SEATING

In general, the layout of a consulting room should provide sufficient space to accommodate all equipment as well as several chairs for patients, as there will be times when three or more members of a family attend a session. If space allows, you may want to provide your patients with the choice of sitting opposite you or at the side of the desk. Some patients prefer physical proximity to the doctor without a barrier, whereas others like to know there is a desk between them.

SPACE

You should be able to move freely around the room and have space at the head end of the bed (about 60 cm) to examine the patient and conduct procedural work around the head and face with the patient lying down. There should be sufficient room at the foot of the bed (about 60 cm) to allow you to stand and bend to examine the feet, even with tall patients.

COMPUTER

The computer should be situated so that it does not obstruct your view of the patient’s face, but also so that you do not have to turn your back to the patient to make notes. The workstation (adjustable chair, seat height, level of keyboard and monitor) should be ergonomically designed to accommodate many hours of sitting, as well as unimpeded access to the other side of the desk and to the examination bed.

FLOOR

The flooring should be made of a washable material, preferably hospital-grade welded vinyl or its equivalent.

LIGHTING

Lighting should provide ‘white light’ and be portable so that it can be used to examine patients either on the examination bed or in their chair.

SINK

The sink should be supplied with hot and cold water and have a handle that can be operated without touching it with the hands. Antiseptic hand wash in a pump pack should be on the sink. A dispenser for disposable hand towels should be mounted on the wall adjacent to the sink.

PRIVACY

The door should be sound-proofed for privacy and there should be a privacy latch on the inside, to prevent unwanted entry. A privacy curtain should surround the bed, allowing enough space for the patient to stand behind it in order to dress and undress and ensuring that the bed cannot be viewed from outside the room if the door is opened.

STORAGE

You will need sufficient storage space for consumables. This improves efficiency by cutting down on time wasted going to a common storage area. Staff members should be assigned to check and replenish supplies daily, and check expiry dates regularly.

UNIFORMITY

If several practitioners are sharing space or working in different consulting rooms, uniformity of layout and equipment will be important for efficiency.

EQUIPMENT

An efficient general practice requires baseline equipment to facilitate emergency and procedural treatments. Specialised equipment will be determined by the individual practitioner’s style of practice. Box 15.1 gives a list of basic equipment.

EMERGENCY AND RESUSCITATION TROLLEY

This should be located centrally in the practice so it can be accessed at any time by any doctor and/or the practice’s registered nurse. Your choice of emergency trolley drugs and equipment will depend on the types of clinical conditions you are likely to encounter and your proximity to tertiary emergency services, so it is important that you customise it according to your practice’s needs.

DOCTOR’S BAG

The contents of your doctor’s bag (Box 15.2) should allow you to perform a basic patient examination outside the consulting room setting. Clearly, it will not be possible to carry everything you might need in one carrying case, so the bag needs to be planned and maintained to take into account the most likely clinical situations in which you might be called upon to do a house call or out-of-rooms visit.

The bag should be lightweight and waterproof, and contain layered shelves for easy access.

You should check the contents of your bag routinely. It should be restocked after each use, and all use-by dates checked about once a month.