Medical Office Today

 

The design of your exam room is important no matter how large your practice is. The ideal exam room takes into account patient and caregiver interaction, privacy, efficiency and accessibility.

 

"An exam room can be very much like a well-designed kitchen-with functional work zones, quick and unhindered access to work areas and effective organization," says Karen Edmundson, a furniture sales executive with Framingham, Mass.-based Business Interiors by Staples.

 

A well-designed exam room can go a long way to minimizing "white-coat syndrome" and helping the patient feel less intimidated. If a patient and caregiver feel as if they can communicate in a more collaborative manner, this fosters more open communication, adds Edmundson. "Providing an interior environment that is soothing through the effective use of colors, art and lighting will also help to make a patient feel more comfortable," she points out.

 

Flexibility is the most important element in the exam room for Troy Chapman, executive project manager at Austin, Texas-based general contracting firm Burt-Watts Industries. "That means the room can be shifted for changing needs," he explains. "It's a room with many different functions serving people with very different needs. Thus, it must accommodate all shapes, sizes and ages."

 

A cluttered exam room is the last thing any practice wants. Storage, cleaning, and diagnostic areas must have enough space and accessibility for a medical staff to work.

 

"It should also be welcoming to partners in care by providing ample room for their supportive role," Chapman adds. "And it must be thoughtfully designed keeping in mind all of whom use the space."

 

A medical practice should consider the following elements:

 

Size of the exam room

 

For medical office architect Wayne Lerman, president of West Long Branch, N.J.-based W. Lerman Architecture, the ideal exam room should be sized appropriately to accommodate the type of practice you have whether it's orthopedic, cardiology, ophthalmology, pediatric or some other specialty.

 

"Know the type of practice to properly size the room since they vary based on the type of patient," Lerman says. "We normally go with an 8x10 or 10x10 sized room. Sometimes it may be an 10x12 or 8x12-that's just a range for a typical exam room. Other types, like an ophthalmology practice, get into unusual sizes. For instance, the distance to the eye chart on the wall has to be at a certain distance, so these rooms are more rectangular in size, like 10x14."

 

With minimal square footage available for exam rooms, Chapman says that it's especially important to make them as efficient as possible. Consistency in the building or renovation of exam rooms is also crucial.

 

"Physicians and nurses often prefer examination rooms that are built or renovated the same," Chapman says. "This consistency allows them to find supplies easily and quickly, no matter which examination room they use."

 

Ease of access to a patient

 

The position of exam table is critical for doctor movement.

 

"In an orthopedic practice, the doctor has to walk all the way around an exam table," says Lerman. "The table can't be pushed up against the wall because they may need to gain access to somebody who has a break or fracture."

 

On the other hand, in a pediatric practice, the exam room can be pushed up against the wall because it prevents a child from falling off the table. In an OB/GYN practice, the exam table has to be positioned in a diagonal from one of the corners of the room.

 

"Plan your space around your exam table," Edmundson advises. "Adjustable height tables will enhance flexibility if your rooms are used for a variety of procedures."

 

Lighting

 

Lerman likes to use lighting to create interest for the patient and a better environment for patients and staff. Again, the type of lighting you use depends on your practice.

 

"In an ophthalmology practice, we use an indirect light in the ceiling because they like to lower the light level," Lerman says. "They don't like it to be very bright, so with an incandescent light, you can lower the light level."

 

In most practices, Lerman says they will use a fluorescent type of light in a lay in fixture that goes into an acoustical ceiling. "To save energy, we put the electric switches on a motion detector," he says. "When someone is in the room there is a sensor that can tell someone is there and the light stays on. When they leave, the light goes off."

 

Deciding on the Décor

 

A patient feels the most vulnerable in an exam room. Anxiety and insecurity can be compounded by the room's aesthetics. (Listen to MOT's free webinar on creating soulful medical offices with Thomas Moore, author of Care of the Soul in Medicine).

 

"Does the décor include pleasant things to look at, from fabrics and wall art, to medical information that may be of interest?" says Lerman. "Is the room temperature adequate? Is there a private place to undress? Is the process set up to decrease a patient's waiting time? All these things, and more, help create a positive exam room experience."

 

For your seating area, many experts recommend using vinyl for all seating, but there are a number of fabrics that now resist stains and germs.

 

Technology integration

 

Edmundson says the type of technology you use is another factor to consider.

 

Are your physicians accessing medical records from a computer in the exam room? Do they have tablets? Are they using paper-based records? She says that these considerations will influence how much space you need in certain areas.

 

Proper storage

 

The casework or millwork in the exam room typically provides the most concentrated area for storage-often with room for overhead storage, as well as storage areas below the work surface. Exam tables can also have storage drawers, making them even more efficient.

 

"The benefits of opting for modular casework within exam rooms include future flexibility, especially during moves and changes within your facility; extended warranties and accelerated depreciation," says Edmundson.

 

When looking at exam room furniture, select materials and finishes that help inhibit the spread of bacteria and also promote long-term durability.

 

"In addition, rounded corners on any casework or millwork will help prevent injuries," Edmundson says.

 

Best practices to follow

 

One of the best practices from a general contractor stand-point is to have buy-in from the medical staff that will be using the facility.

 

"Where do they want millwork? Is their practice paper-free, if so space needs to be made for lap-top computers," says Chapman. "If not, allotment for a writing space area must be found. While we know we can never predict the future, we understand the need to create spaces that enable flexibility, anticipates growth and change over time."

 

Lerman agrees that consultation with the physicians and medical staff is a good practice to follow. "I always sit down with members of the practice and ask questions," he says. "I also show them different options for the exam room, such as where the cabinetry can go and the way the door swings into the room-this is critical because it takes up space. I point out the pluses and minuses of each scheme. They know what has worked for them and what hasn't based on their specialty."

 

Whether you are renovating or building from scratch, Chapman says that cheap isn't the way to go when it comes to building or renovating a medical exam room.

 

"Medical practices are going to be around for years," he says. "Thirty years is the average time for most of these types of facilities to come up for renovation. Removing necessities like power or air will end up costing a practice in the end. Ultimately, if all the right elements are planned for at the beginning of the building process it will be a win-win for the practice as a whole."