Lessons from Google and Apple: creating an open workplace in an academic medical department to foster innovation and collaboration.

PROBLEM: An expanding obstetrics-gynecology department at an academic medical center was faced with too little physical space to accommodate its staff, including trainees, attending physicians, researchers, scientists, administrative leadership, nurses, physician assistants, and scheduling/phone staff. Staff also felt that the current use of space was not ideal for collaboration and innovation. APPROACH: In 2011, the department collected data on space use, using a neutral surveyor and a standardized data collection tool. Using these data, architects and facilities managers met with the department to develop a floor plan proposal for a new use of the space. Site visits, departmental meetings, literature reviews, and space mock-ups complemented the decision process. The final architectural plan was developed using an iterative process that included all disciplines within the department. OUTCOMES: The redesigned workspace accommodates more staff in a modernized, open, egalitarian setup. The authors' informal observations suggest that the physical proximity created by the new workspace has facilitated timely and civil cross-discipline communication and improvements in team-oriented behavior, both of which are important contributors to safe patient care. NEXT STEPS: This innovation is generalizable and may lead other academic departments to make similar changes. In the future, the authors plan to measure the use of the space and to relate that to outcomes, including clinical (coordination of care/patient satisfaction), administrative (absenteeism/attrition), research (grant volume), and efficiency and cost measures.