FINAL DRAFT- 10/31/95
REVISED January 1997
The changes in medical technology and
Bar code readers are utilized in all patient areas
protocol, coupled with continuing readjustment
to record patient flow and charges.
of reimbursement patterns make ambulatory
Emergency Care
care a very volatile category of health
For these reasons, flexibility and
services.
The major function of Emergency at most VA
expandability are required attributes of the
Hospitals is to assess conditions of walk-in and
well-designed Ambulatory Care Facility.
ambulance patients and to provide immediate
treatment for stabilization, admission, or referral
Diagnostic Imaging Services and Surgical
as required.
Services are the types of programs that will
require specialized electrical, ventilation and
The level of emergency services will depend
shielding construction. Changes within these
upon analysis of community needs and other
areas will be driven by technological innovation.
services to be provided by the specific facility.
Also, new programs may come into being as
others are discontinued. In these areas a
The facilities demonstrated in the Guide Plates
"modular" design which can accommodate
provide for elementary emergency treatment
evolving needs may be the most appropriate
including patient examination and stabilization
design solution.
but do not reflect the requirements to
accommodate major trauma or surgical
Functional Considerations
procedures.
Operations: Services
Examination/Treatment Modules
Organization
Ambulatory
Services
are
organized
into
three
categories;
Examination/Treatment Modules are generic
Reception/MAS,
Emergency
Care,
and
clinical examination and treatment facilities
Examination/Treatment Modules.
which
accommodate
scheduled
and
unscheduled outpatient visits with variable
Reception/MAS
assignment capability based on schedule and
workload needs of the using departments which
Activities relating to patient triage
and
include; Medical Clinics, Surgical Clinics and
determinations of eligibility are centralized.
Specialty Clinics.
Medical records are maintained at a central
location utilizing Consolidated Health Records,
Patient Care Concepts
(CHR), which combine inpatient and outpatient
The Ambulatory Care spaces represented in
records.
these Guide Plates provide flexibility to
accommodate changing patient care concepts
Dental Clinics, Home Care, Substance Abuse,
for both outpatients and inpatients.
Service and Mental Health Clinics maintain
records within the department.
Reception and Patient Care Areas may require
The Reception and Control stations are shared
additional acoustical treatment to preserve
among clinics to optimize staffing and
patient privacy. This can take the form of
utilization.
acoustic blankets in walls and ceilings to
minimize noise between rooms.
Reception and
Control Stations should
accommodate
three
clerical
functions;
Aspects of patient participation, patient-focused
reception/check-in, check-out/disposition, and
care, and other concepts need to be addressed
record work-up/appointments.
by specific projects.
The equipment provisions and functional plan of
Level of Care
Reception and Control areas will be effected by
The Guide Plates anticipate a higher level of
the record retrieval, storage and transport
patient care for Hospital based Ambulatory
systems recommended for the facility.
Care.
Computer Record entry and retrieval systems
are being implemented but have not yet
Hospital based Ambulatory Care facilities may
replaced conventional records in VA facilities.
include limited inpatient use within Ambulatory
Care Occupancy.
VA DESIGN GUIDE
AMBULATORY CARE (Hospital Based)
PAGE 2-2
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