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HEALTH CARE FACILITY & SPACE PLANNING
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Space and Functional Programming Sample
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Ambulatory Diagnostic Testing and Treatment Service
Facility Project Description
The area immediately south of the main entrance on the first floor will be reconfigured to consolidate short-duration ambulatory diagnostic testing and treatment services. The Ambulatory Diagnostic Testing and Treatment service will merge pre-admission testing, phlebotomy and other specimen collection, the vascular lab, outpatient cardio-pulmonary testing, and the clinical portion of Occupational Health into a single ambulatory patient care service.
Patient registration and a consolidated first floor waiting area will remain in this area, although may be relocated from its existing site.
Project Objectives
The objectives of the 1st floor Ambulatory Care facility plan are:
1. To provide a "one-stop-shopping" approach to short duration ambulatory care services by integrating ambulatory diagnostic/treatment services; Pre-Admission Testing (P.A.T.), phlebotomy, vascular lab, and selected cardio-pulmonary services.
2. To locate these services in an easily accessible site on the first floor adjacent to the main entrance.
Service Description
All short duration ambulatory care activities, with the exception of radiology exams, will be consolidated into a single patient service line in order to provide seamless patient care. Staff communication, patient's visits, and education programs will be coordinated so the patient feels they are being cared for by a coherent healthcare team not by segregated clusters of providers. For example, phlebotomy functions will no longer occur in the clinical lab and patients will no longer report to the 3rd floor for respiratory evaluations, tests, or treatments.
Professional staffs from several departments are being consolidated into a multidisciplinary service line and will report to a single manager. A matrix model of management is being considered, with managerial responsibility falling to the Ambulatory Diagnostic Testing and Treatment manager and professional practice responsibility or quality assurance falling to the manager of the professional department.
Patient care rooms will be designed to be flexible in their use and support more than one function. Services and staff will move to the patient rather than the patient moving from room to room or from department to department. For example, an exam room is used for pre-admission physical exams but also is suitable for performing an E.K.G. or drawing blood.
Cross training of clinical staff may enhance cost efficiency and reduce patient visit times.
In addition to the benefits to patient care consolidating these services results in a savings of more then 2,500 department gross square feet as compared to configuring the space as distinct independent departments.
Alternatives
The Ambulatory Diagnostic Testing and Treatment exam rooms could be used by the Emergency Department after hours and on weekends for urgent care. It is, however, unlikely that these exam rooms will be immediately adjacent to the Emergency Department exam rooms. It is possible that they would be across the waiting room from the Emergency Department. A model for staffing a somewhat remote urgent care site would need to be developed.
Registration will remain on the first floor adjacent the ambulatory services but may be relocated or reconfigured.
Operational and Facility Assumptions
Operational and facility assumptions applied to the Space and Functional Program for Ambulatory Diagnostic Testing and Treatment service were developed during Planning Team discussions.
Reception and Waiting
Reception Desk
A reception desk will serve as the point of contact for patients seeking Ambulatory Diagnostic Testing and Treatment Services. The reception desk will be configured for 6 staff members who will provide check-in, point-of-service registration, and checkout services.
The check-in process will include acknowledging their arrival and welcoming them, completing, if necessary the registration information, and notifying the staff of their arrival. The check-in process should take only 1-2 minutes.
The majority of patients seeking services at the Ambulatory Diagnostic Testing and Treatment service will have scheduled appointments. These patients will be pre-registered via a phone call prior to the day of their visit in order to expedite their care during their visit time.
Checkout services will include scheduling return visits, consultation appointments with other providers, and ancillary tests.
Patients scheduling appointments over the phone will be routed to central scheduling rather than to the reception desk so that reception staff can devote their attention to patients on-site.
Waiting
Waiting will be configured as a single large waiting area with seating grouped in areas of 4-8 chairs. The configuration of the waiting areas and the procedure for calling or escorting the patient to the exam or diagnostic room should be sensitive to the privacy of the patient.
This waiting area also will function as the surgical waiting area.
It is proposed that patient flow should be managed so that no more than one patient should be waiting in the waiting room for each exam or diagnostic room.
Patient Care
Scope of Service
All short duration ambulatory care activities will occur in this area with the exception of radiology exams.
Facility Requirements
Exam rooms are designed to be flexible in their use and support more than one function. Phlebotomy, specimen collection, and stress testing will occur in rooms dedicated and customized for these purposes. The remaining exam rooms will be used for physical examinations, patient interviews, doppler studies, holter placement and removal, pulmonary function exams (PFT's), and nebulizer or other respiratory treatments. It is recommended that the PFT and Doppler equipment remain in a select rooms and these rooms be held when patients are scheduled for these exams. At other times these rooms can be used for other activities.
Exam rooms will be equipped with a cart, a recliner, or an exam table. Each room will be configured with a computer workstation, a hand-washing sink, supply storage, medical gases - oxygen, vacuum, and air, and both standard room lighting and procedure lighting.
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View Space Program
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HELICON CONSULTING, INC.
4905 Montvale Drive
Durham, North Carolina 27705
919.489.1881
919.489.9032 (fax)
HeliconConsulting@earthlink.net
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