practice management | ergonomics in the workplace | Exam and procedure rooms
since physicians spend most of their time with patients in exam and procedure rooms, it makes sense that these areas are where ergonomic and accessibility principles can have the greatest impact on the quality level of the healthcare environment and care provided. the design and layout of the exam/procedure room can have a significant effect on the quality of patient care and comfort and safety of the facility. the size of the room is very important.
it needs to be large enough to comfortably accommodate the patient, physician, and staff and allow procedures to be properly performed. the industry standard for an exam room is approximately 8 ft × 8 ft; however, increasing the room to 10 ft × 10 ft – or larger, if possible – provides a 60- inch diameter area to accommodate wheelchair turnaround for disabled patients, as recommended in guidelines of the americans with Disabilities act (aDa). procedure rooms can be 12 ft × 12 ft, depending on procedure equipment, and patient positioning required. the slightly larger room allows the door
to be reverse-hinged to increase patient privacy. if a staff member enters the room to assist the physician, the patient is not exposed to other patients in the corridor. larger rooms will also accommodate newer equipment, such as lasers, and will allow for versatility down the road if one needs to add new in-office procedures. For most aesthetic procedures, the work
of the physician and staff is concentrated around the head section of the table. however, there are other procedures that occur at the foot and midsection of the table, so access around the entire table is critical. to facilitate this access, the procedure table should be positioned either in the middle of the room or at an angle, allowing the physician and staff to work at the head end of the table, and as much as possible in a neutral position, without too much overreaching or bending and twisting of the back and head. and adequate room space will mean that the physician can easily move about while seated on a stool, minimizing any aches that might be caused by continually sitting and standing during an exam or procedure. procedure tables must be able to afford the physician an opportunity to
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Lighting should be counter- balanced to provide precise positioning without
drifting and without any undue spring.
inject, laser or otherwise treat without having too much neck flexion. it is also a good idea to include side
a room 10 ft × 10 ft – or
larger, if possible – provides a 60-inch diameter area to accommodate wheelchair turnaround for disabled patients.
chairs in the room. these chairs can have multiple uses. two chairs are commonly used for the patient and potentially an accompanying family member to sit together during any sort of consultation. typically, the patient would sit on the procedure table and a family member would be seated across the room. this is less desirable because the physician must consult the patient and answer questions from all people, wherever they are located. the two chairs, positioned side by side, allow the physician to consult with both individuals simultaneously and maintain eye contact without constantly moving the head or torso, thereby decreasing the stress on the neck and back. as with the lobby and
entrance, the exam and procedure room is another area where trips, slips, and
falls often occur. along with slippery and uneven surfaces, other hazards include cords from all the equipment in the room that stretch across the floor. By using floor outlets, the power cord of
the procedures table can be shortened and kept from stretching across the floor. additionally, outlets located on the procedures table enable the physician to plug equipment into the table and keep the associated cords from stretching across the floor. lastly, using wireless controls can completely eliminate the
March 2011 |
prime-journal.com
control cords going to the equipment and allow staff to position the controls where they make the best ergonomic sense. an emerging trend that certainly helps
the ergonomics of the office is to incorporate a consultation area in the procedure room. this has the benefit of reducing room changes for both the physician and the patient. the doctor can then stay seated and simply turn around when they want to go from the consultation to the procedure. this setup certainly requires a very aesthetically pleasing and friendly, warm environment. the placement of surfaces, instruments, equipment, and access to equipment all require a well thought out plan to make this setup a success, but when it is done correctly it can be a very ergonomic solution.
Lighting it is important to have medical lighting in the exam/procedure room that provides a large pattern size with an even distribution of light throughout that eliminates shadows. it should also remain safe and cool to the touch. the lighting should be counterbalanced to provide precise positioning without drifting and without any undue spring or frictional force that would cause the user to overly push or pull in order to position the light. thus, it should be easy to maneuver, eliminating any strain on physicians.
Physician stool For a physician, the ergonomic properties of the stool are very important. the ideal
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