The three critical elements required to build this type of transformational healing environment were: Physical, Behavioral, and Informational. By understanding the Experience Ecology and the outcomes of all three areas in conjunction with one another, sustainable change can take place, allowing for a patient- specific experience centered on quality outcomes.

1. Expect The Unexpected
Neuroscience Group of Northeast Wisconsin
A Miron Construction Co., Inc. Healthcare Case Study

4. Contents
“Our purpose is to serve
Introduction 8
with the greatest intent,
Walk 10
to show compassion and
provide the ultimate Talk 18
healing environment.” Create 42
Act 66
Philip A. Yazbak, M.D., F.A.C.S., President
Neuroscience Group

5. Introduction
“To be the center of all, working in collaboration with Miron
Construction Co., Inc. and Plunkett Raysich
excellence and the Architects, LLP to create a facility unlike any
recognized leader other.
of comprehensive, As for why we should do this, the answer
is in our purpose ~ to serve others ~ and in
compassionate neuroscience the Neuroscience Group Vision . . .“To be
services in Northeast the center of excellence and the recognized
leader of comprehensive, compassionate
Wisconsin.” neuroscience services in Northeast
The Neuroscience Group of Wisconsin.”
Northeast Wisconsin Mission
Breaking new ground was our only choice.
Statement
Creating the unexpected, our mission. Our
exploration process was under way. The
Creating the unexpected is a thrilling future was ours to shape; the unexpected,
but daunting challenge. Sustaining the to create.
unexpected, even more so. Still, we
considered it our privilege—in fact, our
responsibility—to write the most compelling “What is the new way
chapter in the history of neuroscience of thinking? That which
medicine and healthcare construction.
created the patient
Constructing a state-of-the art building was
out of the question. Creating a beyond-the-
experience of the past is no
state-of-the-art experience was our dream. longer relevant. From the
It was also our greatest challenge, one that
excited everyone involved, connecting us to
beginning, we must design
a mission unlike any other. and construct the patient
A cross-functional team of physicians, experience in a unique way...
practitioners, and other key team members
from Neuroscience Group agreed that
the ideal way.”
setting the standard meant building on the Steven J. Price, M.D., Neurologist
already-strong foundation . . . exploring Neuroscience Group
new territory . . . innovating . . . and, above
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 9

6. Walk

7. “Are patients ever attached
to a building? At Miron
Construction, we realize that
simply to build is not enough.
For our projects to be highly
innovative and supremely
successful, they must transform
how people feel, taking their
thoughts and their emotions to
an entirely new level.”
David G. Voss, Jr., President
Miron Construction Co., Inc.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin

8. “The transformation process began
with three outcomes in mind—
each focused on emotion, the
most important aspect of the Ideal
Patient Experience.
We asked ourselves the following
questions: How well-cared for do
our patients feel when they’re with
us? How do families feel about the
care we’re providing for their loved
ones? How does our team feel in
setting and exceeding the standard
for comprehensive, compassionate
care?
Our facility needed to cater to each
one of the outcomes of those
questions, and that is why its
design and construction was so
integral our goals.”
Margie Wiess, Ph.D., CEO
Neuroscience Group
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 15

9. Collaborative Innovation best
describes the process used to
bring our Creating the Unexpected
Dream to life. We could not have
asked for finer, more creative,
more innovative partners during this
process than Miron Construction
Co., Inc. and Plunkett Raysich
Architects, LLP.
Keeping the desired outcomes in
mind, the first and only choice for
building the Ideal Patient Experience
was Miron Construction Co., Inc. of
Neenah, Wisconsin.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 17

10. Talk

11. The three critical elements required
to build this type of transformational
healing environment were: Physical,
Behavioral, and Informational. By
understanding the Experience
Ecology and the outcomes of all
three areas in conjunction with one “Working together, we created
another, sustainable change can
take place, allowing for a patient-
specific experience centered on
a culture of innovation. True to
quality outcomes.
their mission, we significantly
It was important to align each
element with the expectations of the improved the quality of patient
patient and Neuroscience Group.
However, it was even more critical
that each element was designed to
care and, at the same time,
support and complement the other
elements. One or more of these reduced costs. For example,
main elements are often overlooked
or executed poorly, neglecting
not only their uniqueness, but the
through close scrutiny of
interdependence of all three.
function and patient interaction,
each exam room was right sized
six inches smaller than originally
programmed. This resulted in
significant construction cost
savings.”
Mike Scherbel, Partner
Plunkett Raysich Architects, LLP

12. Guided Co-Creation:
A collaborative, connected
experience during which a
representative selection of
Neuroscience Group employees
designed organizational
transformation. Stakeholders had
a voice during the entire innovation
process. This group was known as
the Innovation Team.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 23

13. E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 25

14. To create the unexpected and bring
the outside in, the architectural
features of the building needed to
complement the natural landscape
elements. The goal… to have
unique design elements that
captured the minds of each visitor.
“We started with the outcomes
– how we wanted our patients to
feel – and moved backward from
there. A very non-traditional
approach.”
Margie Weiss, Ph.D., CEO & Community Health Care Advocate
Neuroscience Group
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 27

15. Design elements and patient
outcomes were identified, illustrated
and examined to ensure they were
brought to life.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 29

16. Neuromarketing:
The connection of the brain
synapses to the positive patient
experience are directly related and
often overlooked.
Reaction - Physical reactions to objects and spaces
Example: Employees stand on toes to reach something.
Adaptation - When an object serves a purpose for
which it was not intended
Example: A box elevates a computer higher on a desk.
Exploitation - Using existing conditions to
accommodate needs
Example: The space beneath a desk becomes a storage
space.
Conformity - Social norms and their patterns
Example: Patients sit five seats apart and star at each
other.
Signaling - Communicating with patients
Example: Post-it notes transform a refrigerator into a
bulletin board.
Stewardship - Caring for the environment
Example: An organization relies excessively on paper
for collecting information that could be transmitted
electronically.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin

17. As advocates for community
health, NSG recognized that the
new facility presented both a
challenge and an opportunity to
integrate sustainable design into
the construction and operational
strategies. A healing environment is
predicated upon the premise that
the land, people and building must
all work together in holistic harmony.
The design process was stimulated
by patterns found in nature and
brought to life through Miron’s C5
Process.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 33

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19. Neuroscience Group leaders
were aware of the economic and
environmental benefits of designing
and building “Green”. Sustainable
buildings lower operating costs,
improve employee retention,
enhance occupant comfort and
health, increase building valuation,
decrease strain on community
infrastructure systems and help
to create patient-centered high-
performance healing environments.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 37

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21. All factors were considered before
immersing the team in any decision
making. Much like a fashion runway,
preferences in colors, fabrics,
and style are unique for everyone.
However, we do know that if
designed with patient-experience
outcomes as the primary focus,
sensations come to life, enabling
patients to feel completely special
and in control of their healing
process.

22. Create

23. “Taking ownership of this
project has been deeply
gratifying for our team. The
building process, in particular,
was carefully planned,
integrated and executed, very
much in the spirit of how we
handle patient care. Miron was
committed, from the beginning,
to build an environment of trust
for all involved.”
Susan G. Hibbs, M.D., Neurologist
Neuroscience Group
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin

24. E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 47

25. Bringing the building to life would
not have been possible without
the use of Building Information
Modeling (BIM) and Dan Bayer,
Miron’s BIM specialist. The Miron
team was equipped to forward plan
and visualize the outcome, allowing
for the NSG team to analyze
the results. Real BIM success
was driven by living the virtual
environment experience. Miron’s
use of BIM tools helped to define
and visualize the outcomes before
the first shovel entered the ground.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 49

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27. The Innovation Team was able
to assist Neuroscience Group
in reducing patient registration
waiting time from 13 minutes to
35 seconds. This savings not
only lowered the initial time spent
in the reception room by the
patient, but also allowed for a more
consistent scheduling workflow.
Because patients rarely arrive 30
minutes early for their appointment,
additional slots were available to
augment the schedule. With the
change in design and caregiver
behaviors, two to three slots per
provider per day were opened for
direct patient care. This change
added 6% additional revenue to
the top line each year, resulting in
a 1.4% increase to the bottom line.
Outcome-based design changes
do make a difference… in patient
feelings, in caregiver connections
and in bottom line profitability.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin

28. NSG’s green vision is a unifying
theme, encompassing of all
aspects of the project. Miron
Construction Co., Inc. was selected
to assist in the implementation
of this vision. Rather than hiring
a sustainability expert, Miron had
the talent, tools and knowledge to
bring the dream to life. Without a
partner who understands and lives
sustainable excellence, NSG’s
LEED® initiative would not have
been possible.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 55

29. New ideas for the patient exam
room transformed into the way
Neuroscience Group is perceived
both internally and externally. To
create the ideal outcome in the
exam room setting, the experience-
design team used the revolutionary
Rapid-Access Prototyping tool
that challenges traditional thought
processes. “Healthcare patient
exam room design has changed
very little since it was created 30
years ago” commented Philip A.
Yazbak, M.D., “In fact, if you read
periodicals from years past, exam
room design today is substantially
the same. The challenge is that
our health care delivery system has
changed quite dramatically.”
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 57

30. “Physicians, healthcare architects,
clinical assistants and associate
practitioners from the group co-
created the ideal exam room,”
Dr. Steven Price said. “First, we
cleared out one of our 10 x 10
exam rooms and began designing
the experience from there. The
revolutionary change we were
looking for would not have come
from simply rearranging the
environment that already existed.
And so,” Price continued, “we
challenged traditional thinking by
starting with an open palette.”
“What was once a sacred space
was up for discussion. Anything
was possible.” commented
Weiss. “Soon, everything became
possible.” Foam items were put
in place, illustrated, identified, and
the creativity began. “We started
with the expected emotional
outcomes connected with patient
flow and physician expectations,”
added Steve Tyink, VP of Business
Innovation at Miron. “Then we took
these expectations to the realm of
the unexpected, our ultimate goal.”
The results? No more frightening
models of half brains, no more
posters of the human body greeting
patients as they entered the exam
room. “Together, we created the
ultimate in patient privacy and an
exam-room environment that was
warm, welcoming, and reassuring.”
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 59

33. Three realities and levels of
expectation can be formed within a
clinical setting:
• Patients receive less than
what they expect. Example:
They would like to enjoy some
coffee, however, it is nowhere
to be found.
• Patients receive what they
expect. Example: Coffee is
available through a confusing
countertop serve dispenser
with styrofoam cups.
• Patients receive more than
what they expect. Example: A
Coffee Barista stands ready to
exceed all patient expectations.
Each outcome brings decidedly
different feelings and emotions.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 65

34. Act

35. “Just as evidence-based
medicine is revolutionizing
health care, evidence-based
design is transforming the
health care environment. We
now have at our disposal proven
methods for improving patient
outcomes, safety, attachment
levels, as well as staff retention
and service efficiency. Our
evidence-based design also
results in improvements to
clinical outcomes, economic
performance, productivity,
Press-Ganey patient satisfaction
and community measures.”
Steven J. Price, M.D., Neurologist
Neuroscience Group

36. Members of the Neuroscience
Group Innovation Team toured
other firms where alternative
methodologies are currently in use.
These trips provided discovery
and insight into the specific areas
needed. Best practices were
identified at Cabela’s, REI Outfitters,
Lush Cosmetics, Whole Foods, to
name a few. Direct observation and
analysis challenged perceptions
and changed outcomes.
E x pe c t Th e Un e x pe c t e d | The Neuroscience Group of Northeast Wisconsin 71

37. “By simply altering processes,
modeling impression areas and
attachpoints, understanding
outcomes and shifting
behaviors, the experience
at the Neuroscience Center
now closely reflects the
organization’s mission and
commitment to its patients.
The result? An experience that
is unforgettable. The ultimate
healing environment and ideal
patient experience have been
created and are well underway.”
Gizell R. Larson, M.D., Neurologist
Neuroscience Group

40. Acknowledgments
We would like to thank the following people and firms who shared their passion
and dedicated their expertise to the successful creation of the Neuroscience
Center:
Miron Construction Co., Inc.
President/Principal: David G. Voss, Jr.
Vice President/Principal: Tim Kippenhan, LEED® AP
Project Manager: Andy Derksen
Project Superintendent: Jim Zeigler
VP, Business Development: Corey Brumbaugh
VP, Health Care Services: Dennis Lynch
Conceptual Estimator: David Schaetz
Project Coordination: Jodette Friedrich & Kelly McCarthy
VP, Business Innovation: Steve Tyink
Plunkett Raysich Architects, LLP
Architectural Design and Renderings
Partner: Michael H. Scherbel, AIA, NCARB
Project Architect: Mary Spriggs, AIA, CSI, CDT
Senior Planner: Daniel J. Becker, AIA, LEED® AP
Interior Design: Dan Effenheim
Engineering Concepts, Inc.
HVAC & Plumbing Engineer
GEI Consultants
Electrical Engineer
STS/AECOM Associates
Civil Engineer
Pierce Engineers, Inc.
Structural Engineer
All Content © 2008 Miron Construction Co., Inc.
Professional Photography
Ark Media Group, LLC
Margie Weiss, Ph.D.
Weston Imaging Group, LLC
Graphic Design
Sarah Parker

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Neenah, WI 54956 Madison, WI www.miron-construction.com
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