Physician offices and outpatient clinics typically consists of a patient intake area with space for reception, check-in/check-out, and waiting; exam/treatment space with a number of identical exam rooms, several office/consultation rooms, and one or more special procedure rooms; and associated clinical and administrative support space. Physician office space may be located in a medical office building (either freestanding or connected to a hospital), co-located with diagnostic and treatment services in a comprehensive ambulatory care center, or part of an institute or center organized along a specific service line — such as a Sports Medicine Center, Heart Center, or Cancer Center. Planning space for physician offices (also referred to as physician practice space) and outpatient clinics begins with determining how many exam rooms are needed and two different approaches are commonly used.
Ambulatory Care
Physician Offices and Outpatient Clinics: Key Space Allocation Factors
There is significant variation in the amount of space planned to accommodate a specific number of annual outpatient visits to a physician office or outpatient clinic. In some cases the department gross square feet (DGSF) may be more than double for the same workload — even when the types of patients seen and physician specialties are similar.
Case Study: Planning a New Outpatient Clinic
University Hospital (UH) planned to replace three outpatient clinics, currently in different locations, in a new freestanding building. Although the number of annual visits (30,000) was not expected to grow significantly, there was considerable debate among the physician leadership regarding the planning of the new facility. Some wished to maintain the status quo regarding their current productivity and wanted to simply replace the three separate clinics in new construction. Others wanted to consolidate the clinics into a single, efficient ambulatory care space ― recognizing that reducing their staff and facility costs would make them more profitable while potentially improving customer service with more streamlined and better coordinated processes. The physician leadership agreed to evaluate the impact on overall space need (and resulting construction cost) of planning a lean facility versus a more generous facility.
Case Study: Planning a Prototype Health Center
Northern Health Authority delivers healthcare to the residents of 20 different communities that are a mix of settlements, towns, and villages. With many of the existing remote health centers in need of replacement, Northern Health decided to develop a prototype community health center that could be replicated to serve communities of less than 1,500 people — some of which are accessible only by air.
Case Study: Planning an Ambulatory Care Facility
Prudent Health System planned to construct a new ambulatory care facility on its main hospital campus to provide space for urgent care, ambulatory surgery, and various hospital-sponsored clinics. The organization needed space to accommodate the following ten-year workload projections and corresponding clinical services:
- Urgent care center with 32,000 annual visits
- Ambulatory surgery center with 4,200 annual surgical cases
- Hospital-sponsored clinics: medicine (23,000 annual visits), surgery (15,000 annual visits), neurosciences (6,000 annual visits), orthopedics (16,000 annual visits)
In addition, Prudent Health planned a small express testing area to consolidate routine, quick-turnaround outpatient testing in a single area — including X-ray, electrocardiogram, and specimen collection — along with a small satellite laboratory.
Transforming Primary Care With the Patient-Centered Medical Home Model
The patient-centered medical home (PCMH) model ― also referred to as advanced primary care and the healthcare home ― holds promise as a way to improve American healthcare by transforming how primary care is organized and delivered. This team-based model of care is led by a personal physician who ideally provides continuous and coordinated care throughout the patient’s lifetime to maximize health outcomes. The PCMH practice is responsible for all of a patient’s healthcare needs or appropriately arranging care with other qualified professionals. This includes the provision of preventative services, treatment of acute and chronic illness, and assistance with end-of-life issues.