Lean Design

This project utilized LEAN planning practices.

A multiphase renovation to expand storage capacity of central sterile processing (CSP). The project included modernizing the existing cart and utensil washers and providing new air handling unit dedicated to the CSP to maintain key pressure differentials between soiled and clean operations within the department.

The project benefited from a LEAN 3P and prototyping process that allowed the team to identify the smallest workable area for each step in the process, allowing the team to maximize the area available for renovations in each phase of construction. It also identified the root cause of the throughput issues which were originally thought to be the washers. It was determined that out-of-sequence work was the root cause for throughput volumes and shortages in supplies. This was addressed with a visual storage solution allowing staff to identify shortages quickly in the visual inventory wall. The LEAN process also streamlined the soiled washroom operations, providing both redundancy and new capacity to accommodate a growing surgical program.

The multiphase project extended between two 1970’s-era buildings and was located in the basement level below diagnostic imaging. Cost was a key concern and the team evaluated multiple options, including a temporary CSP trailer configuration before deciding that renovating in-place was the most cost effective for the client.


Altro Flooring Award


This project utilized Lean planning practices.

This endoscopy renovation project at Lahey Hospital and Medical Center included the relocation and expansion of the endoscopy department within the hospital. The new center totals approximately 14,000 SF and includes nine endoscopy procedure rooms, 23 prep and recovery bays, and a new scope processing system.

Two of the procedure rooms are designed for advanced procedures and include fixed fluoroscopic Imaging equipment. This design is one of the first in the country and the second largest installation in the world of scope pass through washing and drying cabinets which greatly reduces the risks of cross contamination and improved digital tracking throughout every step of the scopes use and reprocessing.

The project also included a cost-effective approach to repositioning the building’s façade to create a dedicated entrance for endoscopy patients and greatly improved the workflows for staff efficiency and improved patient experiences.

MP completed this renovation to expand Lahey Hospital’s current capacity to provide rapid throughput testing of up to 11,100 COVID tests per day and provide a cloud-based IT interface allowing specimens to be resulted in 24 hours or less. The project achieved these goals through the following improvements:

  • Replacement of existing testing equipment with two Thermofisher Module 2 testing components
  • Adding three Bio-Safety Cabinets and two TECAN Module 1 Components
  • Adding staff work stations and storage through modular casework
  • Expanding Specimen Drop Off and Processing to provide a dedicated COVID specimen intake area

The project includes a microbiology lab located within the Lahey Hospital core laboratory used for COVID testing. Existing equipment (which included one Bio-Safety Cabinet and a PANTHER testing unit) was replaced with two Thermofisher Module 2 units, three Bio-Safety Cabinets and two TECAN Module I units. The new larger equipment required minor modifications, including:

  • Demolition of one partition to accommodate the Module 2 equipment size and clearance
  • Addition of a partition and door to separate the bio-safety cabinets and TECAN units
  • Modifications to ductwork to accommodate new layout
  • New monolithic sheet flooring in both rooms
  • New cleanable acoustical tile ceiling
  • New flammable storage cabinets
  • New modular casework work stations and storage
  • New handwashing sinks with eye wash
  • New Reagent sink

Existing Specimen Drop-off, which was located directly across the corridor, along with existing adjacent vacant offices, were converted to a dedicated COVID Drop off and processing area.

This new medical office building allows for Sturdy’s orthopedic and physical therapy clinics to consolidate from three different sites while modernizing their facilities and allowing for future expansion on the second floor. The ground floor is slated for the future relocation of outpatient clinics from the hospital. We presented the senior leadership and clinical teams with a variety of planning concepts to consider how to best suit their workflow and needs. Although there was a consensus amongst the groups to utilize a variation of the traditional exam pod concept, there was discussion about the exact configuration. Our team utilized a proprietary BIM tool to map out the flow of patients and staff between all of the space types under different scenarios, helping select a design concept.

With exams and office ringing the perimeter of the building, we sought to create opportunities to allow views and daylighting into the building core. By opening up the corridor ends, there is a great view to the exterior from every major circulation path and daylight is always present, while allowing access to concealed alcoves for carts and med prep stations.

The building’s exterior is designed to be contemporary and exciting while still economical. Opportunities for branding are a major component of the exterior and primary public spaces. The branding for the signature “S” is alluded to in the ceiling design of the interconnecting stair.

Southern Maine Healthcare, in partnership with Maine Behavioral Healthcare, is expanding access to behavioral healthcare services in Sanford, Maine with a new 5-bed emergency department acute psychiatric (EDAP) suite and 38 new inpatient behavioral healthcare beds, distributed on two inpatient floors.

The EDAP is designed around a small commons for patient access to communal spaces other than their patient room within the protective confines of the suite. The staff nurse station and security use the existing geometry of the building to provide clear sight lines within the suite. The program includes peer counseling for crisis management and the new EDAP will provide a first step in the behavioral health admissions process to the inpatient floors where patients can be safely evaluated.

The inpatient floors are designed around the community space and individual therapy rooms, including those for group therapy, quiet activities, and a new roof terrace on the first floor. The new units are secured with access through an interlocking sally port. Patients are provided with individual bathrooms, and anti-ligature design has been provided throughout the patient occupied areas. Art that highlights nature is incorporated at a variety of seating areas throughout the unit to bring nature inside the building. Seclusion rooms have been provided at both units but other spaces such as comfort rooms are being utilized to de-escalate patients before they need to be restrained.

The units also incorporate new highly efficient anti-ligature chilled beams to heat and cool the new floors, utilizing existing duct work to maintain existing ceiling heights, and removing the prior fan coil units at the perimeter windows. The project has also re-used the existing plumbing chases and wet walls to reduce cost and minimize impact of the construction on the operating rooms below.


  • IFMA Boston Awards
  • CoreNet Global New England Awards | Best New Workplace

Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds of post-9/11 veterans, service members, and their families through world-class clinical care, wellness, education and research.

A National Center of Excellence, Home Base operates the first and largest private-sector clinic in the nation devoted to healing “invisible wounds,” which can include:

Post-traumatic stress disorder (PTSD)
Traumatic brain injury (TBI)
Co-occurring substance use disorder
Military sexual trauma
Family relationship challenges
Other issues associated with military service

Margulies Perruzzi worked with Home Base on their new Outpatient Behavioral Health Clinic. The design includes 20 counseling treatment rooms, three large group therapy rooms, two exam rooms, lab space, Family/Patient Lounge, demonstration/teaching kitchen, recording studio, a multi purpose music/art therapy room, a 1,500 SF Fitness Center, and an exterior deck with healing garden.

Professional support space includes conference, huddle, enclosed work setting phone rooms, patient record, copy and storage spaces.

The program is entirely client-focused; there are no private physician offices, and treatment rooms are designed with a comfortable “living room” aesthetic.

The facility, including the fitness center, is fully accessible to accommodate service members with physical disabilities.

Winchester Hospital’s Breast Care Center relocated to 12,000 SF on the third floor in 200 Unicorn Park building which MP had renovated into a medical office building. Patients at Winchester Hospital’s Breast Care Center receive high quality, state-of-the-art comprehensive breast care from a multidisciplinary healthcare team.

MP was tasked to design a comfortable and attractive space while maintaining high patient satisfaction ratings. Our collaborative design approach incorporated 15 stakeholders made up of doctors, nurses, administrators, and facilities staff representing the center’s varied services. LEAN strategies were incorporated from the very beginning to outline complex patient flows and develop a design that minimized travel and patient wait times. MP utilized the LEAN design methodology of DMADV (Define, Measure, Analyze, Design and Verify) to understand Winchester Hospital’s current processes and to develop future solutions.

MP also incorporated evidence-based design strategies by creating mockup sessions. Using one of the existing treatment rooms as a testing environment for national benchmarking trends helps clinical staff envision what the space will be like (instead of looking at floor plans on paper).

Milford Regional Medical Center opened their new special care nursery to accommodate the rise in the number of neonatal abstinence syndrome infants in the community. The new state-of-the-art nursery offers six special care private bays, an adjacent well baby nursery, and a central nurses work area. The private patient bays have ample room for parents and staff.

MP provided design services for Lahey Hospital & Medical Center’s Samuel and Nancy Jo Altschuler Simulation Center. The space will provide staff with a realistic health care setting using the latest technology and training methods for learning new techniques, strengthening teamwork, and optimizing response to crises and unanticipated events. Unlike most simulation centers, this facility is within the main campus of the hospital and is accessible to staff 24/7.

The new facility includes a functional operating and exam room, simulation spaces, observation room, and classroom. The class space features a moveable wall to configure room size. A glass-paneled corridor provides additional transparency into observation spaces. Additional spaces include a kitchenette and lounge area.

MP’s scope of services for this project included programming and planning, site evaluation and clinical test fits, ground up construction, interior design, sustainable design, WELL Building, and LEAN process improvement. The design team focused heavily on the functionality of the simulation space and created realistic clinical spaces for the most accurate learning experience for the users, while incorporating LHMC’s standard calming hospitality-like design aesthetics.

MP provided design services for the relocation of a vascular suite for Brigham & Women’s main campus. Taking the place of an existing endoscopy space, MP designed the new vascular suite to provide a comfortable and calming environment upon entering.

The suite utilizes the client’s main standards while subtly incorporating new elements to provide a modern, updated look. Bright standards and cool tones of pink reinforce the feel of a calming environment. Additionally, linear and perimeter light around the core of the suite provides lighting comfortable for patients in stretchers. The walls feature bumper rails protecting walls from stretchers and other mobile medical equipment. A skew pattern on the floor provides aesthetic interest and visual separation for walking pathways and storage.

The reception area serves as a portal for patients, featuring self-services, ample seating, and a striking selection of lighting to create a bright, welcoming atmosphere for patients and providers alike.

The program includes two holding bays, five exam/ultrasound rooms and staff support spaces.

Photography by David Pires Photography.