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Floor plans, design and maintenance

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Abstract

Practice managers should decide some overall objective, possibly longer term, regarding the type of practice building they wish to develop and the RCVS standard they plan to achieve on a particular site. If the designer is briefed accordingly, a design can be developed to achieve this objective, even if it has to be undertaken in planned stages over time. This chapters examines floor plans and layout, surface finishes and materials, signage and maintenance.

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Figures

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3.1 Clear and well branded signage helps guide clients and visitors, as well as prompting a coordinated professional image.
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3.2 Wheelchair parking bays provide space for the disabled to get out of their cars and unload their wheelchairs. Clearly lined disabled parking bays should comply with Building Regulations and the DDA.
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3.3 Planners now insist on bicycle parking. This demand is not onerous and may encourage some clients to use their bicycle when collecting prescriptions, etc.
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3.4 A suitable area where clients can let their dogs spend a few moments before entering the premises will allow dogs to urinate and defecate, reducing soiling around the entrance and in reception. A clearly visible bin for dog waste is essential.
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3.5 An attractive tall lamp standard gives a pleasant approach to drive and car park lighting.
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3.6 Wall mounted floodlight ideal for unobtrusive lighting. This model is fitted with an individual photocell.
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3.7 Designated side-by-side entrance and exit doors can reduce the risk of conflict in the doorway. Fully glazed entrance doors allow clients and pets to see what is on the other side, reducing unexpected conflicts.
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3.8 This wheelchair access ramp was added to cater for an entrance which had two steps to floor level.
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3.9 The receptionist has everything to hand and a commanding view of the entrance, ready to greet clients. This reception desk allows the receptionist to monitor the whole waiting area.
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3.10 An example of a floor plan for a consulting room.
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3.11 Traffic flow for patients and for staff must be carefully considered when designing how areas are linked up.
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3.12 An example of a floor plan for inpatient wards and related areas.
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3.13 Mounting cages on a plinth makes cleaning easier, raises patients away from draughts and allows for easier replacement of cages should this be necessary.
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3.14 Under-cage storage can be useful for heavier items, and smaller cages are always best raised above floor level for ease of access.
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3.15 Above the kennel bank is the ideal place to design in electrical sockets, oxygen outlets and storage for bedding, etc.
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3.16 An example of a floor plan for a hub-type preparation area within a building conversion project. Note the use of angled doors into the ultrasonography and cat induction rooms, avoiding corners in the prep area. The arrows mark the positions of sterile pass-through cabinets for instruments.
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3.17 An angled theatre door can be very useful. It avoids turning trolleys 90 degrees and adds space in the prep area.
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3.18 The double glazed sides of the pass-through (sterile) cabinet allow sterile kits to be stored ready for use, and improve light transfer and visual communication.
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3.19 For smaller practices, a combined food prep and uniforms laundry, close to the wards, becomes an nursing station.
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3.20 A cleaners’ cupboard with a low sink for bucket filling and emptying creates a dirty sluice. It also keeps cleaning chemicals away from clinical areas.
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3.21 The space within a dormer-style roof can be ideal for fitting out with a residential flat, administrative office, duty rest room or staff facilities.
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3.23 Slip-resistant flooring, coved up the wall, can split in time. This floor is only 8 years old.
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3.24 Using a smooth coving with a slip-resistant floor avoids the dirt trap that is created when vinyl is coved up a wall. It provides an easy-clean curve and, normally, a much extended life.
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3.25 A modern lay-flat doormat, which takes two strides to cross, helps clean wet shoes and protects the floor. Most types can be laundered by commercial suppliers.
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3.27 Wall protectors, set at trolley rubbing height, avoid damage to the wall surfaces and keep the place looking good for years. The same sort of approach can be used for chair rubbing, or to divide upper and lower walls for a less bland approach, or for decorative purposes.
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3.29 Taking the trouble to ensure that the door finish reflects other design and colour approaches in the practice adds that little extra. It should be noted that the DDA requires a good contrast between the door finish and handle for the partially sighted.
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3.30 Simple coded door locks can be very useful for restricting access to certain areas.
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3.31 The base cupboards of this dispensing area are mounted on a pre-formed plinth which spans an alcove. The cupboards could, therefore, be replaced or altered without damage to the floor.
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3.32 Access to bins should be hands-free where possible. A push to open, push to close foot-operated drawer, like this one in dental cabinetry, is neat, easy to use and can contain more than one receptacle to allow segregation of waste.
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3.33 A worktop with a rear upstand can provide a neat and sealed finish and, in many areas, avoid the need for any form of ‘splash-back’.
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3.34 Sit-on sinks offer the best hygiene option. There is an upstand at the back, no area for water to collect behind the sink, and the sides can be sealed at the worktop joint. (Many base units will need additional struts to carry the sink firmly.)
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3.35 Door labelling produced to match the practice style and image can add an extra touch.
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3.36 There is a range of standard signage for fire exits. All are required to have a green background and white letters. The most common sign is the ‘running man’. In most areas, low-cost self-adhesive signs can be used. Illuminated signs may be required on final escape doors and exits.
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3.37 A handy reporting chart for faults and deficiencies can be hung in a central place. Details of the problem can be noted, and follow-up action recorded so everyone is aware of progress.
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3.38 An example of a format for a fault-reporting form. These can be available in convenient places in the practice, where they can be used to record failure of any equipment or item and to note decorative deficiencies. The completed slips can be given to the relevant manager for action, or used as report forms if faults are remedied immediately. Where repairs are in progress, slips can be pinned on a noticeboard for information. Filing the completed slips with equipment manuals will provide a maintenance and fault timeline, which is useful in decision-making on replacement.
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3.39 An example of a checklist for a client lavatory. Whilst the rota receptionist can check before and after consultation times, it should be the role of a different rota member during the day, or the reception may be left unmanned. First check should be to make sure the out-of-hours cleaners have done a good job. The use of electric hand driers may help reduce littering in the client WC.
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3.40 The right equipment can make cleaning easier and more effective – this cart has separate buckets for clean and contaminated areas. A wall mop is pictured to the right.
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3.41 Careful attention should be paid to cleaning areas frequently soiled, such as finger-plates and door-gripping areas.
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3.42 Example of a control sheet for ensuring audits are carried out.
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3.43 Car park maintenance. Rechargeable sweepers can be useful for larger flat surfaces where hand sweeping can be time-consuming and hard work. Alternatively, sub-contractors with compact road or path sweeping vehicles can be used to keep large areas clear.
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3.44 Permanent bin for rock salt and grit, ready to treat frosty paths in winter.
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3.45 Purple-lidded cytotoxic waste bin.
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3.46 Waste should be segregated at the point of production. In reception, waste is separated into recycling for paper, general waste (mostly packaging) and confidential shredding (for patient and client records).
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3.47 Offensive waste bin, with striped ‘tiger’ bag.

Supplements

Cleaning audit and waste poster

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