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Planning a Large Ambulatory Care Center at an Academic Medical Center: Economic, Political, and Cultural Issues

Pauly, Greg MHA; Jellinek, Michael MD

Journal of Ambulatory Care Management: April-June 2005 - Volume 28 - Issue 2 - p 182–193
Original Article

The Massachusetts General Hospital developed a series of space and utilization guidelines that assisted in the planning of a 450,000-ft2 ambulatory care facility. The guidelines attempted to balance and preserve the critical elements of the hospital's culture while, at the same time, create a highly efficient ambulatory care building. This article discusses the economic, political, and cultural implications of implementing specific project principles and guidelines known as the “9 Commandments.”

Ambulatory Care Development, Massachusetts General Hospital, and Primary Care Practices, Massachusetts General Physician Organization, Boston (Mr Pauly) and Newton Wellesley Hospital, Newton, Mass (Dr Jellinek).

Corresponding author: Greg Pauly, MHA, Massachusetts General Hospital, 55 Fruit St, Bulfinch 130, Boston, MA 02114 (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.