If you don't believe Barry Rabner when he says his ambitious plan to build a new hospital has been "the most fun I've ever had," take a look at the Zen garden on the coffee table in his office.

It looks like any other you might see in a corner office suite — but here, the pebbles have been loaded into a toy dump truck, and tiny plastic orange cones cordon off a toy excavator.

While major construction projects are a source of stress and worry for many hospital CEOs, the head of Princeton HealthCare System clearly wasn't rattled by the 9-year process of planning, fundraising and constructing the $522.7 million University Medical Center of Princeton at Plainsboro.

"I'm just so lucky to have been given the opportunity to do something like this," Rabner said. "I tell the board it's like I'm getting paid to watch 'Nova,' because the things that you learn along the way are really pretty spectacular."

But getting to the finish line for the 636,000-square-foot hospital, which opened May 22, required a broad vision — something Rabner admits he had to develop over the course of the project.

Debra Levin, president and CEO of the Center for Health Design — a California-based nonprofit that seeks to improve patient outcomes and safety through better facility design — met Rabner while the hospital was being designed. She said Rabner, a member of her organization's board of directors, is one of the few people she's met who can see the future of health care, assemble the right people and execute based upon that vision.

"When you're building a new hospital, you can build a better version of what you already have, or you can re-envision what health care might look like, what health care needs to be in your community," Levin said. "Barry has the ability to do the latter — to gather up ideas and thoughts from a wide variety of places, and understand how to articulate that in the best way."

Seeing that bigger picture wasn't something that came easily, Rabner said.

"Over my career, I used to view myself as a very detail-oriented person — and I can still get in trouble for being overly detail-oriented, because it's in my personality — but given the role I have and the magnitude of the project, somebody has to have the job of taking a couple steps back and take a broader view of what you're trying to get done," he said.

Rabner credited the hospital's board of trustees with helping him develop a broader perspective on the project.

"If I were fooling around by myself, I'd be seriously stressed," Rabner said with a laugh. "You get so passionate about it, and it gets so intense and it gets so personal, it becomes very difficult to be objective."

The board was able to strike that objective tone, Rabner said.

"A number of years ago, we collectively decided that because of the size and scope of this project, we would need to realign the management team to allow some others to come in and focus more on the day-to-day operations, to allow Barry to plan and conceive, raise the money and really be the key person on this project," said Don Hofmann, chair of the hospital's board of trustees.

"The experience … forces you to take a broader view," Rabner said. "That's what people are looking for, whether it's lenders (or) donors, especially the ones who are able to make the most sizable gifts — their judgment is based on a process that's not that different than the process used by lenders."

While it was a challenge to adjust his perspective, Rabner took obvious joy in the work, even in tasks like defending the decision to relocate the hospital to Plainsboro, rather than keeping it in downtown Princeton. He described a long series of public meetings on the decision as "pretty intense and pretty emotional."

"He impressed me with his understanding of the community … he impressed me with that insight that's not specific to running a hospital," said Bob Prunetti, president and CEO of the Mercer Regional Chamber of Commerce. "He's very likable, very easy to speak with and very amenable to opportunities to talk about what he's doing at the hospital … he's passionate about it, and seems to enjoy every minute of it."

Rabner said going through the process of explaining the project and answering questions over and over again also reinforced his belief that the project was the right way to direct the hospital.

"He has done an outstanding job, both in terms of conceiving, having the vision for this project and really providing the execution, as well as playing a central role in raising the money," Hofmann said.

Rabner's vision for the project didn't end with the hospital's opening, though. He sees the entire 171-acre Princeton Health campus becoming home to medically aligned businesses — from a fitness center to a nursing home — to create the system's own version of an accountable-care organization. That is expected to amount to a $1.5 billion investment, he said.

"As those things come in place, think of how great it will be when we all work together to integrate that care," Rabner said. "The challenge for us is to complete that picture and get all of those health-related functions on this campus and work to integrate them so people can move seamlessly from a clinical standpoint" as well as financially and from an information perspective.

"Way before the ACO concept was there, we began the process, and it's because it was driven by a picture of good clinical practice and a picture of good business practice," Rabner said. "The fact that we sort of merged conceptually with where the government's going really isn't a surprise, but it feels cool. … It's just a level of validation."

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