P11-NW Metro CBOC_Appendix F_Prototype-04-PlanningModules.pdf
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Department of Veterans Affairs
About this file
This document is a design guide for standardized Community Based Outpatient Clinics (CBOCs) for the Department of Veterans Affairs, finalized on May 16, 2014. The guide establishes modular planning components and architectural standards for constructing or renovating VA outpatient facilities based on the Patient Aligned Care Team (PACT) model of care.
The prototype design utilizes a flexible "kit of parts" approach organized around a 31'-10" x 31'-10" structural column grid, enabling facilities to adapt to varying patient populations and geographic needs. Primary Care Modules support one, two, or three PACT teamlets with universal 125-square-foot exam and consult rooms, centralized team work areas, and integrated support spaces including reception, procedure rooms, and administrative functions. Ancillary Services Diagnostic Modules (ASDMs) scale across three clinic sizes and include components for Audiology, Eye Clinic, General Mental Health, Pathology and Laboratory, Pharmacy, Physical Medicine and Rehabilitation with Prosthetics, Radiology, Dentistry, and Multi-Specialty Care. The guide specifies room types, sizes, adjacencies, and functional relationships to optimize patient flow, staff efficiency, and clinical integration. Entry and security components vary by clinic size, with larger facilities incorporating holding rooms, secure storage, and enhanced police operations. All components emphasize flexibility through standardized room dimensions, enabling future repurposing as clinical needs evolve. The design framework was developed through design charrettes with the VA project team, VISN leadership, and stakeholders, incorporating current VA design guides and feasibility studies focused on the PACT model of integrated, patient-centered care delivery.
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Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Department of Veterans Aff airs
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.1
4.0 Planning Components + Modules
Introduction Th e Planning Components and Modules creates a “kit of parts” that are fl exible and adaptable to work with VA’s many varied care delivery settings, based on the Patient Aligned Care Team (PACT) model of care. Th e “kits of parts” are building blocks that allow for future fl exibility and the ability to achieve the designed clinical layout in new construction, renovation or leased space. Th ey also facilitate the addition or alterations to the clinic as it is customized to each facility’s demographic and geographic needs.
Regardless of the clinic size, shape, or desired fl ow, all spaces are to work within the modules and confi gured with a standard column grid to allow for fl exibility as spaces respond to future needs and growth. To help ensure future clinic fl exibility, a majority of the typical rooms are 125 square feet and are designed as “universal rooms”. Th is means that these spaces will easily transition to an alternate function.
Refer to Section 2.3 - Structural Bay Overview for additional information regarding the options explored throughout this study.
Th e following is a list of spaces that may fi t within the criteria for a universal room:
• Exam Room
• Specialty Exam Room
• Consult Room
• Flex Offi ces
• Mental Health Consult Room
• Clinic Management Offi ce
• Tele-health Room
• Clean Room
• Equipment Room
Th e Planning Components and Modules have been developed and refi ned extensively throughout this project in design charrettes with the Project Team, Core Steering Group, VISN leadership and representatives as well as other key stakeholders. Th e Planning Component and Modules represent the framework from which the kits of parts were created.
Th e Planning Component and Modules were designed utilizing the 31’-10” x 31’-10” structural column grid with careful considerations pertaining to patient fl ow, safety and overall effi ciency while optimizing the net square footage to the departmental gross square footage. Th is was achieved by eliminating redundant patient/staff corridors, consolidating services where appropriate for better utilization and ensuring optimal departmental adjacencies.
Th e Planning Module confi gurations were explored in the Block & Stack options as the CBOC building organization and can be seen in the Block + Stack options presented in Section 2.6 Clinical Growth - Block + Stack. Each module is composed of a group of rooms or departments that are frequently utilized and replicated in the CBOCs. Th ese designs are developed utilizing the most recent VA Design Guides, Feasibility Studies and other information relevant to outpatient clinics and the PACT model of care.
Refer to Section 9 - Appendix for a list of references used throughout this study.
4.2
This page has been left blank intentionally.
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.3
4.1 Planning Components -
Primary Care Planning Components Th e components utilize the universal room size of 125 SF when ever possible to facilitate future clinic fl exibility. Each room in the patient zone has a handwashing sink to re-purpose these spaces for alternate functions. For example, a Mental Health Consult room can become an exam room depending on the workload demands of the clinic by simply changing out the furniture and equipment. Th e components are developed within the 31’-10” by 31’-10” structural bay to optimize the net square footage to departmental gross square footage.
Th e Components included in this section are:
• Entrance Vestibule with Police & Wheel Chair Alcove
• Reception with enclave, work area and admin offi ce
• Shared Medical Appointment Room & Group Room
• One, Two and Th ree-PACT + Extended Team Work Room
• Home Based Primary Care (HBPC)
• Exam, Consult and Women’s Health Rooms
• Procedure Rooms
Flex Offi ces are dispersed throughout all of the Prototype layouts and are not provider-specifi c. Flex offi ces are not programmed as part of PACT or ASDM and can be utilized for Service Organizations, such as, Veterans Benefi ts Administration (VBA), Visiting Providers, Spectacle Shop, Storage, etc. Flex offi ces are typically located along the front public/front bar, but could be located along on the back bar with support spaces depending on the administrative functions of the clinic.
Figure 4.1
Primary Care Module Zones
EXAM
ROOMS
EXAM
ROOMS
TEAM
WORK
AREA
RECEPTION
COMMONS/LOBBY
TEAM WORK SUPPORT AREA
4.4
Primary Care Components
Entry / Police + Security: One-PACT CBOC
Entry / Police + Security - One-PACT CBOC Th e Entry / Police + Security component is designed to be a universal component that is consistent in all three CBOC Prototypes. Th e vestibule is fl anked by a wheelchair storage alcove and a police offi ce. Th e purpose of locating the police offi ce in the front of the clinic is two-fold: for patients, its location off ers a sense of security and comfort. For staff , its location off ers the most visibility into the Commons and also the areas located outside of the clinic such as parking lots and sidewalks. Th e wheelchair storage alcove is strategically located to be accessible to patients. In some cases, the preference is to access the wheelchair storage from the Commons area to avoid congestion within the vestibule. Its location allows family members to quickly retrieve a wheelchair when accompanying a Veteran patient to their appointment. Th e vestibule’s 12 foot depth meets both the depth requirements of ASHRAE and the minimum walk-off mat length required by LEED. Th e off set of the vestibule doors also serve as a barrier to prevent a blast of uncomfortable outside air from entering the clinic.
Key Spaces - Entry
• Vestibule
• Wheelchair storage
Key Spaces - Police + Security
• Operations Room (Police Offi ce)
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.3
Equipment Figure 4.2
Component
75 SF
TLT
167 SF
RECEPTION
COMMONS
188 SF
VESTIBULE
52 SF
WHEEL
CHAIRS
104 SF
POLICE
TLT
RECEPTION
COMMONS
VESTIBULE WHEEL
CHAIRS
POLICE
VOLUNTEER
KIOSKS
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.5
Primary Care Components
Entry / Police + Security: Two + Three-PACT CBOCs
Entry / Police + Security - Two + Three-PACT CBOCs Th e Entry / Police + Security for the Two + Th ree-PACT CBOCs is identical to the One-PACT CBOC component on the opposite page, however, the Police + Security requirements are diff erent. In the Two + Th ree-PACT CBOCs, additional program spaces such as a Holding Room, Locker Room and Secure Storage are located in the Logistics knuckle of the clinic layout. Th is supports the increased police staff at the larger clinics. Th e intent is to have an “off -stage” area to safely accommodate disruptive patients away from public view. Th e Holding Room’s location also facilitates transportation of disgruntled patients via the secondary entrance. Th e Secure Storage, or Safe, within the Locker Room is used to store and load weapons. Security monitors are to be located in the front of the clinic within the Entry component.
Key Spaces - Entry
• Vestibule
• Wheelchair storage
Key Spaces - Police + Security
• Operations Room (Police Offi ce)
• Holding Room
• Locker Room
• Secure Storage, Safe
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.5
Equipment Figure 4.4
Component
COMMONS
MAIN ENTRANCE
187 SF
VESTIBULE
104 SF
POLICE
52 SF
WHEEL
CHAIRS
68 SF
HOLDING
50 SF
SAFE
126 SF
POLICE
LOCKER
156 SF
CONSULT 3
129 SF
CONSULT 2
175 SF
CANTEEN
OFFICE/
STORAGE 114 SF
A&MM
SUPERVISOR
260 SF
OIT
129 SF
COMMONS
MAIN ENTRANCE
VESTIBULE WHEEL
CHAIRS
POLICE
VOLUNTEER
SAFEHOLDING
POLICE
LOCKER
OIT
CANTEEN
OFFICE/
STORAGE
A&MM
SUPERVISOR
CONSULT 2
CONSULT 3
4.6
Reception: One-PACT CBOC
125 SF
FLEX
222 SF
ADMIN
WORK AREA
75 SF
TLT
75 SF
TLT
167 SF
RECEPTION
BL
D
P
134 S
HEALTH
100 SF
PHARM
50 SF
H&W
SF
C. TLT
D
AL
ENTS
COMMONS
D
AL
ENTS
OC. TLT H&W
COMMONS
VOLUNTEER
TLT
TLT
FLEX
ADMIN
WORK AREA
RECEPTION
Reception - One-PACT CBOC Th e Reception is centrally located, providing two distinct entrances into the PACT area. Its location provides a clear check-in point for patients entering the facility through the vestibule while aff ording staff visibility over the activity in the Commons. Kiosks are located in the patients’ path from the Entry to Reception, encouraging patient use within visibility of both the Reception desk and Volunteer area, should a patient require assistance. Th is centralized node of the Reception is immediately adjacent, but not too close to the clinic waiting areas. Th is distance provides patients visual and auditory privacy while talking to staff at the desk by adding privacy panels at each check-in location. Each check-in counter is approximately 5’-0” to provide space for the patient and an accompanying family member. In a One- PACT CBOC, three check-in locations are provided with an additional counseling alcove off the corridor for surge hours or patients requesting additional privacy for conversations. A single entry way leads to the large, open Admin Work Room for offi ce equipment and can be secured after hours.
Refer to Section 2.4.4 Reception Areas for additional options.
Key Spaces
• Reception
• Admin Work Area
• Admin Offi ce (HAS)
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.7
Equipment Figure 4.6
Component
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.7
Primary Care Components
Reception: Two + Three-PACT CBOCs
COMMONS
121 SF
ADMIN
126 SF
FLEX
OFFICE
126 SF
FLEX
OFFICE
125 SF
ADMIN
WORKROOM
463 SF
RECEPTION
71 SF
F 180 SF
KIOSKS
Reception - Two + Three-PACT CBOCs In the Two + Th ree-PACT CBOC Prototypes the reception component refl ects the adjacencies and fl ow of the One-PACT CBOC. In this scenario, there are a total of six, 5’-0” check-in counters immediately off the Commons. Refer to Section
2.4.4 Reception Areas for additional options. Two entry ways
lead to the Admin Work Room or counseling alcoves located off the two distinct corridors into the PACT area. Similar to the One-PACT Reception component, these counseling alcoves also serve to support the reception during surge hours, typically in the mornings or in situations requiring increased patient privacy.
Refer to Section 2.4.3 Lobby / Commons Area for Reception renderings.
Key Spaces
• Reception
• Admin Work Area
• Admin Offi ce (HAS)
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.9
Equipment Figure 4.8
COMMONS
SS
ES
FLEX
OFFICE
ADMIN FLEX
OFFICE
ADMIN
WORKROOM
RECEPTION
KIOSK
4.8
Home Based Primary Care: Two + Three-PACT CBOCs
380 SF
HBPC TEAM
WORK AREA
18 SF
EQUIP
18 SF
EQUIP
121 SF
HBPC
STORAGE
130 SF
PMR
OFFICE
14 SF
R GYM
150 SF
X-RAY
69 SF
P TLT
109 SF
SOILED
CART
LOC
LO
CLI
ST
PARTIAL HEIGHT WALLS
Home Based Primary Care (HBPC) - Two + Three-PACT CBOC Th e HBPC component for the Two + Th ree-PACT CBOCs is located in the Ancillary Services Diagnostic Module (ASDM), toward the rear of the module. Due to the nature of the services provided, a team work area is provided versus traditional offi ces. HBPC providers and staff are not in clinic continuously during normal clinic hours, but rather visiting patients in their homes to provide care. A dedicated storage area is provided adjacent to the HBPC team work area. Th e team work area is also located along the second staff corridor, directly near the secondary entrance to the clinic to provide convenient exterior access for staff . HBPC can also be integrated and collocated with primary care is desired.
Key Spaces
• Team Work Area
• Storage
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.11
Equipment Figure 4.10
Component
HBPC TEAM
WORK AREA
EQUIP
EQUIP
HBPC
STORAGE
PMR
OFFICE GYM
X-RAY P TLT SOILED
CART
LOCK
LOUN
CLINI
STA
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.9
Primary Care Components
Business Services: Two + Three-PACT CBOCs
126 SF
FLEX
OFFICE
122 SF
ADMIN
WORKROOM
458 SF
RECEPT
229 SF
BUSINESS
SERVICES
SF
TLT
24 SF
FLEX
FFICE
97 SF
H&W
180 SF
PROCEDURE
COMMONS
121 SF
ADMIN
Business Services - Two + Three-PACT CBOCs In the Two + Th ree-PACT CBOCs, a Business Services component is included to provide services to the patient that are separate from Primary Care reception functions.
Although located directly adjacent to the Reception, the Business Services Room is comprised of four workstations with side visitor chairs. Th e four workstations are dedicated to personnel handling services such as, Release of Information, Eligibility/Enrollment, Means Testing, Questions about billing and Replacement Identifi cation Cards. Co-locating Business Services with Reception decreases the additional workload off the PACT Reception clerks. In a One-PACT CBOC, this component is absorbed within the Reception component as the clinic is smaller. Th e counseling alcove can also be utilized for Business Services encounters with Veterans in a One-PACT CBOC.
Key Spaces
• Open Offi ce with Workstations
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.13
Equipment Figure 4.12
Component
FLEX
OFFICE
ADMIN
WORKROOM
RECEPT
BUSINESS
SERVICES TLT
FLEX
FFICE H&W PROCEDURE
ADMIN
4.10
PACT Components
Group Rooms / Shared Medical Appts.: All CBOCs
STOR. STOR.
303 SF
GROUP ROOM
374 SF
SHARED
MEDICAL APPT
ROOM
130 SF
75 SF
FAMILY T
74 SF
FAMILY T
117 SF
FLEX
OFFIC
FOLDING PARTITION
FAM
FAM
FL
OF
GROUP ROOM
SHARED
MEDICAL APPT
ROOM
STOR. STOR.
COMMONS
Group Rooms - All CBOCs Th e Group Room component, consisting of a Group Room and Shared Medical Appointment Room, has access directly from the Commons. Th is allows patients to attend appointments and group sessions without entering the clinic space proper. Its location lends itself to hosting evening and weekend appointments since it can be accessed from outside of the clinic. Th e Group Room and Shared Medical Appointment Room can be located adjacent to each other providing the potential for a larger single space through the use of a folding partition. Th is off ers fl exibility to host rather larger groups/conferences as needed. Folding partitions will need to meet strict sound attenuation requirements to meet the acoustic privacy necessary for these rooms.
Refer to Section 2.7 Lobby / Commons Area for renderings of the public areas.
Key Spaces
• Shared Medical Appointment Room
• Storage, Shared Medical Appointments
• Group Room
• Storage, Group Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.15
Equipment Figure 4.14
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.11
Primary Care Components
PACT + Extended Care Team Work Area: One-PACT
PACT + Extended Care Team Work Area - One-PACT
CBOC
Th e PACT Work Area has been combined with the Extended Team Work Area to foster the active communication and coordination important to providing integrative healthcare services, a key element in the PACT model of care. Th e work area includes four work stations for each of the four PACT Teamlets and a minimum of four additional work stations for the Extended Team members. By utilizing the optimum column bay of 31’-10” as described Section 2.3 - Structural Bay Overview, the team work area will also accommodate equipment alcoves, medication alcove, crash cart and support space. Th e support space includes areas for supplies, and printer/fax/copy. In a One CBOC Prototype, the front of the team work area consists of a ADDS Room, since a Pharmacy is not included.
Refer to Section 2.9, PACT + Extended Care Team Work Areas for additional options.
Key Spaces
• Shared Documentation Area (1 per Teamlet)
• Extended Care Team Area
• Medications Alcove
• Heights + Weights Alcove
• Medical Equipment Alcove
• Conference Room
• Training/Consult Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.17
Equipment Figure 4.16
Component
125 SF
TRAINING/
FLEX
269 SF
CONFERENCE
60 SF
STAFF TLT
50 SF
H&W 100 SF
ADDS
PHARM
MED
ALCOVE
CC/EQUIP
ALCOVE
EQUIP
ALCOVE
EQUIP
ALCOVE
1002 SF
TEAM WORK AREA
125 SF
COMM
125 SF
LOCKERS
68 SF
STAFF TLT
125 SF
EXAM 3
128 SF
EXAM 2
129 SF
WOMEN'S
HEALTH 2
57 SF
WH TLT
134 SF
WOMEN'S
HEALTH 1
72 SF
PROC. TLT
180 SF
PROCEDURE
128 SF
EXAM 4
129 SF
EXAM 5
75 SF
CLEAN
126 SF
EXAM 6
129 SF
EXAM 7
129 SF
EXAM 1
PARTIAL HEIGHT WALLS-
AROUND TEAM WORK
AREA, TYPICAL
CONFERENCE
TRAINING/
FLEX
LOCKERS COMM
STAFF TLT
EXAM 3
EXAM 2
TEAM WORK AREA
EXAM 1
WOMEN'S
HEALTH 2
WH TLT
WOMEN'S
HEALTH 1
PROC. TLT
PROCEDURE
EXAM 4
EXAM 5
CLEAN
EXAM 6
EXAM 7
ADDS
PHARM
H&W
STAFF TLT
EQUIP
EQUIP
CC/
EQUIP
MED
TEAMLET 3 TEAMLET 4
TEAMLET 1 TEAMLET 2
EXTENDED
CARE
TEAM
4.12
PACT + Extended Care Team Work Area: Two + Three-PACT
PACT+Extended Care Team Work Area - Two + Three- PACT CBOCs Th e PACT Work Area has been combined with the Extended Team Work Area to foster the active communication and coordination important in providing integrative healthcare services, a key element in the PACT model of care. Th e work area includes four work stations for each of the four PACT Teamlets and a minimum of four additional work stations for the Extended Team members. By utilizing the optimum column bay of 31’-10” as described Section 2.3 - Structural Bay Overview, the team work area will also accommodate equipment alcoves, medication alcove, crash cart and support space. Th e support space includes areas for supplies, and printer/fax/copy. Unlike the One-PACT CBOC, the heights and weights alcove replaces the ADDS room in the Two + Th ree-PACT CBOCs at the front of the team work area.
Refer to Section 2.9, PACT + Extended Care Team Work Areas for additional options.
Key Spaces
• Shared Documentation Area (1 per Teamlet)
• Extended Care Team Area
• Medications Alcove
• Heights + Weights Alcove
• Medical Equipment Alcove
• Conference Room
• Training/Consult Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.19
Equipment Figure 4.18
Component
C.C
130 SF
TRAINING /
FLEX
266 SF
CONFERENCE
125 SF
CLEAN
125 SF
CMO
129 SF
EXAM 2
125 SF
EXAM 3
68 SF
P TLT
129 SF
EXAM 4
132 SF
WOMEN'S
HEALTH 2
56 SF
WH TLT
129 SF
WOMEN'S
HEALTH 1
72 SF
PROCED. TLT
180 SF
PROCEDURE
129 SF
EXAM 5
128 SF
EXAM 6
129 SF
EXAM 7
125 SF
EXAM 8
67 SF
S TLT
120 SF
FLEX
OFFICE
101 SF
H&W
MED ALCOVE
1039 SF
TEAM WORK AREA
32 SF
EQUIP
ALCOVE
PARTIAL HEIGHT WALLS-
AROUND TEAM WORK
ARE, TYPICAL
CMO
TRAINING /
FLEX CONFERENCE
CLEAN
S TLT
EXAM 8
EXAM 7
EXAM 6
EXAM 5
PROCEDURE
PROCED. TLT
WOMEN'S
HEALTH 1
WH TLT
WH TLT
WOMEN'S
HEALTH 2
EXAM 4
P TLT
EXAM 3
EXAM 2
TEAM WORK AREA
MED ALCOVE
H&WFLEX
OFFICE
TEAMLET 3 TEAMLET4
TEAMLET1 TEAMLET 2
EQUIP
ALCOVE
EXTENDED CARE TEAM
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.13
Primary Care Components
Procedure: One-PACT CBOC
Procedure - One-PACT CBOC In the One-PACT CBOC Prototype, one procedure room is dedicated to the PACT module. Th e Procedure Room is located in the patient zone of the module. As shown, it is located towards the front of the clinic, however, due to the fl exibility of the module, the procedure room can shift anywhere along the corridor based on clinic preferences.
Th e procedure rooms are immediately accessed off the team work areas. Support spaces such as clean rooms and medical equipment storage are located within the vicinity of the room. Per criteria, the procedure room also has a dedicated patient toilet that is only accessed from within the room. A sliding door is provided on the staff work area side of the room minimizing door confl icts within the room. A swing door is used on the patient side to allow for handrails along the entire corridor. Th e procedure room is multi-functional and can also be used for bariatric patients and women’s health appointments as needed.
Refer to Section 6.1.4 for Typical Procedure Room Layouts.
Key Spaces
• Procedure Room (1 per PACT Module)
• Dedicated Patient Toilet (1 per PACT Module)
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.21
Equipment Figure 4.20
Component
129 SF
EXAM 7
126 SF
EXAM 6
75 SF
CLEAN
129 SF
EXAM 5
128 SF
EXAM 4
180 SF
PROCEDURE
72 SF
PROC. TLT
SHARED
50 SF
H&W
60 SF
STAFF TLT
1002 SF
TEAM WORK AREA
125 SF
EXAM 8
125 SF
HEARING
AID PRG
152 SF
MEDICAL
EQUIPMENT
125 SF
MH
CONSULT
125 SF
CONSULT 4
125 SF
CONSULT 3
130 SF
FLEX
OFFICE
POTENTIAL CROSS
CORRIDOR
MEDICAL
EQUIPMENT
HEARING
AID PRG
EXAM 8
MH
CONSULT
CONSULT 4
CONSULT 3
FLEX
OFFICE
SHARED ADMIN
H&W
STAFF TLT
TEAM WORK AREA
EXAM 7
EXAM 6
CLEAN
EXAM 5
EXAM 4
PROCEDURE
PROC. TLT
POTENTIAL CROSS
CORRIDOR
4.14
Procedure: Two + Three-PACT CBOC
Procedure - Two + Three-PACT CBOCs As in the One-PACT CBOC, one Procedure Room is provided for each PACT module. When designing a Two- PACT CBOC, clustering of the Procedure Rooms as shown is preferred to maximize the sharing of support spaces such as clean rooms and medical equipment storage. Like the One- PACT CBOC, these rooms are located towards the front of the clinic, however, due to the fl exibility of the module, the procedure room can shift anywhere along the corridor based on clinic preferences. Th e procedure rooms are immediately accessed off the team work areas. Per criteria, the procedure room also has a dedicated patient toilet that is only accessed from within the room. A sliding door is provided on the staff work area side of the room minimizing door confl icts within the room. A swing door is used on the patient side to allow for handrails along the entire corridor. Th e procedure room is multi-functional and can also be used for bariatric patients and women’s health appointments as needed.
Refer to Section 6.1.4 for Typical Procedure Room Layouts.
Key Spaces
• Procedure Room (1 per PACT Module)
• Dedicated Patient Toilet (1 per PACT Module)
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.23
Equipment Figure 4.22
Component
129 SF
EXAM 7
125 SF
EXAM 8
67 SF
S TLT
129 SF
EXAM 6
128 SF
EXAM 5
180 SF
PROCEDURE
71 SF
PROCED. TLT
72 SF
PROCED. TLT
180 SF
PROCEDURE
129 SF
EXAM 5
128 SF
EXAM 6
OFFICE
ADMIN
101 SF
H&W
101 SF
H&W
129 SF
EXAM 8
125 SF
EXAM 7
68 SF
P TLT
EXAM 6
EXAM 5
PROCEDURE
PROCED. TLT
H&W
FLEX
OFFICE
ADMINFLEX
OFFICE
H&W
PROCED. TLT
PROCEDURE
EXAM 5
EXAM 6
EXAM 7
EXAM 8
S TLT
EXAM 8
EXAM 7
P TLT
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.15
Primary Care Components
Exam, Consult and Women’s Health: All CBOCs
Exam + Consult - All CBOC Prototypes Th e patient zone of the PACT module is identifi ed for Exam, Consult and Women’s Health Rooms. On the patient corridor, the room is entered through a swing door while on team work area side staff enter through a sliding/barn door. Women’s health rooms are clustered together towards the front of the clinic. Like the Procedure Room, the Women’s Health Room can easily shift any where along the corridor depending on clinic preference. In cases where there is a larger population of female Veterans, multiple Women’s Health rooms can be clustered at the front of the patient zone with a dedicated women’s entrance for a Small Women’s Clinic. Women’s Health rooms do not have to be used solely for female patient encounters. Consult rooms and tele-health rooms have a single entry point off the patient corridor. All rooms in this zone are designed to be universal rooms at 125 SF.
Refer to Section 6.1.1 and 6.1.2 for Typical Exam Room and Women’s Health Exam Room Layouts.
Key Spaces
• Exam Rooms
• Consult Rooms
• Women’s Health Rooms
• Patient Toilets
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.25
Equipment Figure 4.24
Component
156 SF
CONSULT 3
129 SF
CONSULT 2
129 SF
EXAM 4
129 SF
TELEHEALTH
EXAM
129 SF
TELEHEALTH
EXAM
129 SF
TELERETINAL
133 SF
CONSULT 1
132 SF
WOMEN'S
HEALTH 1
129 SF
WOMEN'S
HEALTH 2
125 SF
EXAM 1
126 SF
POLICE
LOCKER
120 SF
FLEX
OFFICE
MALE TLT
57 SF
WH TLT
57 SF
WH TLT
175 SF
CANTEEN
OFFICE/
STORAGE
195 SF
BIO MED
67 SF
S TLT
125 SF
EXAM 3
129 SF
EXAM 2
HOLDING
POLICE
LOCKER
CANTEEN
OFFICE/
STORAGE
BIO MED
MALE TLT
FLEX
OFFICE
EXAM 1
WOMEN'S
HEALTH 2
WH TLT
WH TLT
WOMEN'S
HEALTH 1 CONSULT 1
TELERETINAL
TELEHEALTH
EXAM
TELEHEALTH
EXAM
EXAM 4
CONSULT 2
CONSULT 3
S TLT
EXAM 3
EXAM 2
4.16
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.17
4.2 Planning Components -
Ancillary Services and Diagnostic Th e basic kit of parts for the CBOC Prototype stems from Components. Th e Ancillary Services Diagnostic Components grow between the One, Two and Th ree-PACT CBOC Prototype Programs for Design. Th ese components can be interchanged; for example, if the Two-PACT CBOC has a more robust Audiology program it can utilize the Th ree- PACT Audiology component to meet workload demand.
Th e Components included in this section are:
• Audiology
• Eye Clinic
• General Mental Health
• Pathology + Laboratory
• Pharmacy
• PM + R and Prosthetics
• Radiology
• Dentistry
• Multi-Specialty Care
• Mobile Technology Pad
Figure 4.26
Ancillary Services Diagnostic Module Zones
EXAM /
DIAGNOSTIC
TEAM
WORK
AREA
RECEPTION
COMMONS/LOBBY
TEAM WORK SUPPORT AREA
EXAM /
DIAGNOSTIC
EXAM /
DIAGNOSTIC
4.18
Ancillary Services Diagnostic Components
Audiology: Two-PACT CBOC
125 SF
EQUIP
125 SF
HEARING
AID
125 SF
EXAM/
CONSULT
247 SF
AUDIO
EXAM 1
248 SF
AUDIO
EXAM 2
125 SF
EXAM/
CONSULT
513 SF
ANCILLARY DIAGNOSTIC
TEAM WORK AREA
125 SF
EXAM 3
125 SF
EXAM 2
125 SF
EXAM 1
139 SF
DILATION
368 SF
GENERAL
RADIOLOGY
140 SF
TELEHEALTH
125 SF
RAD
OFFICE
129 SF
CLEAN
71 SF
P TLT
Audiology + Speech Pathology - Two-PACT CBOC Th e Audiology component is located in the Ancillary Diagnostic Services Module. Th e component has been placed with sensitivity to noise. Two audiometric suites are included in the Two-PACT CBOC prototype. Th e program requirements are situated along a double loaded corridor.
Shared spaces with other Ancillary Diagnostic Service Components include reception, waiting and patient toilets. A Group Th erapy Room is located within the Ancillary Services Diagnostic Module and is shared with adjacent departments.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Exam/Consult Room
• Audiometric Exam Suite
• Hearing Aid Programming/Fitting
• Equipment Area
• Shared Spaces:
- Reception
- Waiting
- Patient Toilet
- Group Th erapy Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.28
Equipment Figure 4.27
Component
Booth Booth
EQUIP HEARING
AID
EXAM/
CONSULT
AUDIO
EXAM 1
AUDIO
EXAM 2
EXAM/
CONSULT
ANCILLARY DIAGNOSTIC
TEAM WORK AREA
EXAM 3
EXAM 2
EXAM 1
DILATION
GENERAL
RADIOLOGY
TELEHEALTH
RAD
OFFICE
CLEAN P TLT
Booth Booth
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.19
Ancillary Services Diagnostic Components
Audiology: Three-PACT CBOC
125 SF
ELECTRO
125 SF
EQUIPMENT
125 SF
FLEX
OFFICE
209 SF
VESTIBULOGRAPHY
129 SF
SECTION
CHIEF
125 SF
HEARING
AID
66 SF
TLT
125 SF
EXAM /
CONSULT
65 SF
PROC
TLT
254 SF
EXERCISE
ROOM
67 SF
S TLT
242 SF
AUDIO
EXAM 3
245 SF
AUDIO
EXAM 2
125 SF
EXAM 4
130 SF
EXAM 3
125 SF
EXAM 5
125 SF
TELEHEALTH
247 SF
AUDIO
EXAM 1
125 SF
EXAM /
CONSULT
125 SF
EXAM /
CONSULT
125 SF
EXAM 3
125 SF
EXAM 2
125 SF
EXAM 1
130 SF
PRETEST 1
174 SF
PROCEDURE
127 SF
CONSULT
Audiology + Speech Pathology - Three-PACT CBOC In the Th ree-PACT CBOC Prototype, the Audiology component grows increases by an additional column grid bay in depth. Th e anticipated workload triggers the need for an additional audiometric suite for a total of three. Like the Two- PACT CBOC component, the program requirements are situated along a double loaded corridor. Shared spaces with other Ancillary Services Diagnostic Components include reception, waiting and patient toilets. A Group Th erapy Room is located within the Ancillary Services Diagnostic Module and is shared with adjacent departments.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Exam/Consult Room
• Audiometric Exam Suite
• Vestibulography Room
• Hearing Aid Programming/Fitting
• Patient Toilet
• Equipment Area
• Supervisor Offi ce
• Shared Spaces:
- Reception
- Waiting
- Group Th erapy Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.30
Equipment Figure 4.29
Component
Booth
Booth
Booth
ELECTRO
EQUIPMENT
FLEX
OFFICE
VESTIBULOGRAPHY
SECTION
CHIEF
HEARING
AID
TLT
EXAM /
CONSULT
PROC
TLT
EXERCISE
ROOM
S TLT
AUDIO
EXAM 3
AUDIO
EXAM 2
EXAM 4
EXAM 3
EXAM 5
TELEHEALTH
AUDIO
EXAM 1
EXAM /
CONSULT
EXAM /
CONSULT
EXAM 3
EXAM 2
EXAM 1
PRETEST 1
PROCEDURE
CONSULT
Booth
Booth
Booth
4.20
Eye Clinic: One-PACT CBOC Prototype
125 SF
EXAM
125 SF
EXAM
125 SF
PRE-TEST
190 SF
PHOTO
125 SF
VISUAL
FIELDS
65 SF
DILATION
Eye Clinic - One-PACT CBOC Prototype Th is component can be added to the One-PACT CBOC Prototype, if necessary to meet local programmatic needs should the workload support inclusion of an Eye Clinic. It is sized to fi t in a single structural bay of 31’-10” x 31’-10” along a double loaded patient corridor. Rooms are at the universal size of 125 SF to remain fl exible within the module for future use.
Key Spaces
• Exam Treatment Room
• Photography Room
• Pre-Testing Room
• Visual Fields Room
• Waiting Area (Dilation)
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.32
Equipment Figure 4.31
Component
VISUAL
FIELDS
PHOTO
DILATION
PRE-TEST
EXAM
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.21
Ancillary Services Diagnostic Components
Eye Clinic: Two-PACT CBOC Prototype
247 SF
AUDIO
EXAM 1
125 SF
EXAM/
CONSULT
125 SF
HEARING
AID
125 SF
EXAM 3
125 SF
EXAM 2
125 SF
EXAM 1
139 SF
DILATION
133 SF
PRE-TEST
129 SF
VISUAL
FIELDS
128 SF
EXAM 4
128 SF
EXAM 5
71 SF
P TLT
177 SF
LOW VISION /
BLIND REHAB
177 SF
PHOTO
71 SF
P TLT
67 SF
S TLT
76 SF
JAN
CLOSET
126 SF
TRAINING /
FLEX
125 SF
COMM
125 SF
ELEC
125 SF
STAFF
WELLNESS
125 SF
LOCKERS
253 SF
SHARED
STAFF
LOUNGE
356 SF
GROUP ROOM
126 SF
CONSULT
60 SF
TLT
711 SF
PMR GYM
729 SF
PHARMACY126 SF
SPECTACLE
Eye Clinic - Two-PACT CBOC Prototype Th e program requirements for a Two-PACT CBOC Eye Clinic are located along a double loaded corridor; one structural bay of 31’-10” x 31’-0” wide. Providers would have work stations in a directly adjacent Team Work Area. Th e Team Work Areas are shared with other providers and staff members within the Ancillary Services Diagnostic Module. Eye exam rooms are sized as universal rooms for maximum fl exibility.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Low Vision/Blind Rehabilitation
• Exam Room
• Spectacle (Fitting and Dispensing Room)
• Photography Room
• Pre-Testing Room
• Visual Fields Room
• Waiting Area (Dilation)
• Shared Spaces:
- Team Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.34
Equipment Figure 4.33
Component
AUDIO
EXAM 1
EXAM/
CONSULT
HEARING
AID EXAM 3
EXAM 2
EXAM 1
DILATION
PRE-TEST
VISUAL
FIELDS
EXAM 4
EXAM 5
P TLT
LOW VISION /
BLIND REHABPHOTO
P TLT
S TLT JAN
CLOSET
TRAINING /
FLEX COMM ELEC STAFF
WELLNESS LOCKERS
SHARED
STAFF
LOUNGE
GROUP ROOM
CONSULT
TLT
PMR GYM
PHARMACY
SPECTACLE
4.22
Eye Clinic: Three-PACT CBOC Prototype
125 SF
EXAM /
CONSULT
125 SF
EXAM /
CONSULT
247 SF
AUDIO
EXAM 1
247 SF
AUDIO
EXAM 1
130 SF
PRETEST 1
125 SF
EXAM 1
125 SF
EXAM 2
125 SF
EXAM 3
129 SF
SECTION
CHIEF
209 SF
VESTIBULOGRAPHY
125 SF
FLEX
OFFICE
127 SF
CONSULT
270 SF
CONFERENCE
125 SF
EQUIP
125 SF
ELEC
125 SF
COMM
130 SF
DENTISTRY
CONSULT
230 SF
LAB
96 SF
STORAGE
125 SF
DENTISTRY
MECH
125 SF
DTR
125 SF
DTR
129 SF
DTR
130 SF
FITTING &
DISP
125 SF
VISUAL
FIELDS 2
125 SF
EXAM 9
125 SF
EXAM 10
125 SF
BLIND
REHAB
203 SF
PHOTO
209 SF
LOW VISION
THERAPY
129 SF
CHIEF
OFFICE
125 SF
EXAM 8
125 SF
EXAM 7
125 SF
VISUAL
FIELDS 1
139 SF
DILATION
130 SF
PRETEST 2
125 SF
EXAM 4
125 SF
EXAM 5
125 SF
EXAM 6
507 SF
ANCILLARY
DIAGNOSTIC
SERVICES TEAM
WORK AREA
258 SF
MALE TLT
130 SF
FLEX
OFFICESHARED
MEDICAL APPT
ROOM121 SF
FLEX
OFFICE
126 SF
FLEX
OFFICE
31 SF
MED
ALCOVE
Eye Clinic - Three-PACT CBOC Th e program requirements for a Th ree-PACT CBOC Eye Clinic are situated along two double loaded patient corridors.
Like the Two-PACT CBOC, providers would have work stations in a directly adjacent Team Work Area. Th e Team Work Areas are shared with other providers and staff members within the Ancillary Services Diagnostic Module. Eye exam rooms are sized as universal rooms for maximum fl exibility.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Low Vision/Blind Rehabilitation
• Exam Room
• Fitting and Dispensing Room
• Offi ce, Blind Rehabilitation (VIST) Counselor
• Offi ce, Chief of Service
• Photography Room
• Pre-Testing Room
• Visual Fields Room
• Waiting Area (Dilation)
• Shared Spaces:
- Team Work Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.36
Equipment Figure 4.35
Component
Shared Shared
EXAM /
CONSULT
EXAM /
CONSULT
AUDIO
EXAM 1
AUDIO
EXAM 1 PRETEST 1
EXAM 1
EXAM 2
EXAM 3
SECTION
CHIEF
VESTIBULOGRAPHY
FLEX
OFFICE
CONSULT
CONFERENCE EQUIP ELEC COMM DENTISTRY
CONSULT
LAB
STORAGE
DENTISTRY
MECH
DTR
DTR
DTR
FITTING &
DISP
VISUAL
FIELDS 2
EXAM 9
EXAM 10
BLIND
REHAB
PHOTO
LOW VISION
THERAPY
CHIEF
OFFICE
EXAM 8
EXAM 7
VISUAL
FIELDS 1
DILATIONPRETEST 2
EXAM 4
EXAM 5
EXAM 6
ANCILLARY
DIAGNOSTIC
SERVICES TEAM
WORK AREA
MALE TLT FLEX
OFFICESHARED
MEDICAL APPT
ROOM
FLEX
OFFICE
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.23
Ancillary Services Diagnostic Components
General Mental Health: Two-PACT CBOC Prototype
335 SF
MH TEAM WORK AREA
65 SF
P TLT
125 SF
MENTAL
HEALTH 8
125 SF
MENTAL
HEALTH 7
125 SF
MENTAL
HEALTH 6
124 SF
NEURO
130 SF
MENTAL
HEALTH 1
125 SF
MENTAL
HEALTH 2
125 SF
MENTAL
HEALTH 3
125 SF
MENTAL
HEALTH 4
125 SF
MENTAL
HEALTH 5
152 SF
CONSULT 4
125 SF
CONSULT 3
125 SF
EXAM 1
125 SF
TELEHEALTH
EXAM
125 SF
TELEHEALTH
EXAM
125 SF
CONSULT 2
130 SF
CONSULT 1
FAMILY TLT
46 SF
STORAGE
PARTIAL HEIGHT WALLS
General Mental Health - Two-PACT CBOC Th is component is for a General Mental Health clinic, with consult rooms that are not provider-specifi c. Provider work stations are in a team work area, similar to the PACT Team Work Area. Th is component is to be adjacent to PACT modules for possible shared staff , support spaces and reception. Co-location with PACT supports integration of care for Veterans.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Biofeedback/Neuropsych
• Counseling Offi ce, Mental Health
• Team Room, Mental Health
• Shared Spaces:
- Patient Toilets
- Group Th erapy Room
- Storage Room
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.38
Equipment Figure 4.37
Component
CONSULT 4
CONSULT 3
EXAM 1
TELEHEALTH
EXAM
TELEHEALTH
EXAM
CONSULT 2
CONSULT 1
MENTAL
HEALTH 1
MENTAL
HEALTH 2
MENTAL
HEALTH 3
MENTAL
HEALTH 4
MENTAL
HEALTH 5 P TLT
MENTAL
HEALTH 8
MENTAL
HEALTH 7
MENTAL
HEALTH 6
NEURO
FAMILY TLT
STORAGE
MH TEAM WORK AREA
4.24
General Mental Health: Three-PACT CBOC
130 SF
NEUROPSYCH
125 SF
MENTAL
HEALTH 6
125 SF
MENTAL
HEALTH 5
125 SF
MENTAL
HEALTH 11
125 SF
MENTAL
HEALTH 10
125 SF
MENTAL
HEALTH 4
125 SF
MENTAL
HEALTH 3
125 SF
MENTAL
HEALTH 9
125 SF
MENTAL
HEALTH 8
125 SF
MENTAL
HEALTH 2
125 SF
MENTAL
HEALTH 7
130 SF
MENTAL
HEALTH 1
130 SF
CONSULT 1
125 SF
CONSULT 2
125 SF
TELEHEALTH
EXAM
125 SF
TELEHEALTH
EXAM
125 SF
CHIEF
OFFICE
125 SF
CONSULT 3
152 SF
CONSULT 4
125 SF
EXAM 1
GROUP ROOM
SHARED
MEDICAL APPT
ROOM
504 SF
MH TEAM
WORK AREA
NEUROPSYCH
MENTAL
HEALTH 6
MENTAL
HEALTH 5
MENTAL
HEALTH 11
MENTAL
HEALTH 10
MENTAL
HEALTH 4
MENTAL
HEALTH 3
MENTAL
HEALTH 9
MENTAL
HEALTH 8
MENTAL
HEALTH 2
MENTAL
HEALTH 7
MENTAL
HEALTH 1
CONSULT 1
CONSULT 2
TELEHEALTH
EXAM
TELEHEALTH
EXAM
CHIEF
OFFICE
CONSULT 3
CONSULT 4
EXAM 1
GROUP ROOM
SHARED
MEDICAL APPT
MH TEAM
WORK AREA
General Mental Health - Three-PACT CBOC Like the Two-PACT CBOC, this component is for a General Mental Health clinic, with consult rooms that are not provider-specifi c. Provider work stations are in a team work area, similar to the PACT Team Work Area. Th is component is to be adjacent to PACT modules for possible shared staff , support spaces and reception. Th is component is three structural bays in depth to accommodate the additional mental health rooms required at this scale.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Biofeedback/Neuropsych
• Offi ce, Chief
• Offi ce, Mental Health Provider/Coordinator
• Storage Room
• Team Room, Mental Health
• Shared Spaces:
- Patient Toilets
- Group Th erapy Rooms
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.40
Equipment Figure 4.39
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.25
Ancillary Services Diagnostic Components
Pathology + Lab: One-PACT CBOC Prototype
64 SF
SPEC.
TLT
81 SF
BLOOD
DRAW
81 SF
BLOOD
DRAW
60 SF
PAT. TLT
145 SF
LAB
134 SF
WOMEN'S
HEALTH 1 130 SF
CONSULT 1
125 SF
FLEX
75 SF
TLT
75 SF
TLT
COMMONS
Pathology + Lab - One-PACT CBOC Th e Pathology + Lab One-PACT CBOC component is located along the front public/private bar of the clinic for ease of entrance from both the public Commons area and PACT module. Its location along the front bar provides convenient patient access, especially for those patients visiting the CBOC for lab appointments only. Th ere is an open lab area and semi-private blood draw stations. Allowances have been made for bariatric patients and patients in wheelchairs. Th ere are two unisex patient toilets; one for specimen collection with the handwashing sink located outside the door, for drug testing situations; the other along the clinic corridor with a specimen pass-thru. A secondary entrance into the main lab space off the clinic corridor minimizes staff travel distances, providing quick access to fainting patients without having to exit the PACT module.
Refer to Section 2.5 - Typical Patient/Staff Flow for additional diagrams.
Key Spaces
• Blood Draw
• Lab
• Toilet, Specimen Collection
• Shared Spaces:
- Reception
- Public Toilets
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.42
Equipment Figure 4.41
Component
CONSULT 1
WOMEN'S
HEALTH 1
FLEX
TLT
TLT
BLOOD
DRAW
BLOOD
DRAW
SPEC.
TLT
LAB
PAT. TLT
4.26
Pathology + Lab: Two-PACT CBOC Prototype
Pathology + Lab - Two-PACT CBOC Th e Pathology + Lab Two-PACT CBOC component is located at the corner of the front public/private bar of the clinic for ease of entrance from both the public Commons area and PACT module. Its location along the front bar provides convenient patient access, especially for those patients visiting the clinic for lab appointments only. Th e lab is scaled from the One-PACT CBOC to meet the program requirements in a Two-PACT CBOC. Similarly, there is an open lab area and three semi-private blood draw and a larger, accessible, bariatric blood draw stations. Th ere are two unisex patient toilets; one for specimen collection with the handwashing sink located outside the door, for drug testing situations; the other within the lab itself. A secondary entrance into the main lab space off the clinic corridor minimizes staff travel distances for quick access to fainting patients without having to exit the PACT module. At this scale, the component also includes Bulk and Clean Storage directly off the main lab area.
Refer to Section 2.5 - Typical Patient/Staff Flow for additional diagrams.
Key Spaces
• Blood Draw
• Clinical Chemistry Lab
• Bulk Storage
• Toilet, Unisex
• Toilet, Specimen Collection
• Clean Storage
• Shared Spaces:
- Reception
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.44
Equipment Figure 4.43
Component
WOMEN'S
HEALTH 1 CONSULT 1
ADMIN
ADMIN
WORKROOM
RECEPT
CLEAN
BULK
STORAGE
BLOOD
DRAW 1
BLOOD
DRAW 2
BLOOD
DRAW 3
BD 4
BARIATRIC +
ACCESSIBLE
TLT
SPEC
TLT
LAB
MMONS
132 SF
WOMEN'S
HEALTH 1
133 SF
CONSULT 1
111 SF
ADMIN
97 SF
ADMIN
WORKROOM
223 SF
RECEPT
123 SF
LAB
55 SF
SPEC
TLT
49 SF
TLT
99 SF
CLEAN
158 SF
BULK
STORAGE
82 SF
BLOOD
DRAW 1
81 SF
BLOOD
DRAW 2
82 SF
BLOOD
DRAW 3
134 SF
BD 4
BARIATRIC +
ACCESSIBLE
61 SF
SHIPPING/
RECEIVING
OMMONS
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.27
Ancillary Services Diagnostic Components
Pathology + Lab: Three-PACT CBOC Prototype
97 SF
H&W
124 SF
FLEX
OFFICE
130 SF
FLEX
OFFICE
73 SF
PROCED. TLT
180 SF
PROCEDURE
99 SF
CLEAN
158 SF
BULK
STORAGE
79 SF
BLOOD
DRAW 1
78 SF
BLOOD
DRAW 2
79 SF
BLOOD
DRAW 3
79 SF
BLOOD
DRAW 4
118 SF
BLOOD
DRAW 5
69 SF
SPEC.
TLT
64 SF
TLT
427 SF
CLINICAL
CHEMISTRY
300 SF
GROUP 58 SF
STORAGECOMMONS
93 SF
SHIPPING/
RECEIVING
Pathology + Lab - Three-PACT CBOC Th e Pathology + Lab Th ree-PACT CBOC component is located along the front public/private bar of the clinic for ease of entrance from both the public Commons area and PACT module. Its location along the front bar provides convenient patient access, especially for those patients visiting the clinic for lab appointments only. Th e lab is scaled from the Two- PACT CBOC to meet the program requirements in a Th ree- PACT CBOC. Similarly, there is an open lab area, however, there are four semi-private blood draw and a larger, accessible, bariatric blood draw stations. Th ere are two unisex patient toilets; one for specimen collection with the handwashing sink located outside the door, for drug testing situations; the other within the lab itself. A secondary entrance into the main lab space off the clinic corridor minimizes staff travel distances for quick access to fainting patients without having to exit the PACT module. At this scale, the component also includes Bulk and Clean Storage directly off the main lab area.
Refer to Section 2.5 - Typical Patient/Staff Flow for additional diagrams.
Key Spaces
• Blood Draw
• Clinical Chemistry Lab
• Clean Storage
• Storage, Bulk
• Storage, Refrigerated (under counter)
• Toilet, Unisex
• Toilet, Specimen Collection
• Shared Spaces:
- Reception
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.46
Equipment Figure 4.45
H&W
OFFICE
FLEX
OFFICE
PROCED. TLT
PROCEDURE
CLEAN
BULK
STORAGE
BLOOD
DRAW 1
BLOOD
DRAW 2
BLOOD
DRAW 3
BLOOD
DRAW 4BLOOD
DRAW 5
SPEC.
TLTTLT CLINICAL
CHEMISTRY
GROUP
STORAGE
SHIPPING/
RECEIVING
4.28
Pharmacy: Two-PACT CBOC Prototype
COMMONS
114 SF
PROS
729 SF
165 SF
CONSULT
WINDOWS
133 SF
PHARMACY
CONSULT 126 SF
SPECTACLE
59 SF
S TLT
PHARM
DISPENSING
Pharmacy - Two-PACT CBOC Th e Pharmacy component is located along the Commons area, for direct patient access. Th ere are two drop-off windows that also function as consult windows. Each patient requires a consultation when beginning new medication. Th e Pharmacy Consult windows also have an entry way into a private Consult Room with a patient entrance off the commons area to be utilized if the patient prefers additional privacy.
Th e consult room is intended to be separate from the main pharmacy. Th ese two windows are outside the “secure” line.
Th e third window, within the main pharmacy, is dedicated for dispensing and is within the “secure” line with wall construction types to comply with security protocols. Th e Pharmacy itself is a large, open space and fl exible. At the time of specifi c CBOC design, the space should be layed out to target specifi c needs driven by the CBOC’s proximity of parent VA Medical Center. Th e layout should consider systems furniture for fl exibility through changing technologies and trends.
Refer to Section 2.5 - Typical Patient/Staff Flow for additional diagrams.
Key Spaces
• Dispensing
• Drug Receiving
• Filling and Assembly
• Offi ce, Pharmacist/Consultation Room
• Prescription Receiving
• Refrigeration
• Storage, Active
• Storage, Medical Supplies
• Shared Spaces:
- Toilet, Staff
- Waiting Area
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.48
Equipment Figure 4.47
Component
PROS
SPECTACLE
PHARMACY
CONSULT
COMMONS
59 SF
S TLT
CONSULT
WINDOWS
PHARM
DISPENSING
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.29
Ancillary Services Diagnostic Components
Pharmacy: Three-PACT CBOC Prototype
1979 SF
PHARMACY
148 SF
PHARMACY
CONSULT
283 SF
CONSULT WINDOWS
129 SF
PHARMACY
OFFICE
124 SF
PROS
130 SF
FLEX
OFFICE
379 SF
PROS FITTING /
STORAGE
64 SF
ST TLTPHARM
DISPENSING
Pharmacy - Three-PACT CBOC Like the Two-PACT component, the Pharmacy is to be placed along the Commons area, for direct patient access. Th ere are two drop-off windows that also function as consult windows.
Th e Pharmacy Consult windows also have an entry way into a private Consult Room with a patient entrance off the commons area to be utilized if the patient prefers additional privacy. Th e consult room is intended to be separate from the main pharmacy. Th ese two windows are outside the “secure” line. At this scale, two windows, within the main pharmacy, are dedicated for dispensing and are within the “secure” line with secure wall construction. A separate dedicated Pharmacist offi ce is provided adjacent to the Pharmacy Consult Window.
Th e Pharmacy itself is a large, open space and fl exible. At the time of design, the space should be layed out to target specifi c needs driven by the CBOCs proximity of parent VA Medical Center. Th e layout should consider systems furniture for fl exibility with changing technologies and trends. By locating the Pharmacy component at the edge of the building, there is future potential for a drive-through pharmacy window.
Refer to Section 2.5 - Typical Patient/Staff Flow for additional diagrams.
Key Spaces
• Dispensing
• Drug Receiving
• Drug Receiving, Breakdown and Verifi cation Area
• Filling and Assembly
• Offi ce, Pharmacist
• Offi ce, Consultation Room
• Prepackaging
• Prescription Receiving
• Refrigeration
• Storage, Active
• Storage, Controlled Substance/Secured
• Storage, Flammable
• Storage, Medical Supplies
• Shared Spaces:
- Toilet, Staff
- Waiting Area
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.50
Equipment Figure 4.49
Component
PHARMACY
PHARMACY
CONSULT
CONSULT WINDOWS
PHARMACY
OFFICE
PROS
FLEX
OFFICE
PROS FITTING /
STORAGE
ST TLTPHARM
DISPENSING
4.30
PMR + Prosthetics: Two-PACT CBOC Prototype
PMR STORAGE
711 SF
PMR GYM
121 SF
PMR
OFFICE
51 SF
DRESSING
60 SF
TLT
128 SF
EXAM 5
128 SF
EXAM 4
129 SF
VISUAL
FIELDS
133 SF
PRE-TEST
PMR GYM
PMR STORAGE TLT
DRESSING
PMR
OFFICE
EXAM 5EXAM 4VISUAL
FIELDS
PRE-TEST
PMR + Prosthetics - Two-PACT CBOC Physical Medicine and Rehabilitation has been combined with Prosthetics to support their co-location need. A large, open gym area is fl anked by support spaces and offi ces to allow each CBOC site to fi ll the space with the modalities needed for their population. Th e prototype equipment shows machine allotments along the glazing, a private treatment cubicle, and open space in the center of the gym for mat tables, parallel bars, or other equipment. A dressing room and patient toilet is also accessed from within the gym area. Th e component is placed along exterior walls whenever possible to allow for abundant natural light.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Dressing Room
• Offi ce
• Storage, Equipment
• Toilet, Patient
• Treatment Exercise Area
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.52
Equipment Figure 4.51
Final Submittal May 16, 2014 Planning Components + ModulesOffi ce of Construction & Facilities Management
Prototype for Standardized Design and Construction of Community Based Outpatient Clinics
4.31
Ancillary Services Diagnostic Components
PMR + Prosthetics: Three-PACT CBOC Prototype
69 SF
150 SF
X-RAY
129 SF
CLEAN
CART
133 SF
DTR
129 SF
DTR
128 SF
DTR
379 SF
PROS FITTING /
STORAGE
1979 SF
PHARMACY
914 SF
PMR GYM
155 SF
PMR
STORAGE
64 SF
DRESSING
63 SF
TLT
130 SF
PMR
OFFICE
121 SF
HBPC
STORAGE
96 SF
STORAGE
125 SF
DENTISTRY
MECH
125 SF
DTR
125 SF
DTR
129 SF
DTR
130 SF
FLEX
OFFICE
124 SF
PROS
129 SF
PHARMACY
OFFICE
230 SF
64 SF
ST TLT
PMR + Prosthetics - Three-PACT CBOC In the Th ree-PACT CBOC, Physical Medicine and Rehabilitation have also been combined with Prosthetics to support their co-location need. At this scale, Th e PMR Fitting and Storage have dual entrances off the patient corridors and are combined with an offi ce for the technician. Like the Two-PACT CBOC, a large, open gym area is fl anked by support spaces and offi ces to allow each CBOC site to fi ll the space with the modalities needed for their population.
Th e prototype equipment shows machine allotments along the glazing, a private treatment cubicle, and open space in the center of the gym for mat tables, parallel bars, or other equipment. A dressing room and patient toilet is also accessed within the gym area.
Refer to Section - 5 Proposed Prototype Layouts for additional information.
Key Spaces
• Dressing Room
• Offi ce
• Storage, Equipment
• Toilet, Patient
• Treatment Exercise Area
Refer to Section 3 - Prototype Program for Design, for specifi c programmatic requirements.
Figure 4.54
Equipment Figure 4.53
Component
DTR
DTR
X-RAY
CLEAN
CART
DTR
DTR
DTR
PROS FITTING /
STORAGE PHARMACY
PMR GYM
PMR
STORAGE
DRESSING
TLT
PMR
OFFICE
HBPC
STORAGESTORAGE
DENTISTRY
MECH
DTR
DTR
DTR
FLEX
OFFICE
PROS PHARMACY
ST TLT
4.32
Radiology: Two-PACT CBOC Prototype
Radiology - Two-PACT CBOC In a Two-PACT CBOC, the Radiology component is…
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