Mayo Magazine

A Vision in the Desert
Mayo Clinic Specialty Building Takes Shape

The MCSB is a product of infinite details and a work of profound generosity. It is being funded almost entirely by benefactors who have contributed about $34 million toward the project.

In 2000, a planning group at Mayo Clinic Arizona began to see the mirage of a new patient-care building standing next to Mayo Clinic Hospital on the Phoenix campus. The mirage might have been hazy at first, but the idea that inspired it was crystal clear. The Mayo Clinic Specialty Building, as it came to be called, would be the first step in Mayo Clinic Arizona's master plan to integrate and consolidate patient care on the Phoenix campus, and to create a collaborative biomedical research community on the Scottsdale campus.

As the facility evolved from mirage to blueprints to girders and beams, the planners — along with the physicians, nurses, technicians and administrators who would use the building — ensured that the building would provide improved communication between physicians and patients, state-of-the-art medical equipment and advanced Web-based systems to streamline the entire cycle of each patient's visit. Like all Mayo Clinic endeavors, it was a team effort driven by consensus.

"There was no single Renaissance person who provided all of the programmatic solutions for this project," explains Steven Pattyn, director of facility planning and design at Mayo Clinic Arizona. "It took the combined efforts of many Mayo resources and a lengthy series of design and operational meetings to pull this all together. It's impossible to design a complex building for health care without input from the people who are going to use it. One can't just make it up."

A work in progress
Work began on the Mayo Clinic Specialty Building (MCSB) in 2004. A webcam, linked to Mayo Clinic internal and external Web sites, allowed employees and the public to watch the building take shape.

The benches in the Healing Garden incorporate many curative and life-affirming Native American motifs

Christopher Hilgemann, MCSB project manager, seldom seen without his hard hat, sent updates to key staff containing the kind of details that would awe the weekend home-repair hobbyist: " ... 95 percent completed with interior metal stud wall framing on the concourse Radiation Oncology floor ... ductwork, plumbing and electrical work is very active on concourse ... installation of Radiation Oncology's new linear accelerator on schedule for January ... completed pouring the Healing Garden concrete retaining walls."

The Healing Garden especially became a labor of love for project planners. Located on the concourse level by the Radiation Oncology Department, it is open to all patients and visitors, but is especially accessible to patients undergoing radiation therapy for cancer. The Healing Garden is a special expression of Mayo Clinic's Humanities in Medicine Program, which is devoted to integrating art, music and compassionate design into the medical environment.

In 2005, Mayo Clinic Arizona began collaborating with four Native American artists affiliated with the Heard Museum of Native Cultures and Art in Phoenix. The artists designed 10 mosaic benches for the Healing Garden using themes suggested during talks with Mayo Clinic staff and patients. More than a dozen benefactors stepped up to support the project. The benches incorporate many curative and life-affirming Native American motifs, such as dragonflies, the sun and landscape. The benches are grouped to create intimate spaces within the Healing Garden. "Illness is exhausting for all concerned. The way the benches are placed allows you to take a breath," says Connie Tsosie Gaussoin, one of the artists.

From special lights to a special beam
Early in the 20th century, Henry Plummer, M.D., Mayo Clinic's renowned efficiency expert, designed the first wall-lighting system to track exam-room occupancy. The tier of lights outside each exam room, a hallmark of Mayo Clinic, has evolved over time to incorporate new technologies. As part of the MCSB planning, a team of cabling and computer experts, headed by Rocky Fransen, has raised the science of room occupancy to a new level.

Mayo Clinic's first Web-based room-occupancy system tracks each patient on an interactive program used by registration, nurses and physicians. The program, which triggers lights outside each exam room, follows the patient from the time a room is reserved (purple light), to occupancy (white), through the exam with nurses and physicians (yellow, orange and blue), to a signal requesting the room be prepared for the next patient (purple and orange).

The system records the time patients spend in rooms prior to their exams. This information is analyzed to ensure wait times are kept to a minimum. The system, however, does not track the time a patient spends with a physician, underscoring Mayo Clinic's promise to physician and patient alike that there will always be enough time to conduct a thorough exam.

It took more than a year to work out the program and design the lighting system to get the "splash" (how the lights reflect off the wall) and color of the LED lights just right.

The MCSB is a product of infinite details and a work of profound generosity. It is being funded almost entirely by benefactors, who have so far contributed about $34 million toward the project. In February 2005, many of these generous supporters, as well as Mayo Clinic patients and employees, had the opportunity to write personal notes on an 800-pound, 20-foot-long steel beam. It took 12 strong employees to carry the beam into and out of Mayo Clinic on the Scottsdale campus. Some of the inscriptions included, "Cancer clean after 5.5 years. Thanks Mayo." ... "Thanks, Mayo, for my leg."

Five months later, with completion of the structural steel frame for the MCSB, construction workers raised this special beam to the roof of the building as part of a traditional "topping off" ceremony and decorated it, as is the custom, with a tree and the American flag.

The commemorative beam is just one of countless examples of the care and planning that have gone into the MCSB. Every beam and girder, switch, cable, socket, doorknob and exam-room light tells a story of choices made with one, and only one, goal in mind — assuring that the needs of the patient come first.

A day in the life...

Mayo Clinic Specialty Building (MCSB) is the first step in Mayo Clinic Arizona's master plan to integrate and consolidate patient care on the Phoenix campus, and to create a collaborative biomedical research community on the Scottsdale campus.

Rocío Hernández supplies rooms

5:45 a.m.
Rocío Hernández has been at work since 4 a.m. She is wending quietly through the corridors of the Mayo Clinic Specialty Building (MCSB), pushing a cart stacked with patient gowns and checking each exam room to make sure the linen closets are well supplied for the day. As part of its commitment to patients, Mayo Clinic provides soft cotton gowns, rather than those stiff disposable ones that make a patient feel like a life-sized paper doll. Ms. Hernández and her 130 colleagues in Building Services keep Mayo Clinic facilities well provisioned and neat as a pin. As Todd Thyssen, the MCSB/Mayo Clinic Hospital housekeeping manager, says, "Just try to find a speck of dust in this building."

8:05 a.m.
It's a chilly morning — for Arizona — and General Service attendant Brian McIntosh stands at his post at the entrance of the MCSB with a warm smile and a helping hand. He ushers patients into the building with the skill of a traffic cop and the kindness of a Samaritan. "Good morning." "May I get you a wheelchair?" "Have a nice day." "If you'll wait a moment, I can order an electric cart to give you a lift over to the hospital." "Let's see, you just need to take the elevators to the concourse level." "The restrooms are to your right." "Yes, it sure is nippy, but it'll warm up soon." Mr. McIntosh is living proof that Mayo Clinic's promise — the needs of the patient always come first — begins right at the front door.

Richard Hayden, M.D. examines a patient

8:30 a.m.
"Since moving into this new facility, we can truly provide our patients with one-stop shopping," says head and neck surgeon Richard Hayden, M.D. He and his colleagues across all surgical specialties can make better use of their time in surgery and time spent with patients because the MCSB provides 133 patient exam rooms right next door to Mayo Clinic Hospital. Pre-MCSB, surgeons and patients alike had to drive between the Scottsdale and Phoenix campuses. While they see patients this morning, Dr. Hayden and Wayne J. Harsha, M.D., a fellow in advanced head and neck surgery, will check the progress of Cecilia Monarque. Dr. Hayden and his team replaced her jawbone, which had been fractured by a tumor, using a piece of bone and associated artery and vein from her leg. Not a hint in Ms. Monarque's countenance suggests her surgical reconstruction. The next step is to provide her with dental implants so, as Dr. Hayden says, "She can bite apples and chew steak."

9:35 a.m."We are thrilled with our new area," says hand therapist Cynthia Ivy. "It's 30 percent larger, with a private whirlpool room, more privacy at the patient stations and closer proximity to the doctors." Opened barely two weeks, the Hand Therapy Suite is packed this morning. At all eight stations, hand therapists are literally holding their patients' hands, gently massaging, bending and flexing fingers and thumbs. Everyone is talking quietly, and there's a sense of deep concentration throughout the room. The hand is a beautiful and complex instrument that people take for granted until it malfunctions. Maureen Silhasek suffers from rheumatoid arthritis. Hand therapist Michelle Smith adjusts a made-to-order splint that Mrs. Silhasek has been wearing after surgery to improve mobility and dexterity of her right hand. Mrs. Silhasek does a series of exercises while Ms. Smith measures. "You've got a 5 percent increased extension in one finger and 2 percent in the other," she says. "That's excellent."

11:15 a.m.
Eugene Kuhlman has a big grin on his face, and for good reason. He's just completed his eight-week course of cancer radiation therapy, and he's ringing the bell that hangs on the wall in the new Radiation Oncology patient area just for this celebratory purpose. His therapist, Teddi Axne, celebrates with him, and there is a round of applause from fellow patients who are awaiting their treatment — and the time when their turn comes to ring the bell. At 30,000 square feet, the new Radiation Oncology Department in the MCSB is two and a half times bigger than the patient area on the Scottsdale campus. Mayo Clinic can now treat an additional 60 to 65 cancer patients a day. Chris Bernard, another radiation therapist responsible for Mr. Kuhlman's care, says the new space helps him better care for patients. "The interior design is very logical and enhances the flow of patients, and it's very tranquil," he says.

1:20 p.m.
"All our design decisions focus on patients and making sure they feel welcome, secure and comfortable," says Steve Pattyn, who guided the design for the MCSB. As with all Mayo Clinic facilities, a priority design issue for him and the planning team was way-finding — making sure patients can easily navigate through their round of appointments in the building. The first panorama patients see when entering the MCSB is a brightly lit bank of registration desks trimmed in warm wood. On the walls are murals of colorful desert landscapes. Susan King, one of five patient services representatives in the MCSB, prepares for the stream of patients coming in for appointments after the noon lull. Among the many attributes that recommend Ms. King for this job is her beautiful smile. "Hi, there," she says to a patient who has stepped up to her desk. After determining the patient's name and pulling up her medical record on the computer, Ms. King says, as if this were the first, not the jillionth time today she has asked this question, "Can you tell me your birth date, please?" She surrounds the patient with a sense of caring and concern, and in her warm, efficient manner she helps bring the building's design to life.

3:15 p.m.
Lyndsay Russell, R.N., is the living donor coordinator for liver transplantation at Mayo Clinic Arizona. She counsels people who volunteer to give part of their liver to a relative or friend who will not survive without a liver transplant. Mayo Clinic Arizona ranks No. 1 in the state and seventh in the nation in performing this procedure. Ms. Russell is very pleased with the new transplantation area in the MCSB. "There's more privacy for our patients and more space," she says. "We can see more patients in a day, and we have room to grow." Ms. Russell's job is to educate the potential organ donor. She methodically explains the risks of the surgery and the postoperative recovery period while the living donor's own liver regenerates. She prepares prospective donors for five days of medical tests to check their health and determine if they qualify. If tests reveal that a prospective donor is not a good match, Ms. Russell will explain why — a delicate task that draws upon her abundant compassion. She spends all the time it takes — usually about an hour and a half — in her first encounter with a living donor. Besides her role as educator, she puts people at ease and underscores their generosity. "You are offering a gift," she says to a prospective donor. "I'm here to be your advocate in the process. Your safety is my first priority."

4:30 p.m.
The Healing Garden is in cool shadows. Walter Heilman sits on a bench quietly reading. The sound of water offers a soothing background. Pavers scattered on the garden's floor are inscribed with "Peace" and "Hope" and "Courage." The Healing Garden at the MCSB is on the concourse level next to Radiation Oncology. Placed below ground on the building's northeast side, it is a cool, inviting space even in the high heat of the Arizona summer. Intimate seating areas are clustered throughout the garden. This place is living proof of Mayo Clinic's commitment to provide environments that promote healing. To embrace the many life-giving symbols of the Native American cultures of the Southwest, Mayo Clinic collaborated with four artists affiliated with the Heard Museum of Native Cultures and Art in Phoenix. The artists designed the 10 benches in the Healing Garden, using themes suggested during meetings with Mayo Clinic staff and patients. Each mosaic bench incorporates a motif or symbol special to the artist's culture and traditions. These include images of dragonflies, rivers, corn, the sun and moon. "My hope is that these benches evoke feelings of strength, healing, nourishment and balance," says one artist, David Gaussoin, who is of Picuris, Navajo and French heritage.