Clinic models and trends Essay

This chapter discusses some clinic models -pick one and discuss:

1. Convenient Care Clinics (CCC’s)

2. Clinics in Retail Settings

Discuss some trends in retail care facilities–pick one and discuss:

Healthcare reform
Cultural shift
Wellness vs Disease management
Landlord attitudes
Consumerism
Economics
Reimbursement structures
Return on Investment
Demographics
Ownership
Reading for this question is below:

“Beginning Detailed Operational and Space Programming
ETAILED OPERATIONAL (FUNCTIONAL) and space program- ming begins once a specific project has been defined, approved, and funded. This final stage of the predesign plan-
ning process generally begins once consensus has been reached on an appropriate long-range facility investment strategy and a phasing/imple- mentation plan has been prepared. Detailed operational and space pro- grams should be prepared for immediate or short-term projects for which planning needs to commence. This process provides a forum to rethink operational processes and the use of technology such that facility investments enhance operational efficiency and improve customer serv- ice, in addition to providing newer, code-compliant, and aesthetically pleasing facilities. After administrative approval, the operational and space program becomes an “approved” document serving as a control mechanism for all members of the planning and design team during the schematic drawing and design development phases of the architectural design process. The operational and space programming document should provide all necessary information for the design architect to begin schematic design.
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DEFINING OPERATIONAL AND SPACE PROGRAMMING
Operational and space programming, as it is defined today, includes the two-step process of documenting the operational (functional) plan- ning assumptions and preparing a detailed space listing (space program). Traditionally, a list of spaces and their corresponding sizes was the only written documentation preceding facility design. Today, operational planning precedes space planning, and one document— the operational and space program—combines the results of both processes. Although the terms functional and space programming and functional space programming are commonly used, I prefer to use the term operational and space programming throughout this book to emphasize the rigor that should be involved at this critical point in the facility planning process.
The tasks necessary to develop a detailed operational and space pro- gram are among the most critical in the facility development process. From my experience, long-term operational costs often exceed the initial capital cost of renovation and construction in a couple of years. Efficient planning at this stage will save significant operational dollars in the future. Also, paying careful attention to the development of realistic workload projections and differentiating between actual space needs versus wish lists will guard against the construction of inappro- priate and inflexible space and will eliminate overbuilding.
COMPONENTS OF THE OPERATIONAL PROGRAM
The operational program should provide a description of the scope of services and operational concepts as well as the numbers and categories of people, systems, and equipment necessary to operate the specific department or service line at a projected workload level. The operational program should also address facility layout considerations, necessary and desired physical proximities, and opportunities to achieve operational flexibility and accommodate future growth. Although the outline can be tailored to meet an organization’s specific situation, typical components of the operational program are described below, along with sample text that illustrates the scope and level of detail that should be provided. Clinic models and trends Essay
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EXAMPLE: OPERATIONAL PROGRAM FOR AN ENDOSCOPY SUITE
Current Situation (Baseline)
The current scope of services, space allocation, and location should be identified, and deficiencies requiring correction should be documented.
Mercy Medical Center (MMC) currently operates two endoscopy suites. One is located on the second floor of the Ambulatory Care Center (ACC) on the MMC main campus, and the other is located on the second floor of the Mercy East Campus (MEC) hospital.
• MMC. This suite currently has seven procedure rooms and occupies approximately 4,580 departmental square feet (DGSF). Only six rooms are used because one of the proce- dure rooms is small and difficult to use. The suite also has 12 patient prep/recovery bays that are undersized, and there is limited area for patient nourishments, linens, supply stor- age, and trash holding. There is no fluoroscopy capability within the suite, so ERCP’s are done within a dedicated fluoroscopy room in the main radiology department. Bronchoscopies are performed in the pulmonary lab with nursing coverage provided by the endoscopy department.
• MEC. This endoscopy suite is composed of five procedure rooms (four endoscopy and one bronchoscopy), occupying 4,470 DGSF. The rooms are adequately sized with contigu- ous patient toilet rooms. Patient prep and recovery func- tions occur within the shared 30-bed ambulatory recovery area on the fourth floor of the hospital.
Future Vision and Planning Goals
Strategic (market) planning and operational performance improve- ment goals pertaining to the specific department or service line should be specified to keep the planning team focused on the expected results.
MMC is considering consolidation of the endoscopy suite located on the third floor of the MEC with the endoscopy suite located on the second floor of the ACC on the MMC main campus. It is anticipated that the consolidated suite will continue to be located on the second floor of the ACC. Adjacent expansion space is
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potentially available because of the recently vacated dialysis unit (5,350 DGSF); other adjacent space currently used for private physician offices could also be relocated.
Other assumptions include the following:
• Outpatient registration will continue to occur on the first floor of the ACC, and patients will then proceed to the second floor endoscopy waiting area.
• Bronchoscopy procedures will be consolidated at MMC as well. These procedures will continue to be done within the pulmonary lab with nursing coverage provided by the endoscopy staff.
• ERCPs will eventually be moved to the consolidated endoscopy suite with the timing dependent on acquisition of a new digital unit. In the short-term, ERCPs will continue to occur within the main radiology department on the first floor of MMC.
Current and Projected Workloads
A detailed analysis of the current and future workloads for patient care functions can involve evaluation of case mix and scheduling patterns, as well as the interrelationship between the volume and timing of arrivals, desirable waiting times, and the number of procedure rooms or workstations. Identification of average and peak workloads is par- ticularly important for those services whose workload is primarily a random occurrence, such as emergency visits and obstetrics deliveries.
A total of 12,096 patients received gastroscopy or bronchoscopy procedures in 2004: Clinic models and trends Essay
• 9,222 procedures at MMC (8,853 GI procedures and 369 bronchoscopies)
• 2,874 procedures at MEC (2,759 GI procedures and 115 bronchoscopies)
Approximately 55 percent of the total procedures are colono- scopies and 30 percent are gastro procedures. In addition, flex- ible sigmoidoscopies, ERCP, esophageal motility, TEE, 24- hour pH monitoring, and bronchoscopies are performed. Outpatient procedures represent 90 percent of the total vol- ume. The combined workload is projected to grow at a rate of
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