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  • Practice Layout

    Creating the practice working environment

    Layout of the surgery can be broken into five areas:

    1. waiting area for patients
    2. administrative area (reception, secretarial, management, hand-over room)
    3. consulting, procedure and treatment rooms
    4. recreational area for staff (tea room, kitchen, meeting/training room)
    5. the links between these areas.

    Waiting area

    Reception area

    The waiting area gives your patients their first impression of the practice, so it is important to ensure it reflects what your business is all about. You can actively promote your practice philosophy whilst patients are waiting by having posters, leaflets and notices readily available for them. Make sure you have your practice logo in a prominent area to help patients identify with your practice. It is important that the reception area and waiting room is as comfortable and welcoming as possible.

    Comfort involves many aspects including:

    • Waiting room size - ensure that it is an appropriate size to avoid patients feeling cramped
    • Comfortable and appropriate sized chairs
    • Suitable lighting and heating/cooling
    • Magazine racks with current magazines
    • wall-mounted children's toys or children's play area/play room (rather than boxes of toys which become scattered throughout the waiting room)
    • Access - is it easy to access and visible from reception?
     

    The reception area is also part of the patient's first impression. Not only is this to do with layout, but it is also reflected in the efficient, friendly and courteous way staff deal with patients. In terms of layout, it is crucial that patients are encouraged to come to the reception desk on arrival and prior to departure.

    The reception area is a workplace and must provide a safe and comfortable environment for staff that spends all day there.

    It is important that the waiting area can be viewed from reception. This is for a variety of reasons, most importantly triage.

     

    Rooms

    Disability access for patients with mobility issues

    A hand-over room is a great asset if space allows. This provides a working area with a computer for practitioners or other staff to complete documentation etc. if other areas are all full. This is particularly useful in multi-practitioner practices with shared rooms.

    The consulting rooms allow for a more personalised atmosphere, and practitioners may have preferences depending on the type of consultations, procedures and treatments they generally perform. Your rooms need to be set out in an efficient, safe but comfortable way.

    Procedure and treatment rooms are separate from consulting rooms and equipped to deal with patients undergoing treatment. The links between the areas must be designed to avoid congestion and ensure safety, confidentiality and security. Note that in general practice, a treatment room should be situated close to the waiting area and reception so that nurses are immediately on hand in case of medical emergency.

    A recreational area is important for staff breaks, keeping staff on site and giving them a much-needed opportunity to unwind and refresh. If space allows, a large kitchen area is ideal, with room for a table big enough to be used for meetings if there is no separate meeting/training room.

    Disability access is a key issue for many medical practices. It is important when setting up any practice to ensure that the needs of patients with disabilities and limited mobility are taken into consideration. In general practice, disability access will be assessed as part of the accreditation process with AGPAL/QIP or GPA, however it is important for all practices to ensure they are suitably equipped to meet patient needs. You should review the layout and design of your practice with a view to addressing the following:

    • Is there ramp access into the building or between buildings that is wide enough for a wheelchair or walking frame and at a pitch that meets current standards (AS 1428)?
    • Are the doorways wide enough to allow for a wheelchair to pass through without difficulty (compliant with standards AS 1428)?
    • Do the toilet facilities have handrails and an emergency button?
    • Is there sufficient space in the waiting area and consultation rooms to allow for a wheelchair or walking frame to move freely?
    • It is also important that these facilities allow prams/pushers to be able to move without undue obstruction.
     

     

    Improving your practice

    • Functional separation between waiting area/reception. This can be in the form of a partition, pot plants, notice board and screen. It helps maintain confidentiality.
    • Spare room for phone calls, counseling
    • Room/area for distressed patients
    • Auditory privacy in waiting area (e.g. soft background music and/or TV). Ensure a license is obtained from the Australasian Performing Rights Association (APRA) if using a sound system in the waiting area.
    • Toilets clearly marked and easily accessible to patients
    • Designated play area for children if possible
    • Compliance with Work Health and Safety standards for staff and patients
    • 'No smoking' signs
    • Ensure the telephone system is capable of supporting the anticipated volume of incoming and outgoing calls.
    • Always be prepared for the potential of having to deal with abusive or dangerous patients - ensure there are multiple access/exit points in the reception area, consulting rooms and treatment room.
    • Back-to-base duress alarms available in the reception area, consulting and treatment rooms.