Design Tips for the Exam - Consult - Office Hybrid

Updated June 14, 2013.

One of the things that fascinates me most about architecture, interior design, furniture, and medical supply planning is the way these elements can transform a space. To make a space perform the way you want it to, you don't start with the space in mind first. Instead, you begin with what you want to accomplish in that space.

How do you want it to function? The space is there to serve us. And when you can sit back and observe your medical team perform their work in a flow, pattern, and rhythm that maximizes the quality of whatever it is they are doing, then you've found good design.

But if you step back and observe your team needing to constantly adapt the way they work to their environment's limitations, then you've found poor design.

Space should serve people, not the other way around. Plan a space that flexes to support optimized work.

In the first half of the twentieth century, you would commonly find doctors examining their patients and consulting with them on treatment plans in the same room where they did their office work. The second half of the twentieth century saw the rise of ambulatory care clinics and medical office buildings. This trend often packed several exam rooms side by side along a corridor. The consult room would be a separate room, either in that same clinic, or else in another building altogether. The physician office would then be a third location. The office might sit down the hall from the exam rooms, or it may be in another building.

Hybrid Planning

I've noticed in the last few years that what I call the Hybrid Model is coming back into favor.

If you're considering planning a combination physician's office - exam room - consult room, here are some tips to keep in mind:

1. Office. Take advantage of the mixed-use purpose and make it comfortable and inviting. Patients will be spending some time in that room, so make them feel like your office guest, which is preferable to being treated like a helpless, sick patient. The room does not need to look institutional. Furnish it with warm materials such as wood and acrylic in the architectural details, wood-grain laminates on the desk and storage cabinets, antimicrobial copper such as brass or bronze at the sink, and comfortable but cleanable seating.
2. Consult Room. Arrange the furniture in a way that promotes trust, reduces anxiety, and builds rapport. Consider using tables, conferencing desks, or meeting surfaces that swing out from the wall so that clinician and patient can sit aside each other, or facing each other without a big desk between them. Think about the personal brarriers you build when you space-plan with furniture. Patient trust increases, and their anxiety decreases, when they feel connected to their caregiver. Remember that to build rapport, you need more than just some common ground on conversation topics. Body language and furniture positioning can create or break-down barriers. Make the space happen the way you want it to happen. The space serves the people who use it, not vice versa.
3. Exam Room. This same room that has served as office and consult room can still function as an exam room. You may have an exam table in it, but many specialists don't need them. According to the "Blueprint for the Clinic of the Future" published by The Healthcare Advisory Board (March 28, 2013), "60 percent of the encounters between patients and caregivers do not require an exam table." So make it comfortable, like a living room, to get the patient to open up and tell their caregiver everything they need to know. That said, you can still plan for the typical "institutional needs" such as infection prevention. Use attractive and hospitable sinks made from antimicrobial copper, including brass and bronze, which naturally kills 99.9% of the bacteria that lands on its surface. Mount diagnostic instruments, paper towel holders, soap and disinfectant dispensers onto attractive pieces of equipment rail. Equipment rail allows you to take advantage of the quick-release brackets so that you can clean behind these tools, and even replace them, without damaging the wall. And finally, you can enhance privacy and absorb sound in an attractive way with wall panels. Ecophon for example makes an attractive wall panel design that mounts to the wall, makes the room attractive, and also minimizes the sound that travels between rooms.