Subscribe for 17¢ / day

Chief Executive Officer John Felton shows equipment in the larger patient rooms at the new RiverStone Health Clinic on Jan. 11.

To do RiverStone Health Clinic's $11 million expansion and renovation right, John Felton, who leads the county’s public health agency, called upon a team of experts — those who care for the 16,000 patients served in the South Side facility — to help design the most efficient and useful clinic they could.

During an open house from 4 p.m. through 6 p.m. on Wednesday, Jan. 17, the public will get to see the fruits of their labor. Tours will launch every 15 minutes, with speeches commencing at 5 p.m.

Medical staff will begin seeing patients in the facility’s 48 new exam rooms Monday, Jan. 22.

“I probably had less input than anyone on campus,” Felton said Thursday during a sneak preview. “These are the folks who do the work, so they’re the ones who spent hours and hours with the architects and the design team.”

The design team used a “spaghetti diagram” based on employees’ actual daily steps, which were carefully tracked, to design a clinic that would cut down on extra legwork and locate important services — such as X-ray — centrally and conveniently.

About 100 of RiverStone Health’s 380 staff helped design the place, and staff pulled $510,000 from their own pockets — more than $1,300 each, on average — to help make the nearly 32,000-square-foot space, at 123 S. 27th St., a model of efficiency with a patient-centered design.

One example, this one funded by a RiverStone foundation mini-grant: rooms designed to allow a mental health counselor to speak with a patient come equipped with built-in toys for the patient’s children and iPods with earphones so that the grownups can speak frankly without the youngsters listening in.

The 48 exam rooms, each about 120 square feet, are grouped into four pods, effectively turning the new clinic into four smaller clinics, each run by a team of physicians, physician assistants, medical residents, nurses and other professionals. Each area has different wall colors and signs, and each team has a central area to ensure members can more easily work together.

Patients will be assigned to one of the four teams to help ensure familiarity and continuity of service. That’s part of RiverStone Health’s patient-centered medical home model, which takes advantage of the team approach to treat everything that ails a patient under one roof, and hopefully during one appointment. Low-income patients, Felton explained, often are in jobs where sick days aren’t readily available.

According to a provided fact sheet, the community care center approach used at RiverStone Health Clinic saves the Montana Medicaid program $33 million each year because its costs are 24 percent lower than those of other primary care clinics.

With the additional capacity, RiverStone Health has hired more staff, including doctors and physician assistants. Felton said the increased efficiency the new clinic will offer could well increase the number of patients who receive care there — now at least 80,000 and up to 90,000 visits per year.

Each exam room is laid out and furnished identically, eliminating the guesswork over which drawer houses a needed supply.


Staggered check-in walls for enhanced patient privacy are featured in the new RiverStone Health Clinic.

Patients enter an airy lobby and will be served at check-in windows that are slightly offset — at the suggestion of a RiverStone staffer — to give patients a little more privacy. The lobby has two family-friendly waiting areas with kid-size furniture, activity tables and books.

While the new clinic’s layout will clearly aid those who work there, patients will be better served, too. When they’re sent down the hall for an X-ray, it’ll be through a private hallway where they’re visible only to staff. There’s both a main lab and two satellite labs, the smaller ones designed for more routine care, such as blood draws.


The new RiverStone Health Clinic features larger educational rooms to train medical staff.

A new educational space features ample room for teaching physicians to train residents as part of the Montana Family Medicine Residency, the state’s first graduate medical education residency training program. Since 1991, 121 doctors have completed the program, with more than 60 percent of them practicing in Montana.

The new building was made possible through a public-private partnership, with more than $3.78 million of the $11 million cost raised through private gifts, including the lead gift of $1 million from Bill and Merilyn Ballard, for whom the building is named.

RiverStone Health’s Building a Healthy Community capital campaign needs to raise the remaining $1.72 million, which includes funds for the project’s second phase. That work, expected to be completed by June, will connect the new clinic with the existing one and redesign part of the former space into a wellness center. Dental; pharmacy; Women, Infants and Children; and other family health services should see no interruption in service during the upcoming work.

“It’s just going to be more appealing for people,” Felton predicted. “In our experience, people meet our staff and are treated with kindness — and they want to stay.”



City Government Reporter

City reporter for The Billings Gazette.