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Start Up Urgent Care Centers- Phase II of IV
Phase II of IV
Looking at the picture to the side of this article, you can visualize the steps and the ramifications of certain items being present or NOT in the location you have chosen for your urgent care center. Below, the descriptions and the advantages/disadvantages of each of these:
Is the location at street level, or does it require you take stairs or elevator to access the front entrance? It is way better that it be street level in that the regulations are lesser strict for the street level access. But, if it is on the second floor or above, then these are the things you must be aware of for the space chosen. First, are there stairs to gain access?
There must be stairs to gain access regardless if there is an elevator or not. Elevators are only compliant so long as the stairs are present, and with that the elevators must be the size to accommodate the type of gurney that the EMS uses, which are the types that the head raises up and forms more of a chair effect. The sq ft is usually the size of around 66 sq ft. to safely accomodate the unit, the paramedics, and family member. Any number of floors greater than two that has only the stairs is not compliant in that you cannot expect an illing patient to safely walk down more than two flights of stairs in the event of an emergency.
Next, there is the lobby of the space. Is your lobby large enough to house the capacity of your patient allocation in rooms and treatment rooms. For example, if your your exam rooms and treatment rooms are in total number of 15, then the number of chairs in the lobby should equal that number or more. The theory is that behind every patient, there is an adult that will be with them since they are ill. More is better, but at a minimum, the 15 will allow for you to become certified/accredited as an Urgent Care Center.
Restroom accessibility- is there a separate or unisex restroom available to the guests of the lobby without the need to walk through the clinical area of your center? It is ok that you use the restroom area of the common space outside the doors of your center if and only if the location of the common area restrooms is no more than 200 feet away from your front door. The requirement is that you make one available to them, under lock and key to gain access if fine, so long as they can gain access to it quickly and without the need to walk through the clinical space of your center.
Is the restroom that is made available to them, it is ADA compliant? To meet ADA compliancy, one has to ensure that the space can fit the normal size wheelchair and that any exposed pipes to the hot and cold water inlets, they must be covered by the non-temperatured coverings that can be obtained from your local hardware store. There must be an emergency pull up bar that is located next to the commode and ideally, there should be a pull tab that enable staff to be called should there be a true emergency. These pull tabs can be expensive and there are shortcuts to spending thousands of dollars for this requirement.
For centers that are located on the second floor or above, there must be a sprinkler system installed for the use in the case of a fire. Street level centers, they do not have to have the sprinklers if not already installed. However, the second floor and above, they must house the sprinkler system and there must be a direct alarm system that is connected to the local fires station, should there be an actual fire.
The walls in the center should already have or are able to be customized to contain lead in the walls should you plan on having any radiography type of services. I cannot imagine an urgent care center without this service, and with that, you must be able to protect the lives of the patients and folks outside the room that has the radiography being used. The only exception to this requirement is the use of fluoroscope. Fluoroscope has mild to non-measurable amounts of isotopes in the fluoro and thus, the lead walls are not necessary in most states. Be sure to check with your state to rule out the need for this requirement if you plan to use only fluoro in your services to your patients.
This concludes the second of four phases to urgent care start up and urgent care accreditation. Be sure to look for the third phase around the week of 12/8/2012.