As I walked into the recently renovated Columbia University Fertility Center, I was greeted by a friendly young woman at the desk. She asked me to sit in the waiting room as I waited for Dr Zev Williams to escort me. As I waited, I immediately noticed how small the waiting room was. After having visited 10 fertility clinics in New York City during my own fertility journey, “small” would not be what I’d use to describe waiting rooms.
Dr. Williams introduced himself and took me to his office. I could not help myself. The first question I asked was, “Do you have a backup waiting room?” He smiled and said, “No. That is our only waiting room. The last thing our patients want is to wait and the last thing they’d prefer to see is everyone else waiting. We’ve worked as a team to minimize wait times and, in fact, our volume has increased and wait times have plummeted.”
I could not wait for the tour. With a background in healthcare consulting, one of our hot topics is the need to change “the system.” Whether it be around patient-centered care teams to improved patient experiences, we know what needs to be done. The question is how? While Apple, Google, Amazon, and others are tackling the data side, let’s get back to Columbia and how they are tackling the patient experience.
The story began when the fertility center decided to renovate and move to a central location – Columbus Circle. The plans were developed by an architect. When asked if a cardiac unit would be designed in the same way, the architect said, “Yes!” This is when Dr. Williams, new on staff and now the Chief of the Division of Reproductive Endocrinology and Infertility, stepped in. While this is not at all to minimize patients’ suffering when under cardiac care, it was important to take patients’ experience into account for this new center. Patients come in multiple times a month – sometimes for years – trying desperately to create a family. Designers volunteered their time and worked with the staff to create the ideal clinic.
Let’s start with the waiting area. The aura is all about the circle of life – a woman’s eggs. Colors are soft hues and corners are rounded. There are no medical journals or televisions – those struggling with infertility spend enough time learning and researching. Filtered water and organic fruits are the only available snacks – no coffee.
The check-in counter is just that – a counter. There is no serious activity going on behind it. If there is, it is behind the wall. While most counters are designed for the average height of a man, this one is four inches lower. Additionally, it is deep so you can put your bag on the counter rather than the floor. The face of this counter leverages the Fibonacci Sequence, which is a mathematical pattern found throughout nature.
To reduce confusion and complication, the whole floor is designed with a “need to know” philosophy – if you, the patient, don’t need to know about it, you don’t see it. Even doors aren’t labeled unless the patient needs to know about it. Let’s take the lab – again, no sign. It is a triple-air locked room, meaning one has to go through three doors to step inside, making the air as pure as possible. There is a small window between it and the procedure room to allow for easy access to eggs, sperm, and embryos during retrieval and transfer.
As we walked up and down the hall, I noticed how intimate the clinic felt. There were no hidden hallways or confusion over which door led to the elevator. It was intimate, yet it still conducts about 1200 retrievals in a given year. All computers were recessed into the wall to limit obstruction. Patient rooms are double wide allowing for plenty of room to change.
Given the floor is the building’s penthouse, views of Columbus Circle and Central Park are key. Guess who gets to see Columbus Circle all day? Those who are at desks all day and who really need it! You guessed it – the back-office staff and patients. Dr. Williams took a small office instead. He said, “Why do I need a view? I’m not at my desk very often.”
Well said, Dr. Williams!
It warms my heart to see changes to clinic aesthetics and processes. Visiting with clinicians, regardless of your health condition, can be anxiety-provoking. I remember in one case, I’d sit in a sterile clinic that was packed. Transfers and retrievals would happen hours after they were scheduled to, and we got the token Dunkin’ Donuts coffee and donuts as we waited. (Aren’t processed foods a “no-no” for fertility?)
The team at Columbia – yes, Dr. Williams emphasized the team approach to these changes – did a great job. It is clear their focus was not to be gimmicky, but instead focus on improving the patient experience.
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Disclaimer: By writing this article, we are not partnering with or endorsing Columbia University Fertility Center. Instead, it is our mission to provide helpful and insightful information to the public. May this article serve as inspiration to all clinicians and the centers in which they work.