Brenda Bosma, executive director for Annapolis, Md.-based Anne Arundel Gastroenterology Associates (AAGA) and ambulatory surgery center, the Maryland Center for Digestive Health, says the design of the surgery center was focused on giving patients a positive experience while waiting to be seen by the physicians.
Larger exam rooms. Now that medicine has adopted a more consultative relationship between patient and physician, more patients are bringing a family member along to help them remember what the physician has to say and be an advocate. To accommodate three or even four people, exam rooms are increasing in size. "You have to have … a triangulation between the physician, the guest, and the patient. And the doctor needs to have access to the computer so he can be inputting all the pertinent information from interviewing the patient," Puffer notes. "We used to be able to do exam rooms at 7-6 by 9-6; now we are really more like 11 by 9."
Implementation of EHR. With the elimination of paper charts, chart rooms are becoming a thing of the past; freeing up not just physical space, but staffing needs as well. AAGA has used an EHR since 2002, says Bosma, and currently uses a tablet to accomplish patient registration, payment, and questionnaires. "… We were trying to cut down on the number of trees we kill,” she says. “So instead of having patients fill out all these paper forms that had to be scanned manually into our EHR system, we chose to do the [tablet] which integrates with our EHR …."
Cloud-based IT solutions. Depending on the size of the practice and its technology choices and infrastructure, there may not be a server room or centralized computing center with desktop computers, printers, fax machines, and scanners. If a practice chooses a cloud solution, they may only need a local area network (LAN) and devices with Wi-Fi capability, like laptops or tablets. Derek Kosiorek, principal consultant with the Medical Group Management Association's Healthcare Consulting Group, says not only do you save on space requirements with a cloud solution, "but [also] facilities requirements like air conditioning for [the server] room, and the electricity needs."
When the physician-owners at AAGA decided that they needed to expand their ambulatory surgery center to accommodate functions like in-house billing and administration, they chose to build a new facility, rather than redesign the old one.
A well-designed practice has multiple benefits for both patients and staff, say experts. Eliminating chart rooms can open up space for things like multiple waiting rooms, consultation rooms, and separate check-in and check-out areas — all of which can improve patient flow and staff efficiency.