1. Creating the Facility Environment
Chapter 10
Creating the Facility Environment

2. Creating a Welcoming Environment
Tangible elements: lighting, color choice, furniture arrangement
Intangible: administrative medical assistant’s greeting and attitude
Convenience of access and privacy
Attention to safety, prevention of hazards, response to emergency situations

3. The Reception Area
Should be a welcoming, warm environment that can make patients feel secure and comfortable
[Figure 10-1]

4. The Reception Area Place of reception, not a “waiting room”
Adequate and comfortable seating
Reception area should accommodate:
1 hour’s patients per provider and friend or relative who may accompany each patient
2.5 seats in reception area for each examination room
Environment that enhances patient comfort

5. The Reception Area The receptionist
Positive “We can help you” attitude
Smile for each patient
Genuine “We care about you” personality
Telephone prioritization, retrieves records, greets patients, presents bills, makes appointments, logs data into computer

6. The Reception Area The receptionist
Monitors children who may be disrupting patients
Maintains tidiness of reception area
Notifies patients of delay tactfully and graciously

7. The Reception Area Cultural considerations
Impact on amount of space necessary for reception area
Many people do not like to face other patients in reception area; prefer anonymity
Middle Eastern and Latin cultures encourage closeness and touching
Some people do not like to be touched by strangers

8. The Reception Area When children are patients Children’s area helpful
Special table and chairs for children; interactive toys
Pediatric facility might consider a theme for its design

9. The Reception Area
[Figures 10-3 A & B]
If clinic sees children, a safe, clean, colorful children’s area is a must

10. The Reception Area Education in the reception area
Providers place educational materials for patients in reception area
Patient information brochure
Educational material presented in media form on television screen

11. Clinic Design and Environment
Ventilation and infection control
Air filters (HEPA), airflow direction, air pressure are critical elements to reducing airborne infection
Surface cleaning and use of alcohol-based hand-rub dispensers
Face masks recommended when patient may have respiratory infection

12. Clinic Design and Environment
Lighting
Sunlight boosts serotonin; helps to lessen pain and depression
Images of nature or nature itself
Provide as much peace and relaxation as possible to reduce stress and healing
Ceiling can lights and lamps provide ample light  

13. Clinic Design and Environment
Clinic environments, are places persons who are ill gather for support, diagnosis, healing
Goal in medical care should be to empower patient with as much control as possible
[Figure 10-5]

14. Clinic Design and Environment
Nature, music, water, and color
Floor-to-ceiling windows that overlook garden of plants, trees, flowers as well as a waterfall or pool
Built-in aquarium
Music, melodious tunes, water sounds
Use of cool or warm colors

15. Clinic Design and Environment
Windows to garden area or cascading water may be seen in some facilities
[Figure 10-7]

16. Clinic Design and Environment
Noise reduction
Sound-absorbing ceiling tiles and surfaces help reduce clinic noise
Telephone system that produce pleasing chime
Staff voices that are muted and pleasant
Fabric and texture of draperies, upholstery, carpet

17. Legal Compliance in the Facility
HIPAA
HIPAA compliance for protecting patient information and privacy
Mandates certain building features
Privacy implies patient’s conversation cannot be overheard in any other part of facility
Examination room privacy especially important

18. Legal Compliance in the Facility
Americans with Disabilities Act (ADA)
Passed by U.S. Congress in 1990
Comprehensive national mandate to end discrimination against individuals with disabilities
Accessibility for all patients in all settings important
Doors and hallways must accommodate wheelchair
Bathroom facility available for handicapped individuals
Elevators provided if facility more than one level

19. Creating a Safe Environment
On regular basis, safety inspection made of all areas of facility
Adherence to building ADA compliance
Exit signs clearly indicated and easily seen
Restrooms have safety bars and pull cord
All floors nonslippery; spills promptly cleaned and dried

20. Safety Evacuation procedures Carefully identified procedures
Close clinic facility for period of threat
Check of every examination room, restroom, procedure area
Turn off oxygen or compressed gas systems
Never use elevators; always stairs

21. Safety Emergency codes Code Red: fire emergency
Code Blue: adult medical emergency
Code Pink: infant/child abduction
Code Gray: combative individual/assault
Code Green: bomb threat
Code Yellow: hazardous material spill
Code White: evacuation necessary

22. Safety
Fire safety
Evacuation considered unless fire quickly contained without threat to others
Employees must know where fire alarms are located and how activated
Personnel receive training on use of fire extinguisher

23. Safety Fire safety RACE Remove patients and personnel
Activate the Alarm
Contain the fire
Extinguish with fire extinguisher
Evacuate as necessary

24. Safety Fire extinguisher safety
Checked periodically to make certain pressure at appropriate level
Readily visible
Dry chemical extinguishers shaken monthly
Replace immediately after use

25. Safety Response to natural disaster or emergency
Know what to do and be prepared
What to do if there is no access to food, water, electricity for some time
Two places for family members to meet
How you will communicate with and reach others
Have disaster kit ready

26. Safety Medical assistant’s response to disaster preparedness
Perform emergency first aid and CPR
Function in calm, yet “take control” manner

27. Opening the Facility Everything should be in readiness
Visual check of each room
Comfortable temperature
Well organized
Pleasantly illuminated
Spotless
Equipment ready

28. Opening the Facility Schedule of day’s activities
Review and retrieve patient charts for day
Check answering service or machine

29. Closing the Facility Check each room Secure all doors and windows
Shut down all equipment
Secure confidential materials and records in locked cabinets
Comply with Controlled Substances Act

30. Closing the Facility Prepare day’s receipts and bank deposit
Consult local law enforcement officers for security measures
Notify answering service office closed and where and how to contact medical staff in case of emergency

31. The Future Environment for Ambulatory Care
Patients 85 years or older with multiple chronic conditions will greatly increase over the next few years
By 2020, 40% of provider’s time will be treating members of aging population
Primary care providers willing to take new patients 65 years and older must increase
Family members of elderly adult will have increasing presence in care of their parents

32. The Future Environment for Ambulatory Care
Elder adults’ frustration with medical care can be lessened
Provide clear/concise written instructions
Create environment allowing ease of movement from one department to another
Make certain patients understand prescription instructions and directions
Remind patients of when they are to report back to provider for follow-up

33. The Future Environment for Ambulatory Care
American Medical Association (AMA) predicts within 5 years, 50% of providers will treat patients through online methods
Patients becoming astute consumers