Creating a Welcoming Clinic Environment: Maximizing Comfort and Safety for Patients

1. 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

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 • 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

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

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 • http://www.ready.gov/are-you-ready-guide • 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