Whether a patient care area is used for patient exams and treatments, diagnostics, medical or surgical procedures, or for inpatient recuperation, associated space is needed to store and stage medical supplies, medications, nourishment, and equipment used in the department or nursing unit. These spaces are often referred to as “clinical support space” and are usually standardized throughout a healthcare facility. The generic rooms or areas listed in this article can be used for most patient care areas. The minimum sizes can generally support a wide range of exam/treatment rooms, procedure rooms, and inpatient beds. A further increase in workload or beds can usually be met with the addition of a second supply cart, bin, cabinet, etc. For very large departments or nursing units, an additional set of these spaces may be provided to reduce staff walking distances.
Facility Components
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Ten Key Questions When Planning the Clinical Laboratory
Laboratory testing has grown from a manual, “hands-on” process providing a simple test menu — with staff organized by testing methodology or discipline in multiple small rooms — to an automated, multidisciplinary, high-volume instrument-centric clinical enterprise. A visit to a hospital laboratory today reveals a varying array and number of instruments, often operating with little human intervention. While test volume and staffing were once used to determine the amount of space in a laboratory, today, the instruments and degree of automation dictate the test volume capacity. The number of staff required to support the instrumentation is then determined.
Rethinking Customer Access Services
In the traditional healthcare facility, multiple departments and staff were involved in patient reception, admitting and registration, scheduling, cashiering, insurance verification, and billing, resulting in fragmented customer service and complicated wayfinding. Although many of these departments are located on the first floor of the facility — along with various patient and visitor amenities — only a few staff in each department needed face-to-face interaction with visitors, patients, and their families. The question is: How can a healthcare organization better utilize both its staff and space to potentially enhance operational efficiency and improve customer service?
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.
Estimating Capacity and Space for Cardiovascular Services
Cardiovascular procedures include routine noninvasive diagnostic tests as well as more complicated cardiovascular diagnostic and therapeutic interventions. Noninvasive tests typically include electrocardiography (ECG), cardiac stress tests, Holter monitoring, tilt table testing, echocardiography, transesophageal echo (TEE), vascular studies, and nuclear cardiography. Interventional cardiovascular procedures involve longer procedure times and recovery periods and include cardiac catheterization, therapeutic cardiovascular procedures, and electrophysiology.
Generic Administrative Office Suites Provide Efficient Space Utilization
The traditional healthcare facility has many departments involved in the administration and management of the organization in accordance with policies established by the governing board. Most of these administrative services use generic office space with a mix of private offices, open or partially-enclosed cubicles, and open workstations to accommodate different hierarchies of staff dictated by the organizational structure and peak-shift staffing. Patient traffic to these areas is rare. As many of these departments are being forced to resize their staff in response to cost containment pressures and changing skill requirements, vacant offices and workstations are often scattered throughout the organization. At times, growing departments may need to pack multiple people into a single office, while shrinking departments have surplus space. Many departments also have dedicated conference rooms which, although infrequently used, are not available for use by other hospital staff due to an inaccessible location.
Space for administrative staff ― not involved in day-to-day patient care ― is increasingly being centralized into generic administrative office suites with a central reception area, groups of conference rooms, shared office equipment, and flexible workstations. This configuration provides the most efficient space utilization and ensures that space is equitably allocated and distributed among the departments and services that need it at any given time. The intent is to assign offices and workstations according to the immediate need allowing for the flexibility to reassign the space on a periodic basis as demand changes and staffing levels fluctuate. This prevents staff from becoming overly territorial about their space. With more sophisticated information systems, space can still be charged to department or cost center budgets based on use. Conference rooms and classrooms can be scheduled centrally based on daily demand thus ensuring optimal utilization.
The abrupt closure of many offices and workplaces during the global pandemic in the spring of 2020 ushered in a new era of remote work for millions of employed Americans ─ including hospital administrative staff. Video conferencing also replaced face-to-face meetings to allow social distancing, and these trends are predicted to outlast the current emergency health crisis. This will likely impact the amount and configuration of administrative office space and the need for conference rooms and large meeting spaces in the future.
This article is an update of a previous post.