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Optimizing Space Case Report: University of Minnesota Health

In 2016, University of Minnesota Health consolidated 37 different specialty clinics into one building called the Clinics and Surgery Center. This afforded an opportunity to design a space that facilitated collaboration, not just within departmental clinic teams but also across specialties. The design also focused on social connections, which have been associated with reductions in physician burnout.1 Improved collaboration and social cohesion make for a better patient and provider experience.

During the planning process, “zones” were created to improve patient flow and support relationship-building across care teams. Patient zones were shared waiting spaces across clinics. Patients move from the patient zone to the exam/treatment zone, which includes an intake area and vital sign station, exam rooms and procedure rooms. A collaboration zone runs across the entire building within the exam/treatment zone, connecting the clinical teams to one another. Staff-only zones are located behind the exam/treatment zone.

These zones have facilitated innumerable one-on-one, face-to-face conversations about patient care between clinicians. Before the clinics moved to the new shared space, these conversations were taking place over the phone, asynchronously within the electronic health record or not happening at all. As University of Minnesota Health Primary Care physician Kathleen Watson, MD, explains, “It's great having the urologist in the next clinic over. I have wandered over to talk with him when I need “curbside” advice about the workup of a urological condition before I send a patient to them. Boy, do they get excited whenever I have a patient with kidney stones! We also share many patients, and it's been helpful to talk face-to-face about some of the diagnostic and therapeutic dilemmas. It saves time, builds relationships and improves patient care, and I learn something new every time!”

As ambulatory and hospital care follow divergent career paths, practice is becoming more “siloed.” With this separation, the social connectedness that grew from primary care and specialty physicians sharing patients within the hospital physicians' lounges has been lost. The design of the Clinics and Surgery Center makes it easy to find collaborating clinicians in a way that makes great things happen for patient care. “In the same way that I consult with my urology colleagues, it's not uncommon for me to walk over to orthopedics to ask an opinion about management or try to help get a patient's care expedited. Just last week, a patient came in for preoperative assessment for gastrointestinal surgery. She had accidentally fractured her distal radius on the night before her preoperative visit. I was able to talk to an orthopedist, stabilize the wrist and get her in to be seen the next day for proper immobilization. The patient was amazed and so was I!” says Dr. Watson.

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West  CP, Dyrbye  LN, Rabatin  JT,  et al.  Intervention to promote physician well-being, job satisfaction, and professionalism.  JAMA Intern Med. 2014;174(4):527-533. http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1828744.Google ScholarCrossref

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