A Village
Leads a Nation

“ The first step in the redesign was to define what our business was really about. It is about trusting relationships between human beings. Prior to our redesign, the medical system misunderstood the core product as being tests, diagnoses, pills and procedures. ”

Dr. Douglas Eby Vice President of Medical Services

NBBJ helped one of Alaska’s largest and fastest growing healthcare organizations bring physical form to a new primary care approach that is outperforming better-known peers on performance and quality measures. Set at the southern edge of the established Alaska Native Health Campus in Anchorage, these additions, 55,000 square feet in 2002 and 75,000 square feet in 2010, provide a new public face for the institution.

Southcentral Foundation’s unique Nuka System of Care features a team of experts that care for both the mind and body by recognizing the interrelated nature of factors affecting health and wellness. The Integrated Care Team can include a variety of specialists such as tribal doctors, behaviorists and acupuncturists that seek to bring the mind and body in alignment.

Design for a Team-based Model

To support this model of care and the foundation’s core hallmarks of same-day access and better management of chronic conditions, NBBJ worked onsite at the medical campus to research the opportunities for innovation. By analyzing the customer journey from check-in to recovery, NBBJ helped identify the need for improved sight lines, informal collaboration zones and a mix of clinical and non-clinical spaces to improve patient flow. The result was open-plan workspaces that replace typical private physician offices and flexible “talking rooms” at various scales that serve multiple purposes and allow for expansion.

Since the redesign supported the transformation of the system, the clinic’s better management of chronic conditions and whole system design has dramatically improved utilization (ER use is down 50% per capita) and clinical outcomes data. The relationship-based care and same-day access policy has created an 80% match rate. Customer and staff satisfaction rates top 90%. The facility and program design now attract national and international attention as a model to be replicated elsewhere.

Mapping the Journey to Streamline Flows

Each Integrated Care Team includes a primary care provider and a group of specialists who work on building a lifelong relationship with the customer and their family. This new kind of care features a team capable of bringing together the mind and body and coordinating care across all boundaries.

Integrated Care Teams
The ICT seeks to develop relationships with each other and their customers through a collaborative
approach to care and wellness.
Central Support
The Primary Care Center’s three floors are organized into a continuum of public and private spaces,
divided into two zones flanking a service core.
Zones of Care
Rather than the traditional mix of physician offices and exam rooms, the clinic is organized into an outer
zone of flex spaces that support six integrated care teams, talking rooms and an inner zone of exam and procedure rooms. Zones of care that range from less to more critical results in a more efficient use of space, and less waiting time.

Proof that it Works

The efficiencies of this new model have clearly saved money. Between 2004 and 2009, Southcentral’s annual per-capita spending on hospital services grew by a tiny 7 percent and its spending on primary care, which picked up the slack, by 30 percent, still well below the 40 percent increase posted in a national index issued by the Medical Group Management Association.



Video: Making health a lifelong journey instead of a one-time visit

Awards and Publications


Modern Healthcare Design Award, Citation/Built


New York Times, “A Formula for Cutting Health Costs,"July 21, 2012
Interior Design, “Healing Properties," January 2004