Proposal for Design of Non-laboratory Space at NCRC:
Designing For a Future That Is Not Yet Known
Background
The pathology relocation and renovation (PRR) project now underway provides a unique
opportunity to design innovative solutions for utilization of space in a digital age for which no
predicates, exemplars or templates exist.
Anatomic Pathology (AP) has invested in a number of site visits intended to generate deeper
understanding of opportunities for innovative design. The desire is to enable Lean Facility
Design that takes advantage of digital solutions while driving collaboration in an
increasingly subspecialized practice for which teamwork remains a core value.
A team comprising our Directors of Clinical Informatics (Ul Balis), Surgical Pathology (Dave
Lucas) and AP (Jeffrey Myers) visited the University of Toronto in November 2011 to gain
insights regarding all-digital workflow using whole slide imaging as a core technology.
Although much progress had been made at this site much remained to be done and little had
changed with respect to either laboratory or work space design.
A team comprising Christine Rigney (Assistant Administrator for Operations), John Perrin
(Quality Assurance Coordinator), Dave Lucas (Director of Surgical Pathology), Jeffrey Myers
(Director of Anatomic Pathology), Julia Dahl (Pathologist, CEO, and Medical Director, The
Mosaic Companies; MLabs client and colleague), and Ulysses Sean (“Sean”) Vance (Assistant
Professor, A. Alfred Taubman College of Architecture and Urban Planning) visited the
laboratories and offices of Hospital Pathology Associates (HPA) at Abbott-Northwestern
Hospital (Allina Health) in July 2012 to observe a unique approach to surgical pathology
workflow and space utilization as part of a large facilities project in Minneapolis, MN.
Observations included a unique approach to assigning shared office space to services rather than
individuals linked to a model that synthesizes patient characertistics, subspecialty practice, and
workload leveling for “smart” case triage. Other key components included shared “huddle”
space designed to encourage collaborative and educational interactions between staff and faculty.
A large team comprising staff and faculty from AP and Clinical Pathology (CP), departmental
leadership, and our PRR Project Manager Christine Baker, visited the pathology department at
Indiana University in May 2014 to gain knowledge of challenges and potential countermeasures
for providing pathology services from a central location situated at a distance from the sites of
health care delivery. Observations were captured in an onsite brainstorming session that
informed issues pertaining to specimen couriers, employee services, connections between faculty
and their non-pathology peers, conferencing space, trainee space, on-going operational costs,
waste and logistics flow, and use of natural light.
PRR Design Proposal
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This project is an academic exercise centered on a real world problem with the potential to
significantly influence the future of our discipline. With this proposal we seek permission to put
in place a process to ensure an innovative approach to designing effective and efficient nonlaboratory space for staff, trainees and faculty that encourages collaboration and Lean workflow
in a digital age while also mitigating ergonomic and activity issues unique to our specialty. Our
goal is efficient design that drives collaboration across subspecialty subcultures with sufficient
flexibility to meet the needs of our patients, providers, staff, trainees and faculty now and in the
future. We are confident that departmental staff and faculty, partnered with Christine Baker,
Corrie Pennington-Block (PRR Lean Coach), and our consultant Karen Mortland, are
sufficiently expert in Lean principles and laboratory design to develop and execute effective
space solutions for our laboratories in collaboration with Project Directors in Architecture,
Engineering and Construction (AEC) and contracted architects at Tsoi-Kobus and Associates
(TKA). The scope of this project is instead focused on an opportunity to develop and articulate
unique design solutions for how pathologists, students, trainees and staff will work together in an
uncertain future. Partnering with U. Sean Vance allows us the opportunity to take advantage of
his academic interests in health care design and creating spaces that mitigate the physical
consequences of working in an increasingly sedentary world.
Scope
The focus of this project is to clearly articulate design principles and concepts that will inform
schematic and detailed design of non-laboratory work space by Tsoi-Kobis. The key deliverable
is a document (“report”) intended not to supplant but rather to inform the architectural design
done by Tsoi-Kobis.
Proposal
We propose a multistep approach with the goal of delivering a report to AEC and (TKA) Project
Directors by November 1, 2014, or earlier should the project timelines require it. Preliminary
work should also inform the two day Lean event for future state planning scheduled for October
9 and 10, 2014.
1. Clearly articulate the problem – The scope of this project is to clearly articulate opportunities
and potential solutions for offices assigned to both AP and CP staff and faculty, signout
rooms, and shared spaces including those intended for conferencing, at NCRC. Areas of
focus include a) the impact of digital workflow, b) collaboration across subspecialty based
and geographically hardened subcultures, c) teamwork across traditional authority gradients in
more horizontally constructed, multidisciplinary, fully integrated, diagnostic teams, and d)
physical movement efficiently aligned with a)-c) that addresses ergonomic consequences of
microscopy and other sedentary work-related tasks.
PRR Design Proposal
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2. Engage faculty, staff and trainees – We will make one or several presentations to faculty, staff,
and trainees to share some of the observations made in the previously referenced site visits as
opportunities to expand the dialogue regarding innovative use of non-laboratory space in a
digital age. One goal of this engagement is to identify champions willing to serve as members
of a newly created AP Design Work Group.
3. Contract for services of U. Sean Vance – U. Sean Vance, Assistant Professor of Architecture,
specializes in design for healthcare and more recently has focused on creating spaces that
create opportunities for collaboration and mitigate the physical consequences of sedentary
tasks. He has been engaged in preliminary dialogue with AP leadership and Christine Baker
to understand challenges and opportunities in designing space for a workflow likely to be
significantly different from our current state. He will be primarily responsible for preparing
the key deliverable of this project, a report that translates the solution concepts developed by
our Design Work Group into the language of architectural design. He will make himself
available to AEC and TKA Project Managers to serve in a consultative or advisory role as
they may deem appropriate. Additionally, U. Sean Vance will assist the Design Work Group
in reviewing design deliverables from TKA in Program Validation, Schematic Design and
Design Development to ensure that the concepts are integrated into the overall project
narrative and design.
4. Appoint Design Work Group – This work group will be led by Jeffrey Myers and be
comprised of AP and CP staff, trainees and faculty, Christine Baker, Corrie PenningtonBlock, and if deemed appropriate, outside practitioners. Team members must have the
capacity to invest their time in working closely with U. Sean Vance to, a) deeply understand
the relationships between design, Lean workflow, and collaboration in a subspecialized
environment, b) benchmark against other sites as appropriate, and c) develop solution
concepts for schematic design of non-laboratory pathology space in the new pathology
building.
5. Budget – All expenses related to this project will be born by the Division of Anatomic
Pathology (A. James French fund).