DESIGN AND

BY :DIVYA KHANDELWAL 16164

Outpatient care was once on the sidelines, and having being originally designed with a limited scope, it offered only basic, minor services.

In a significant move all over the world, outpatient care has changed as a major service encompassing a wide range of treatment, diagnostic tests and minor surgeries, some of which required hospitalization earlier.

FOCUS Of healthcare

Ambulatory care

Primary Healthc

are

Comprehensive

Healthcare

OUT PATIENT DEPARTMENTProvides

For patients who come for :DiagnosisTreatmentFollow-up Care.

It is the first point of contact between a Hospital and the patients.An OPD is therefore appropriately called as the ‘Shop Window’ of the hospital.

Functions Control disease

Facilitate screening and investigations

Provide effective

treatment

Provide follow-up care

Facility for training

Control and surveillance

By early diagnosis and timely treatment

To confirm whether or not hospitalization is required

On ambulatory basis

To discharged patients and their rehabilitation

For training of medical, para-medical and nursing staff.May also provide avenue for epidemiology and social research

Of communicable diseases to prevent an outbreak of epidemic and conduct activities in the field of preventive medicine.

OBJECTIVES

Provide Quality of care

Modern Techniques for investigation and treatment

Facilities for total patient satisfactionGood Public

relation

A well-designed and well- organized outpatient department can be high revenue generating area of the hospital.

By limiting the no. of outpatient consulting rooms and support services facilities, the hospital promoters fail to realize the full potential in terms of efficient and quality service and revenue generation.

Key Planning and Design parameters

Close to vital

adjuncts

Easily accessible

Smooth flow of traffic

Should be on ground

floor preferably/ separate complex

LOCATION

DESIGN CONSIDERATIONS:

Patient accessibility

Centralized polyclinic or

decentralized speciality clinic

Effective, comprehensible, standard signage

should be planned

Maintain dignity and privacy of

patients

Cater for future expansion

Educational resource areas to

be integrated in main lobby

Waiting area and public spaces should

be large enough

Day care facilities may be planned as support services

Should allow natural light and good ventilation.

Physical Facilities

to be planned

Public areas

Clinical areas

Consultation rooms

Special examination

rooms

Administrative area

Circulation area

Ancillary/subsidiary facilities

Auxiliary/additional facilities

Injection roomsTreatment and dressing roomsPharmacyMedical records room

LaboratoryMedical imaging servicesScreening clinicsMedico-social servicesHealth education facility

• Main entrance• Foyer• Bays for trolleys and wheelchairs• Public telephone booths• Public conveniences• Value added services• Registration area• Cash counter• Health education facilities

Public zone

• Consultation and examination rooms-combined consultation examination rooms, shared examination room, common pool of shared rooms.

• 12.5 square meter is adequate

Joint use zone

Func

tiona

l zon

es

Clinical Laboratory• Centralized sample

collection area for urine, stool and blood

• Wash room, toilets and a blood collection room should be provided.

• In large OPD, routine examination room adjacent to collection station

Pharmacy• Located so as to

serve both inpatients and OPD patients.

Specialised OPD services• Gastrointestinal

endoscopy lab, sigmoidoscopy, colonoscopy.

• Pulmonary function lab

• Cardiac OPD • Staff Zone

Parking and Entrance• Main entrance-

gentle sloping ramps to facilitate movement

• Entrance should have a double door with a width of 1500 mm

• Wheelchairs should be readily available at the entrance

• Staff and patient entrance should be separate

• Parking should be close to entrance

Enquiry desk, Reception Station• Height of counter

should be adapted to need of wheelchair patients

• To ensure privacy, reception should have counters

Waiting area• Space

recommended is 0.8 square meter per patient for one third of average daily patients attending OPD in one session

• Sub-waiting areas may be shared between the various consultation rooms.

• Distance from waiting area to the consultation room should be short

• Toilets should be close

Four major organizational components

Medical staff

Nursing staff

Ancillary staff

Clerical staff

In large Hospitals, the medical director or the director for professional services or the medical superintendent may be directly in charge of the out patient department.

Central to the organization

Registered nurses, ANMs and nursing or hospital aides

Radiology, laboratory and ECG technicians

Carries out registration, billing, receiving cash, secretarial and medical records function.

PROBLEMS

Long waiting time annoying to the patients and bad public relations for the Hospital

Large number of patients not the only reason for people waiting.

Stages where delay occurs:RegistrationPreparation of medical recordCollection/payment of fees

Day care clinic : The consumer shift

REASONS:Healthcare expenses are rising. The primary driver for this trend is the cost factor. They facilitate quick discharge and faster asset turnaround.

With the evolution of medical technology, availability of skilled consultants, trained medical manpower and improved commuting facilities, there is a trend towards establishing day care centres for patients to simply walk in and walk out within hours of completing the procedure.

OPD TREATMENT

Insurance Regulatory and Development Authority (Irda) has defined OPD treatment as the one in which the insured visits a clinic/hospital or associated facility like a consultation room for diagnosis and treatment based on the advice of a medical practitioner.

Among the innovations health insurance customers can look forward to in 2014 are products focusing on OPD (Out Patient Department) treatment, that is, treatment that does not require a stay in a hospital.

A recent report by ICICI Lombard General Insurance company says insurance companies will focus on OPD, in line with changing customer trends and the emergence of shorter treatments.

The fact that primary healthcare in India is still largely unorganized is the biggest reason insurers don’t offer or market OPD covers in a big way. That is also why the pricing for such covers tends to be 100 per cent.

The key to operational efficiency in the outpatient department is the efficient patient flow. If the units are arranged in a manner that facilitates coordination of various procedures, patients need not waste time waiting, and the personnel can handle large number with ease and efficiency.

THANK YOU !