Identify organisational tensions and agree a strategy for managing them

The agreed principles for spatial organisation will inevitably generate some tensions as it is usually difficult to achieve all goals without some compromise. These tensions should be recognised and noted and, where possible, a means to overcome them or minimise their impact should be sought.

The agreed principles for spatial organisation will inevitably generate some tensions as it is usually difficult to achieve all goals without some compromise. These tensions should be recognised and noted and, where possible, a means to overcome them or minimise their impact should be sought. Issues that may need to be addressed include:

Maintaining confidentiality whilst providing welcoming and inviting reception desks

This can be overcome by carefully locating curved reception desks with one end positioned away from waiting areas or entrances. Alternatively, or additionally, provide an interview room adjacent to the reception desk where private discussions can occur.

The need for privacy, while maximising observation

It is essential to provide some privacy to patients/clients in recovery spaces, waiting areas, etc. Equally, staff must be able to observe activity. A sense of privacy can be given by angling bed heads or providing movable screens and planters to break up spaces. Observation can be improved by the use of well-placed mirrors.

Clinicians’ desire for fast throughput, while maximising patient dignity

It is important to achieve efficient throughput of patients/clients without making them feel undervalued or rushed. Minimising lost time between patient/client appointments can be achieved by placing well-designed sub-waiting areas near to clinical rooms (not chairs in the corridor) or by scheduling the activity into more than one room (allowing a patient to change in private between the consultation and examination part of the visit).

The need for close working between staff, while clearly separating clinical and administration space

There are clear advantages of separating clinical space from administration space although there is also a need to maintain close links between different staff members. This can be achieved through the use of technology (access to telephone and e.mail facilities on every desktop) and by using meeting spaces for regular discussions.

A clear policy for managing treatment room spaces

Treatment room spaces are often difficult to plan. There must be a balance between the conflicting demands generated by planned/unplanned activity, fast/slow throughput and ‘clean’/‘dirty’ procedures.