In the ever-changing healthcare environment, the balance between providing the highest quality of care at the lowest possible cost is critical. Healthcare organizations are challenged each day to provide this exceptional care while competing for patients, staff, and providers who all have choices of where to receive and provide care. Their organization is not any different than those throughout the country facing similar challenge. Their organization is a multi-specialty medical group practice and is part of a larger healthcare delivery system. As their organization continues to grow, they have reached a point where additional space is needed to add providers and to grow their ambulatory services. As they considered all of the factors previously mentioned their focus was on how to create an environment where they could design a new medical office building where the building itself creates an area where the patients are truly at the center of all that they do. The goal is to also develop a building that would help them recruit and retain the best providers and staff to provide care for their patients. After significant discussion it was determined the use of LEAN Six Sigma “LEAN” design was their best approach. This approach was completely unique to anything they had previously developed. The Medical Group plans to construct a new 60,000 square foot medical office building (MOB) that will provide multi-specialty space for approximately 35 to 40 providers. An overarching goal of the new facility is to differentiate the patient experience from others in the region through an ideal patient and provider experience. The plan is to design a new approach to the clinic visit and develop a care model that will provide a private, efficient, and exceptional patient experience. The goal is to leverage the expertise of the team to create a standardized clinical design that supports both flexible and reliable care that can be easily replicated in subsequent expansions of other new facilities. This approach redesigns the traditional method of building design by first developing required changes in workflow, processes, and behaviors and then develop the building which will effectively serve as a model to facilitate exceptional care. While they have begun implementing LEAN principles in other parts of their organization, they had never designed and built a medical office building using LEAN principles. It is their goal to design and build a medical office building where the patients are truly at the center of their care and use people and technology to provide the highest quality of care at the lowest cost.