Federal Requirements
Outpatient facilities care for patients who are recompensed under Medicare. Therefore, these facilities should satisfy federal criteria. The accreditation of the facility is only possible if it satisfies the conditions set by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). Outpatient clinics are regarded as healthcare facilities that offer healthcare services to patients who are capable of traveling, from one place to another and out of the facility unaided. This category encompasses the physically challenged individuals on wheelchairs or other walking aids. The facility should meet the requirements of the Americans with Disability Act (ADA) (Lagu et al., 2013). All outpatient facilities should comply with the stipulations of the Ambulatory Care Centers section of NFPA 101 (Shi & Singh, 2014).
The first requirement is the accessibility of the facility. All healthcare facilities should be accessible. The entrances should be clearly marked and should exclude irrelevant traffic within the unit. However, in buildings with multiple occupancies, the lobby can be shared. The location of the facility is also crucial. Community outpatient clinics need to be conveniently accessible to patients and members of staff through the available public means of transport. The facility needs to provide a formal parking space. However, in the absence of such a provision, parking spaces at predetermined rates recommended for each unit type should be provided. Exceptions to this rule may apply in instances where there is enough public parking, or the facility can be accessed easily by public transport.
Patients’ privacy is another crucial requirement. The facility needs to be designed in a manner that ensures audible and visual privacy and self-esteem for patients during interviews, assessment, medication, and recuperation.
In addition, outpatient facilities should have administration and public areas. The public areas should include convenient and easily accessible wheelchair storage, an information desk or reception, waiting for lounge, expediently reachable public telephone, public toilets, and a drinking fountain among many others. There should be a provision for storage of staff personal items, which should be in the proximity of individual workstations.
Outpatient clinics’ design should also consider the safety of their staff to enhance their work. Nurses spend about 33% of their working time walking between the main nursing station and patient rooms as well as looking for various supplies (Stichler, 2013b). Dispersing nursing stations and provisions by bringing them closer to patients would be more time effective and less tiring. The design should also encompass appropriate lifts and ergonomic technologies (Hignett, Wolf, Taylor, & Griffiths, 2015).
State Requirements
State requirements for outpatient facilities vary from state to state. However, certain general requirements apply in all states including cleanliness and sanitation, accessibility and controlled movement of people within the facility, aesthetics, security and safety, and sustainability.
Local Requirements
Apart from the obvious state and federal requirements of outpatient clinics, the main local requirements on the design of outpatient clinics include accessibility, affordability and quality of services offered. The design of outpatient clinics should use evidence-based designs that improve the efficiency of the facility.
The Impact of Legal and Regulatory Requirements on the Development of Organizational Health Care Policies Related to Facility Design for an Outpatient Clinic
The regulatory substructure can throttle design inventions aimed at minimizing the risk of patient injury. Consequently, no one person can satisfactorily have comprehensive knowledge regarding the design and planning for an outpatient clinic. For these reasons, specialized consultants are valuable in the design and planning process for a hospital. Additionally, the operational components within the outpatient clinic may have contending needs and precedence. Therefore, there is a need to strike a delicate balance between unrealistic scenarios, strong predilections and mandatory requirements, actual functional needs.
Accountability and Liability Implications for Individuals and Organizations within Facility Design for an Outpatient Clinic
Irrespective of their size, dimensions, or financial plan, all outpatient clinics should have certain common attributes namely proficiency, cost-effectiveness, flexibility, and expandability, and provide a therapeutic environment. Along with the wide range of services that must be hosted, outpatient clinics are expected to handle the needs of different users and investors. In an ideal world, the design course integrates direct contributions from the proprietor and main hospital staff in the early stages. The services of the designer then follow. The designer needs to consider the needs of the patients, guests, support team, unpaid helpers, and providers who may not have a chance to provide their input.
Sound hospital design puts together functional requisites with the human wishes of its various users. Considering the input of patients and their relatives in the design of the corporeal surroundings assures patient-centeredness of the managerial culture. Including employees in the design process is useful in developing an environment that enhances workflow. Novel design ideas have been reported to allow clinical staff to spend quality time with patients while growing the clinic’s capacity to care for patients.
Analysis of Legal versus Ethical Considerations Related to Facility Design for an Outpatient Clinic
Legal Considerations
The state, local and federal regulations already mentioned comprise the legal considerations that influence the design and construction of outpatient facilities. These factors must be considered when carrying out the actual design and construction to ensure that the facility complies with the set standards. The legal requirements stipulate the minimum requirements of an outpatient facility with respect to location, accessibility, constituents of the facility. Consequently, the size, design, and size of the facility should strive to comply with the requirements. For instance, the design of the facility should optimize the space available to ensure that the outcome meets the legal requirements.
Ethical Considerations
The four main tenets that comprise the foundation of ethical decision-making are autonomy, beneficence, non-maleficence, and justice (Butts & Rich, 2013). Autonomy denotes a person’s right to self-governance and free will when making decisions. When deciding on the construction firm to build the outpatient hospital, the decision-makers should allow all experienced construction firms to contend for their projects. Firms that have damaged their trust or those with a poor job reputation such as lateness and cost ineffectiveness should not be considered in future projects (Stichler, 2013a). The hospital decision-makers should desist from preferential and treat all competing firms fairly to promote justice. Justice also entails the equal dissemination of risks and benefits. The management should resist the temptation to accept gifts from the construction firms, which could come in the form of hefty donations. Such gifts may be given with the aim of coercing the management’s decision. The principle of non-maleficence requires that no maltreatment is done to other parties. When deciding on the design and construction process, none of the parties involved either directly or indirectly should be harmed. One unethical practice as reported by Stichler (2013a) is a case where a hospital knowingly allowed a construction firm to use the intellectual property of their rival firm, which was obtained from the firm’s presentation material. The firm went ahead to receive public acknowledgment for a stolen design. Such an instance breaches not only ethical boundaries but also legal bounds and is punishable by law.
References
Butts, J. B., & Rich, K. L. (2013). Nursing ethics (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Hignett, S., Wolf, L., Taylor, E., & Griffiths, P. (2015). Firefighting to innovation using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals. Human Factors: The Journal of the Human Factors and Ergonomics Society. Web.
Lagu, T., Hannon, N. S., Rothberg, M. B., Wells, A. S., Green, K. L., Windom, M. O.,… & Lindenauer, P. K. (2013). Access to subspecialty care for patients with a mobility impairment: A survey. Annals of Internal Medicine, 158(6), 441-446.
Maben, J., Griffiths, P., Penfold, C., Simon, M., Pizzo, E., Anderson, J.,… & Barlow, J. Shi, L., & Singh, D. A. (2014). Delivering health care in America. Jones & Bartlett Learning.
Stichler, J. F. (2013a). Ethical consideration in healthcare design and construction. Health Environments Research & Design Journal, 6(4), 5-9.
Stichler, J. F. (2013b). Healthy work environments for the aging nursing workforce. Journal of Nursing Management, 21(7), 956-963.