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Interpretive guide to the RACGP Standards

for Aboriginal community controlled health services

Standard 5.1 Facilities and access

Our practice provides a safe and effective environment for our practice team and patients.

Criterion 5.1.1

Practice facilities

Our practice facilities are appropriate for a safe and effective environment for patients and the practice team.

Indicators

► A. Our practice has at least one dedicated consulting/examination room for every member of our clinical team working in our practice at any time.

► B. Each of our consultation rooms (which may include an attached examination room/area):

  • is free from excessive noise
  • has adequate lighting
  • has an examination couch
  • is maintained at a comfortable ambient temperature
  • ensures patient privacy when the patient needs to undress for a clinical examination (eg. by the use of adequate curtains or screens and gowns or sheets).

► C. Our practice has a waiting area sufficient to accommodate the usual number of patients and other people who would be waiting at any given time.

► D. Our practice has toilets and hand cleaning facilities readily accessible for use by both patients and staff.

► E. Prescription pads, letterhead, administrative records and other official documents are accessible only to authorised persons.

► F. Our practice and office equipment is appropriate to its purpose.

► G. Our practice has one or more height adjustable beds.

H. Our practice waiting area caters for the specific needs of children.

Explanation

Key points

  • Practice facilities need to be safe for GPs, other practice staff and patients
  • Patients should have auditory and visual privacy (eg. by the use of curtains, screens, drapes or gowns)
  • Practices need to have one or more height adjustable beds
  • This criterion cross references to Criterion 5.1.3 Physical access.

Occupational health and safety

Health and safety requirements cover both consultation areas and all other areas of the practice. The practice facilities need to provide appropriate security for staff, patients and visitors.

Design and layout

The RACGP publication Rebirth of a clinic assists practices with the design and layout of practice facilities which are fit for purpose and address security needs. It is available at www.racgp.org.au/your-practice/business/design/architectural-design/.

Ideally, the practice layout should enable reception staff to see and monitor waiting patients to identify medical emergencies and reprioritise appointments as required.

While this criterion discusses consultation and examination ‘rooms’, it is acknowledged that some practices have consultation or examination ‘areas’ instead. Such consultation areas need to meet the same requirements for safety and appropriateness.

Ambient temperature

Consultation room temperature needs to be such that a patient undressed for an examination remains comfortable.

Privacy and patient dignity

The dignity of the patient should be protected by suitable visual and auditory privacy. Visual privacy can be afforded to patients during the clinical examination by the use of a gown or sheet and an adequate curtain or screen. This requirement includes situations in which there is a door opening to an area to which the public may have access and also when patients are required to undress/dress in the presence of the GP or practice nurse.

Location of toilets and hand cleaning facilities

Ideally, toilets should be located within the practice. Toilets not within the practice itself need to be within close proximity. Toilets need to be easily accessible and well signposted. Separate staff and patient toilets are desirable.

Washbasins need to be situated in close proximity to the toilets to minimise the possible spread of infection and need to be easily accessible to GPs, other staff and patients.

Height adjustable beds

The RACGP has been involved in ongoing discussions with consumer bodies, the disability sector and the Australian Human Rights Commission (AHRC) with respect to improving access to high quality general practice for people with a disability.

Height adjustable beds are especially necessary for patients with limited mobility and the College has therefore determined that each accredited practice must have one or more height adjustable beds.

Height adjustable beds may assist general practice teams to:

  • reduce the risks associated with patients getting on and off the examination couch, especially for people with impaired mobility
  • reduce the risk of misdiagnosis or nondetection of serious medical conditions through difficulty in conducting an examination if a patient is not able to be examined on a standard examination couch
  • reduce the risk of practice staff injuring themselves when examining patients or assisting patients on and off an examination couch
  • reduce risks associated with the practice’s legal responsibilities under the Disability Discrimination Act to ensure equal access for people with disability to the same range and quality of medical care as others.

Practices need to consider where a height adjustable bed may be best located. Many practices have told the RACGP that they have their height adjustable bed in a treatment room, rather than a consultation room.

The RACGP acknowledges that cost is a factor for some practices. The RACGP continues to advocate for infrastructure support for general practices in its representations to the Department of Health and Ageing.

Rebates for practice equipment that relates to occupational health and safety may be available through state and territory jurisdictions. Practices are advised to check jurisdictional WorkSafe websites for information on rebates that could apply.

In exceptional circumstances where the physical space of a practice is limited and a height adjustable bed cannot be accommodated, the practice needs to be able to demonstrate why it cannot accommodate a height adjustable bed, as well as how the practice safely manages examinations of patients with impaired mobility and protects the occupational health and safety of practice staff.

The disability sector has had experts review height adjustable beds available currently on the market to ensure they meet the needs of people with disabilities.

Services providing care outside normal opening hours

For services providing care outside normal opening hours that only provide visit based care, Indicators A, B, C, D, F, G and H are not applicable. However, all reasonable efforts should be made to protect the patient’s privacy during a consultation and these services need to refer to, and meet, the infection control criterion in these Standards (see Criterion 5.3.3 Healthcare associated infections).

While Indicator D is not applicable, services will need to ensure that effective hand cleaning (eg. with alcohol based hand rub) can occur when patients are seen outside the general practice.

Standard 5.1 Facilities and access

Our practice provides a safe and effective environment for our practice team and patients.

Overview of Standard 5.1

This Standard is about ensuring that the facilities at your health service meet OH&S requirements, and promote safety and security for your staff and patients. Your health service’s physical environment needs to enable staff to protect patient confidentiality and privacy. It is also about taking reasonable steps to assist patients with disabilities and special needs to physically access your health service.

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