Inside Duke Medicine

Reinventing Duke Clinic to maximize space by strategically co-locating related services

Next month’s opening of the new Cancer Center facility creates opportunities to reinvent Duke Clinic in order to maximize clinical space utilization by strategically co-locating related services and providing additional room for services whose growth capacity currently is constrained by space limitations.

“We have a great chance to think about where we have had services in the past that have not had the benefit of working collaboratively together,” said Chris Samples, MBA, interim vice president for Ambulatory Care Operations. “The Cancer Center opening gives us the opportunity to put the services together and ease the crunch in space-locked areas.”

The opening also provides an important opportunity to build care around patients and their diseases rather than on the traditional model based on providers’ disciplines, said David Zaas, M.D., MBA, chief medical officer of the Private Diagnostic Clinic, and vice chair for clinical practice in the Department of Medicine.

“We’re committed to improving the patient experience by co-locating multidisciplinary service lines that meet their needs, even as we seek to address providers’ needs, pursue opportunities for growth and align with the goals of Duke Medicine,” Zaas said.

Rearranging the clinics to optimize care delivery and patience convenience also is consistent with our core value of caring for our patients, their loved ones and each other.

Examples of some of the changes include creating an acute care sickle cell clinic, moving an acute heart failure clinic from the North Duke Street Clinic, and expanding infusion services. Also, multidisciplinary thoracic and abdominal transplant clinics will be created to unite services now provided at several locations on- and off-site.

Synergies between the clinics and Duke Hospital will be further enhanced by keeping services on the medical campus that need to be there and moving services to campus that will be better utilized there.

“We want to provide a coordinated, convenient, one-stop-shopping experience for our patients as they meet with their provider, transplant coordinator, nutritionist, social worker or financial counselor,” Samples said. “It also makes sense programmatically from a staffing viewpoint and in enhancing opportunities for growth.”

Maximizing space centers around providing room for clinical services currently at or above capacity that have nowhere to expand but which anticipate growth in the coming years. Creating additional clinical space – by efficiently co-locating related programs or putting programs such as trauma services in more convenient, accessible locations – will take priority over seeking new space for non-clinical programs.

The transition process begins when the Cancer Center opens, but everything doesn’t happen at once.

We can’t move folks within Duke Clinic until other folks move out,” Samples said. “And the Duke Clinic moves depend on how long it takes to renovate areas to match new services they will be providing and to optimize patient flow.”

Zaas said those who think the new Cancer Center will immediately create vacant, available space should consider Duke’s robust growth in recent years. “Everything will be full when the Cancer Center opens, even with the Duke Clinic backfill,” he said.