Lets Get Physical – Architecture and General Practice

martin.jpgDoes the physical design of your surgery still support the way you look after your patients?

There is no doubt that general practice has changed over the last 10 years.

For one thing, we now have 9000 practice nurses that weren’t there in 1999. Not to mention chronic disease managers, diabetic educators, dieticians and exercise physiologists.

Yet most of us are working in’surgery’ that was designed last century.

How can we use practice design to facilitate team based care? How on earth can we get everyone to fit in?

The relative shortage of general practitioners has meant that we each need to spend more time ‘in the red zone’ – focused on the real value in what we do: the relationship with our patients. As Doctors Grand Plaza say: ‘only do what only you can do’.

Can the design of our surgeries make our workflow more efficient? Can they better support ‘assisted consultations’? Can we eliminate ‘muda’?

I have been lucky enough to visit many well designed and visually attractive surgeries, some of them very new. They have incorporated some excellent ideas. Certainly, they are much more functional than the old house in which we work, with its various add-ons and extensions.

However, they have the same basic features – waiting room, reception area, corridor with doctor offices (one per doctor), and a nurses room out the back, of varying size, with one or more beds. The newer ones have cool staff rooms, that are the envy of our practice team.

If you had the chance, how would you redesign your surgery? Would the waiting room be different? (a ‘patient lounge’ like at the Brunswick Heads surgery?). Could you improve your reception area? How about the location, size and number of the doctors’ offices? Given the emerging importance of practice nurses, how would you best provide facilities for them?

I’d be very interested in your thoughts and comments, which can be posted below. I’d love to hear from you if you have addressed these issues in the design of your building – even if it is just in your dreams. Or perhaps you could ‘dob in’ a practice that you think has done a good job. Perhaps you’ve been impressed by a concept you saw overseas? Or maybe you’ve just got some dreams you’d like to share generously.

I’d like to feature some interesting concepts in a series of articles over the next few weeks.

PS Of course, I have an ulterior motive – we are planning on some ‘clinical redesign’ of our own.

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6 Responses to “Lets Get Physical – Architecture and General Practice”

  1. Cathy Pearson
    May 20th, 2009 | 10:16 am

    Practice design;
    We are currently redesigning our Medical Clinic to include an extra consult & exam. room Plus multipurpose room etc. This will be a huge improvement altho’ we are limited in space to what we can do.
    However, I would like to dob in a practice that has done well in design (they did build from scratch). Lincoln Medical Clinic in Port Licoln, SA, is possibly the most well thought out clinic I have seen! They have also used some fabulous colours (not puke green) and their main entrance doubles as an ambulance bay (for the 000 callouts) As a PN, I love that beside a treatment room and nurse consult room, they have put a treatment room between each 2 GP consult rooms, with access direct from each GP room and also the main corridor. This would enable the GP to handball wound care issues and ”quick” nurse education sessions ie puffer/spacer ed. so that the nurse can see those extras in between their booked patients, (and not go searching in the waiting room). These are just a couple of observations from a visitors point of view! I am sure there are many more well thought out features.
    Cathy
    PS/ I reckon it is also worthwhile phoning the clinic and being put on hold, as whoever choses the music has very eclectric taste!

  2. Robyn Ashman
    May 20th, 2009 | 10:17 am

    I purchased a Practice 5 years ago and have done a complete refurbishment. I am Owner/Practice manager and sought advice from the Doctors and looked at many practices and consulting rooms in Brisbane. We have pale blue walls will raspberry pink furnishings, light wood furniture and many bright flower prints. The staff room is big and light and also where we hold meetings and have informal gatherings. The bathroom was designed to full disabled codes and the ramp out the front of the buiding also complies with all the regulations. Treatment room is streamlined and has heaps of cupboards to hide everything away. Two locked cupboards also for drugs. We are very happy with our surroundings – the patients love it and are always commenting on how peaceful it is and such a nice place to visit. We often have little morning teas in the waiting room area and a gold coin donation is suggested for a nominated charity. Hope this helps others to plan. We also have large notice boards where we advertise community events as well as our targets for diabetes and CHD – many suggestions on life style changes and also lists of things to ask your Doctor about.

  3. May 20th, 2009 | 10:27 am

    UQ Health Service is a GP clinic for students and staff of UQ. Our practice sees over 52,000 consultations each year with the bulk from the St Lucia site. We have had practice nurses since the service began in 1959 and have been amazed that it took everyone else so long to realise the value of practice nurses.
    Last year we had a refurbishment of our service at St Lucia campus to help cope with increased demand. As part of that refurb we relocated the RNs to rooms branching off our sick bay/treatment area to give us a hub where 2 RNs rooms, treatment room, and sluice with steriliser and vaccine fridge are located. This works well as it is also in the centre of the building and easy for the doctors to access. The only other advise I can offer is to visit other practices and “borrow” on any good ideas you come across. Small things can make an enormous difference.

  4. Dr Sam nelapati
    June 3rd, 2009 | 2:58 pm

    Gr8 thought Dr lembke,
    last year we built a new general practice in lake cathie NSW and in 3 months we had run out of space. we started with 288 sq meters. we have been the grateful receipients of NRRHIP grant , now we are building next stage with a size of 580 sq meters. (total 868 sq mtrs)
    We had terble time finding any templates in print or on the web regarding design and floor plans. so we decided to design it as a team. each member of our team has pooled their ideas. I am happy to share the plans on this site for everyone’s benefit. It may not suit other areas but can still be useful to start a train of thought . there is no perfect plan. what ever works best and we as GPs adapt to whatever there is. this is a great begining of sharing ideas. If you guys are travelling along the pacific highway , drop in for a cuppa.

  5. Mike Levick
    January 27th, 2010 | 10:58 am

    I am merging my practice in Melbourne and shifting next door to a totally new site in a private Hospital. I would love to see all your plans, which can be emailed to me at tlevick@alphalink.com.au. My more immediate question is how did you work out the size of the waiting room, reception area and the staff room and how many patient and staff toilets?
    Thanks in advance – Mike

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