The physical layout of general practices has generally been overlooked in research on safety in the health system. This article provides an overview of the evidence that is available on physical design, and the implications of this research for general practice.
Case study 1
When the receptionist in the practice raised concerns about the rudeness and agitation of some patients who were waiting to see their doctor, Dr Ofili decided to put a television into the waiting room. She had heard that a distraction could reduce the perceived waiting time for patients. She was surprised that the problems got worse, and wondered why.
Case study 2
When Dr Johnson built an extension to his clinic, he decided to build a meeting room in which he could fit all his staff. Over the following 6 months, he noticed that, apart from the monthly meeting for the whole team, it was used only occasionally and then only by a small group. He wondered whether he had made a sound decision by including it.
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