Accessibility, or making facilities and equipment available to all users, is a major consideration when creating the health care environment. The Americans with Disabilities Act (ADA) was passed by the United States Congress in 1990. The purpose of this act is to provide a clear and comprehensive national mandate to end discrimination against individuals with disabilities and to bring them into the economic and social mainstream of life. In addition to accessibility regulations, this act also provides employment protection for persons with disabilities. ADA applies to businesses with fifteen or more employees; however, some states may have stricter legislation. Even before ADA became legislation, most health care facilities attempted to make their premises barrier-free and accessible to patients with special needs. While many ambulatory care settings will have less than fifteen employees, accessibility for all patients in all settings is very important.
A professional designer can provide advice on how the facility must be accessible to persons who are physically challenged. For example, all doors and hallways must accommodate a wheelchair. There must be a bathroom facility available for handicapped individuals. Signage in Braille accommodates patients with visual disabilities. Elevators must be provided if the facility is on more than one level. Be alert also, to patients whose impairment is not obviousindividuals with impaired hearing or vision and individuals whose infirmity (temporary or permanent) may prevent them from doing certain physical activities.
The receptionist is the person on the health care team who must always keep a positive ''We can help you" attitude, have a smile for each patient, and a genuine "I care about you" personality. This individual, who often is a medical assistant with other duties as well, must be able to perform telephone triage, retrieve records, greet patients, present a bill, make appointments, and log data into the computer all the while remembering that the patient's comfort is of primary concern. The receptionist must genuinely like people and not be upset when they are grumpy, irritable, or depressed and worried about an illness.
The receptionist is the person who sets the social climate for the interchange between the patient and the physician and the rest of the staff. Patients who are very ill should not have to wait in the reception area, but should be shown to an examination room away from other patients. The receptionist or medical assistant may also have to entertain children who may be intent on disrupting patients. This is especially necessary if the parent seems unconcerned about keeping youngsters under control. If there are unexpected delays in the physician's schedule, be certain to notify patients of the delay tactfully and graciously and offer them the alternative of making other arrangements. Keep in mind that the patient's time is as valuable as the physician's.