Research studies over the past several decades have indicated the possible harmful effects on healthcare workers from low-level work-related exposure to any of more than 200 medications that are considered hazardous drugs. As a result, the United States Pharmacopeia (USP) — a nonprofit compendium of drug information — published the nation’s first standards on the handling of hazardous drugs from receipt to disposal. Chapter 800, titled “Hazardous Drugs — Handling in Healthcare Settings,” applies to all healthcare personnel who handle hazardous drug preparations and all entities that store, prepare, transport, or administer hazardous drugs, such as pharmacies, hospitals, clinics, and physician offices. Hazardous drugs include those used for cancer chemotherapy, antiviral drugs, hormones, and some bioengineered drugs. Effective December 1, 2019, most pharmacies need to comply with USP 800.
How To Articles
Learn how to determine facility capacity, estimate bed need, plan specialized facilities, and much more.
Out of Space and Money? Creative Ways to Improve Space Utilization
Existing space in hospitals is a valuable resource that historically has been overlooked as organizations focus on renovating and expanding their physical plants. With fluctuating workloads, rapidly changing technology, staff turnover, and limited access to capital in today’s dynamic healthcare environment, hospital leaders are increasingly looking for ways to better use what they already have. They are also committed to building flexible space when they do renovate or start from scratch.
Reconfiguring Hospital Diagnostic Services
Planning space for diagnostic services, and assessing the need for equipment, can be complicated from many perspectives. Some equipment is becoming miniaturized, portable (even handheld), and more affordable so that it can be easily used at the patient’s bedside, in the physician’s office, or even in the patient’s home. Other equipment continues to require a large footprint, unique design features, and a big investment, and is increasingly specialized. Imaging services no longer reside within the boundaries of the “radiology department” but instead are provided in many locations throughout the healthcare enterprise — often replacing other testing modalities that once occupied their own departments. The challenge is not only to determine what equipment to purchase but where to locate it.
Factors Affecting the Size of a Surgery Suite
The hospital surgery suite has undergone revolutionary change over the past several decades. For a long time, the focus has been on shifting surgery to a lower-cost outpatient setting. This has been replaced with a focus on lowering both the costs and risks of surgery with the ongoing migration from invasive to less-invasive surgery or noninvasive procedures. Minimally-invasive, image-guided, robotic, and telesurgery ― along with intraoperative imaging techniques ― continue to replace traditional surgical procedures. Aside from the economies of scale achieved with larger surgical suites, the biggest single factor contributing to the overall footprint of the surgery suite is the size and specialization of the individual operating rooms (ORs). Other factors include the proportion of outpatient surgery performed in the suite, and the type of patient care spaces provided, as well as the efficiency of the surgical suite layout.
Planning an Outpatient Pharmacy: Small, Medium, or Large?
Most outpatient pharmacies that are located within a hospital or in an ambulatory care center (on- or off-campus) fall into one of four categories ― minimal, small, medium, or large. Assuming that outpatient demand has been established based on the availability and convenience of similar services and potential competition from commercial pharmacies, the primary determinant of an outpatient pharmacy’s size is the average number of daily prescriptions (scripts) that will be filled during the busiest eight-hour shift. This generally determines the numbers and sizes of rooms or areas and overall department gross square feet/meters (DGSF/DGSM). Larger outpatient pharmacies may be equipped with an automated picking and dispensing carousel, reducing storage space and improving staff productivity.
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.