a really well-established and very seasoned footprint.

Starting the process of developing capital programs that will help us strategically and systematically address that deferred maintenance backlog while we modernize the platform, I think that’ s not only a Yale New Haven Health issue. I think it’ s an issue for the industry writ large.

AB: Healthcare is changing pretty quickly, from how and where care is delivered to the technology supporting it. How are those changes influencing the way Yale New Haven Health thinks about its existing facilities?

CM: It starts with an app. It starts with some digital sort of doorway into our care delivery model. And so, aligning the physical infrastructure with the digital infrastructure— not just focusing on creating space, but creating place. A place that inspires our folks to feel that I’ m in a healthy and safe environment, and that this environment is going to contribute to my overall productivity.

It’ s about building systems that are agile and nimble and able to quickly respond to whatever the market pressures may be to promote adequate geographic access, operational efficiencies and sustainability— all of those things that are going to help us leverage our facilities, extract value from our real estate portfolio and hopefully drive down our total cost of ownership while elevating the experience of our patients, staff, students, faculty and everyone who occupies our facilities.

AB: Hospitals have to balance aging infrastructure, resiliency and 24 / 7 reliability with increasingly ambitious sustainability and decarbonization goals. How do you approach that balance, and where do you think innovation can make the biggest difference?

CM: On the facilities and infrastructure side of the equation, we have to understand the strategy. Then we visualize how we get to that future and what are the tools that we need to get there.

A lot of times people think about design standards as just, okay, what are the finishes that we’ re going to have? What’ s the color of the paint? But I think it speaks to what are the operational requirements of the facility. How are we going to build sustainability into this facility? It may be that we’ re going to spec no VOC-emitting compound materials. It may mean that we are going to spec technologies that introduce smart building technologies.

I’ m also really concerned about how I’ m going to operate that building in the future with the potential for staffing shortages and technology gaps. The industry is not producing all of the technicians that you typically need to operate a platform like a hospital. So how are we going to compensate for that?

A lot of health systems are migrating to electrification, and that’ s a deep decarbonization issue. But a lot of systems are still heavily reliant upon steam. I came from the United States Navy, and the Navy used to be one of the highest producers of people who understand steam— boiler technicians and things of that sort.

The military has transitioned from steam in its ships, so it’ s not producing a lot of those boiler technicians and operators who used to go out into the industry and do these types of jobs. It’ s increasingly harder to find them. That’ s one of the reasons that we have to leverage technology to compensate for that deficiency. AB: You’ ve managed facilities and real estate for very different organizations, including Jefferson Health, Kaiser Permanente and the U. S. Navy. What have those experiences taught you about leading complex, mission-critical facilities, and what are you bringing from those experiences to your work at Yale New Haven Health?

CM: This is going to sound like a commercial for the Navy.

I honestly don’ t see how I could do what I do today as confidently and professionally had I not done 25 years in the Navy.

The more executive-level disciplines of running an infrastructure— facilities operations, real estate, and facilities planning, design and construction— all of that came from the Navy. Plus, the Navy was a really great source of understanding the executive leadership side of this equation. How do you rationalize your investments and build a solid business case for those investments? And then how do you strategically align those investments over a five- to 10-year capital program?

I think of all of those things as an orchestra, and I think about the capital program as the sheet music that everybody is using to play the music. The Navy taught me how to be the band director, how to be that orchestrator, and bring that to the healthcare sector.

AB: Let’ s talk about aging infrastructure. How are you approaching upgrades across the system?

CM: There’ s that type of work going on across our enterprise.

We talk about a building that was built in the 1950s,’ 60s,’ 70s era, with a certain expectation of what the power requirements were going to be then. How does that building evolve into the future? If you don’ t modernize over time, you lose the capacity to really be able to address some of the future needs.

Today, we’ re looking at robotics in our ORs and robotics and AI in general, a lot of technologies, a lot of imaging equipment. They require a quantum leap more power than these buildings were built for. We’ re going through a major power upgrade at our academic medical center to ensure that we have adequate power to facilitate the new technologies that are coming to the table. And there’ s a permutation of that investment that has to occur across our entire platform.

The issue is, are you going to address it as sort of break-fix, or are you going to create strategic capital initiatives that allow you to not only address your deferred maintenance issues, but since you’ ve torn everything up anyway, go ahead and modernize this for the future?

AB: Is there anything you’ d like to see more of from the architects, engineers, subcontractors and construction managers who work with Yale New Haven Health?

CM: I believe that, for the most part, our general contractors and our architects and many of our other vendors, they’ re very effective in delivering the requirements that we need when we define those requirements with clarity.

The biggest thing that I can do to drive my cost down is be very clear in what I’ m asking them to do for me.

Spend a little time listening to what their pain points really are and then craft your strategies to fill those gaps. I think when we find contractors and architects, engineers that really partner with us, that really make it easier for us to do our work because the level of trust that we have between the two is very strong, that’ s where you get the repeat work.

It’ s got to be a deep level of trust that forms the foundation of the relationship. And that foundation of trust allows you to really productively talk about conflict. We shouldn’ t be running from conflict. We should lean into it because conflict and bad news— it’ s not like fine wine. It doesn’ t get better over time.

The sooner we’ re able to resolve those issues, which is predicated upon the trust that we have, the quicker we can get to alignment, accountability and results.

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