Clinic / Health Unit

by WBDG Staff

Last updated: 03-13-2007

Overview

The Clinic/Health Unit space types are facilities where outpatient ambulatory health services are provided. Sub-space types, such as office spaces, private toilets, and filing and storage areas are included.

This space type does not include provisions for invasive surgery, in-patient services, medical diagnostic categories I, II, and III equipment (including exam lights and medical gas systems), radiological diagnostic services (including special structural elements and radiation shielding on ceiling and floor areas), darkroom revolving door systems, or medical laboratory spaces. Clinics where general anesthesia, invasive procedures, or overnight care are provided require Institutional Occupancy construction types and are not included.

See Health Care, Hospital, Nursing Home, Outpatient Clinic, and Psychiatric Facility for more information about inpatient and specialized care facilities.

Space Attributes

The Clinic/Health Unit space type should provide a sanitary and therapeutic environment in which patients can be treated by medical practitioners quickly and effectively. Typical features of clinic/health unit space types include the list of applicable design objectives elements as outlined below. For a complete list and definitions of the design objectives within the context of whole building design, click on the titles below.

Accessible

All areas should comply with the minimum requirements of the Americans with Disabilities Act (ADA) and, if federally funded or owned, with the Uniform Federal Accessibility Standards (UFAS). For more information, see WBDG Accessible Branch and Comply with Accessibility Requirements (historic facilities).

Functional / Operational

Cleanliness and Sanitation: The cleanliness of a facility is not only related to a patient's medical recovery, but can also affect the perceived level of care. To maintain a sanitary environment, spaces should be easy to clean and maintain. Use durable finishes and sterile/antimicrobial surfaces as necessary. For more information, see WBDG Therapeutic Environments.
Occupancy: The occupancy classification for the Clinic/Health Unit space type is Business Occupancy B2, with sprinklered protected construction and GSA Acoustical Class C2.

Productive

Efficiency and Flexibility: The layout of the Clinic/Health Unit should promote prompt and reliable medical attention. Relationship and flow diagrams created at the beginning of the design process will ensure a sensible programming of space. Office support spaces such as workrooms, file rooms, copier areas, coat storage, and lockers typically will be integrated into the clinic environment. Flexibility must also be a basic feature of any health care facility to keep it from rapid obsolescence in the face of changing needs and technologies.
Acoustic and Visual Privacy: The new HIPAA (Health Insurance Portability and Accessibility Act) regulations address the security and privacy of "protected health information" (PHI). These regulations put new emphasis on acoustic and visual privacy, and may affect location and layout of workstations that handle medical records and other patient information-both paper and electronic-as well as patient accommodations. Flow diagrams created in the beginning of the design process should address controlled access areas.

Secure / Safe

Emergency Backup Systems: Typically, this space type will require emergency battery backup for 25% of lighting. Refer to individual utility requirements for specific medical equipment.

Example Program

The following building program is representative of Clinic/Health Unit spaces.

HEALTH UNIT

Description Tenant Occupiable Areas	Qty.	SF Each	Space Req'd.	Sum Actual SF	Tenant Usable Factor	Tenant USF
Entry Lobby				240
Waiting	1	120	120
Reception/Registration	1	60	60
Payee Window	1	60	60
General Patient Care				684
Physician Office/Consult	1	120	120
Exam Room	3	108	324
Nurse Work Area	1	40	40
Patient Toilets	1	60	60
Clean/Supply Room	1	60	60
Medications Storage	1	20	20
Soiled Utility Room	1	60	60
Medical Records				60
Medical Records Files	1	60	60
Staff Support Spaces				216
Staff Toilet (Male)	1	60	60
Staff Toilet (Female)	1	60	60
Staff Break Room	1	60	60
Housekeeping	1	36	36

Tenant Suite			1,200	1,200	1.53	1,840

Tenant Usable Areas						1,840

Example Plans

The following diagram is representative of typical tenant plans.

Example Construction Criteria

For GSA, the unit costs for the Clinic/Health Unit space type are based on the construction quality and design features in the following table (PDF 57 KB, 5 pgs). This information is based on GSA's benchmark interpretation and could be different for other owners.

Relevant Codes and Standards

The following agencies and organizations have developed codes and standards affecting the design of health facilities, including clinics. Note that the codes and standards are minimum requirements. Architects, engineers, and consultants should consider exceeding the applicable requirements whenever possible:

Americans with Disabilities Act
Guidelines for the Design and Construction of Hospitals and Health Care Facilities by AIA Academy of Architecture for Health. Washington, DC: The American Institute of Architects, 2001.
Facilities Standards for the Public Buildings Service, P100, GSA
International Building Code
Uniform Federal Accessibility Standards
Department of Veterans Affairs (VA): Office of Facilities Management Technical Information Library contains many guides and standards, including: Design Guides for planning hospital based ambulatory care clinics, community based outpatient clinics, satellite outpatient clinics, and ambulatory surgery clinics. This information library also includes Design Manuals of technical requirements, equipment lists, master specifications, room finishes, space planning criteria, and standard details.

Major Resources

WBDG

Publications

AIA Academy of Architecture for Health (AAH)—Contains AAH newsletters, reports, and other documents related to health care design
Architectural Graphic Standards, 10th Edition by Charles Ramsey, Harold Sleeper, and John Hoke. New York: John Wiley & Sons, Inc., 2000.
Building Type Basics for Healthcare Facilities ed. Stephen A. Kliment. New York: John Wiley & Sons, Inc., 2000.
Design That Cares: Planning Health Facilities for Patients and Visitors, 2nd ed. by Janet R. Carpman, Myron A. Grant and Deborah A. Simmons. New York: John Wiley & Sons, Inc., 2001.
Innovations in Healthcare Design: Selected Presentations from the First Five Symposia on Healthcare Design ed. Sara Marberry. New York: John Wiley & Sons, Inc., 1995.