Defining the Levels of Care within the rural healthcare clinic!

There are multiple levels of care in the healthcare industry.  One level of care for people is the “walk in clinic”.  The space that is needed for a walk-in clinic is at the entrance – a reception area where the clinic personnel greet the patients.  There would need to be a waiting area for the patients to sit while waiting their turn.  There needs to be a computer area where the staff can sit and chart on their patients as well as another area to house any patient records.  In most walk-in clinics there is also a space for radiology and phlebotomy needs. Within a walk-in clinic there are various caregivers. There are non-clinical staff members who greet the patients and register them for care.  There are clinic staff members who check the patients out and file their insurance after care has been rendered.  These non-clinical staff members would need space with computer access as well as a desk area to delineate their area from the patient’s common area.  The second layer of caregivers beyond the front reception area would be those giving direct patient care.  The MA (Medical Assistant); PA (Physician Assistant); LPN (Licensed Practical Nurse); RN (Registered Nurse) and the MD (Medical Doctor).  In the clinic, many of the lab and radiology needs can be done by the Medical Assistants.  All these caregivers require single rooms in which to examine their patients as well as a private area to chart and speak with their patients.  The patients have access to common areas such as the restrooms.  As Bakken (2020) notes “among the areas RedMed clinics become an alternative for medical needs are in cough, cold and sinus areas, illness and infections, physicals and wellness care, injuries and pain treatment. RedMed also offers an on-site lab and X-rays, and flu shots and vaccines. RedMed and other urgent care clinics can be a complement to other medical facilities.”

Another layer of care in the healthcare industry is the emergency room.  People should visit the ER when they have an emergent need such as a heart attack, car accident or stroke.  In this setting, there is a need for multiple private rooms, an ambulance bay as well as phlebotomy and radiology service areas.  There is a central door leading to the receptionist who will triage each situation and notify the Triage nurse if the need is emergent. The ER must have access to everything they need in one location in order to provide the quickest and safest service to the patients.  Like the clinic, most of the caregivers are the RNs; ER Techs and the MDs.  There are also Radiology and Lab techs who help to take diagnostic imaging and collect blood. Many ERs are centered around a location housing the computers and information needed to conduct business. DiNardo (2016) states, “a central nurses’ station provides views into the glass-door exam rooms, keeping staff accessible while reducing travel distances for patients, staff, and family members”. There are usually intercom systems within the ER to allow for quick communication among staff.  There is a waiting area (or two) to allow the patients an area to wait for their turn.  In many of these waiting areas, there is access to vending machines and restrooms.

A third layer of healthcare is the acute hospital.  Many people who enter the emergency room are “admitted” to the hospital for further care.  Many of these rooms are single occupancy but in some older hospitals, there are still rooms that house two people.  Within the hospital, there are regular rooms and critical care rooms.  In the critical care areas, there is usually a 2 to 1 ratio of patient to nurse.  There is usually only a staff of Registered Nurses (RNs) on the critical care units and the MDs round on their patients throughout the day and night.  Nurse Practitioners (NPs) are registered nurses who have completed further school in order to have more responsibility in the care of their patients.  Many hospitals and clinics employ the NPs to care for their patients.  In the Critical Care areas, rooms are single occupancy and have glass doors that always allow a visual of the patient.  Most rooms face the central hub where the Unit Secretary (if possible) is seated. The nurses and doctors work from these central stations. In the regular rooms, the patients are usually located on a long hall in their single occupancy room.  At the end of the hallway is the nurses’ station where a Unit Secretary and Nurse Assistants (NAs) will be located. The RNs and NAs work with the patients providing the care.  As in the critical care areas, the MDs will round on their patients daily.  As in the other layers of care within the healthcare industry, each of these caregivers need access to computers and a private area in which to chart on their patients.  Several other types of caregivers are used within the hospital setting, such as Transporters, Medical Social Workers and Respiratory and Physical Therapists.  These types of caregivers are usually not seen within the clinic or Emergency Room areas.

REFERENCES

Bakken, Bob ( January 2, 2020) “Holliday leads new urgent care clinic in Olive Branch”. Desoto-Time Tribune.

DiNardo, Anne (April 13, 2016). “A Different Approach To ED Design”. HCD Magazine.