The location, site, and overall design including layout, equipment placement, and capacity all had a direct effect on patient flow. Thundermist studied patient flow for many years and took lessons on flow management elements of the patient's cycle time and mapping. Wait times and footsteps were analyzed and patient satisfaction, in regards to their perception of wait time, was assessed. The building, a converted big-box retail store, was transformed into a space that is open and full of light. Once entering the building, the public interface (lobby, waiting area, community conference room), with 20-ft high ceilings, features six free-floating staffed check-in kiosks.
These kiosks allow the presence of staff to be among the patients in the waiting areas; the focus and view is shifted to the patient. Patients are given pagers for when it is their turn, so they can sit in multiple areas within the day-lit space or roam outside. Because of the hard surface features within this space, ambient noise has been tuned to a level so that conversation is heard but cannot be overheard. Area rugs, fabric architecture, and the furniture have sound-absorbing properties. The clinic space is organized by three practices, (women's health, pediatrics, and adult medicine), each with a medical assistant station, with the goal of integrating services, creating privacy, providing orientation to the outside, and maximizing light. The medical assistant station has sight lines to the main corridor; adjacencies include clinical support rooms and provider offices.
The 28-exam rooms are shared among practitioners and are not dedicated to an assigned provider, providing scheduling flexibility and the opportunity for integrated services. At Thundermist, there is a saying, "you are always within three steps of natural light." The 20-ft high ceilings, skylights in the hallways, and three light wells provide the visitor consistent orientation to the outside, support that concept.
