Clinic / Health Unit

by the National Institute of Building Sciences

Updated:
03-20-2018
OVERVIEW
WITHIN THIS PAGE
 Overview
 Space Attributes
 Relevant Codes and Standards
 Additional Resources

The Clinic/Health Unit space types are facilities where outpatient ambulatory health services
are provided. Support and sub-space types, such as office spaces, private toilets, and filing
and storage areas are included.
This space type does not include provisions for invasive surgery, in-patient services,
medical diagnostic categories I, II, and III equipment (including exam lights and medical gas
systems), radiological diagnostic services (including special structural elements and
radiation shielding on ceiling and floor areas), darkroom revolving door systems, or medical
laboratory spaces. Clinics where general anesthesia, invasive procedures, or overnight care
are provided require Institutional Occupancy construction types and are not included.
See Health Care, Hospital, Nursing Home, Outpatient Clinic, and Psychiatric Facility for
more information about inpatient and specialized care facilities.
Clinic /health unit space designs are as varied as the people and communities they serve.

SPACE ATTRIBUTES
The Clinic/Health Unit space type should provide a sanitary and therapeutic environment in
which patients can be treated by medical practitioners quickly and effectively. A clinic's size
and configuration are determined by its specialization and location. The clinic/health unit
space type can be configured into a number of different types of modules to accommodate
many approaches to clinic/health unit design. There is however, a trend toward more
collaborative health care, which requires nurses' stations and physicians' offices to be close
to each other (or eliminate private offices altogether) to provide shared work areas and
more opportunities for communication. A clinic/health unit setting is intended to also serve
as a healing environment. So there is also a trend to designing less clinical-looking spaces,
and introducing more of a personal or homey feeling in individual patient rooms and
admitting areas. Access to nature and the colors of nature also support healing. So design
the space holistically by incorporating the colors or scenes of nature when views to nature
are not available or possible.
Typical features of clinic/health unit space types include the list of applicable design
objectives elements as outlined below. For a complete list and definitions of the design
objectives within the context of whole building design, click on the titles below.
An efficient clinic design may include medical assistant stations with accessible storage and plenty of
workspace. Community Health Care clinic in Lakewood in Washington.
Photo courtesy of Johnson Architecture & Planning

Accessible
 All areas should comply with the minimum requirements of the Americans with
Disabilities Act (ADA) and, if federally funded or owned, with the GSA's ABA
Accessibility Standards. For more information, see WBDG Accessible
Branch and Provide Accessibility for Historic Buildings (historic facilities).
 Clinic/health unit space must be easy to use by patients with temporary or
permanent disabilities.
 Consider patients with hearing loss or vision impairments, as well as physical
disabilities.
 Use mechanical door openers to assist in entering and leaving the facility.

Aesthetics
Aesthetics are important to the clinic's public image and visibility within the
community as well as the connection to healing and the patient experience.
Aesthetic considerations include:
o Increased use of natural light, natural materials, and textures.
o Use of artwork, including nature scenes when views or access to nature are
unavailable.
o Attention to detail, proportions, color, lighting, and scale.
o Bright, open, generously scaled public spaces.
o Homelike and intimate scale in patient rooms and offices.
o Signage that promotes optimal way-finding, satisfies the orientation needs of
the first-time patient, allows easy navigation, and provides highly visible
reference points immediately adjacent to each major entrance.

Functional / Operational
o Cleanliness and Sanitation: The cleanliness of a facility is not only related
to a patient's medical recovery, but can also affect the perceived level of care.
 To maintain a sanitary environment, spaces should be easy to clean and
maintain. Use durable finishes and sterile/antimicrobial surfaces as
necessary. For more information, see WBDG Therapeutic Environments.
o Comfort: Provide space that is comfortable and inviting for family members
to congregate and visit without feeling they are in the way.
o Occupancy: The occupancy classification for the Clinic/Health Unit space
type is Business Occupancy B2, with sprinklered protected construction and
GSA Acoustical Class C2.
o Flexibility: Plan for flexibility and future expansion and/or modifications to the
design.

Productive
o Efficiency and Flexibility: The layout of the Clinic/Health Unit should
promote prompt and reliable medical attention. Relationship and flow
diagrams created at the beginning of the design process will ensure a
sensible programming of space. Office support spaces such as workrooms,
file rooms, copier areas, coat storage, and lockers typically will be integrated
into the clinic environment. Flexibility must also be a basic feature of
any health care facility to keep it from rapid obsolescence in the face
of changing needs and technologies.
o Acoustic and Visual Privacy: The new HIPAA (Health Insurance Portability
and Accessibility Act) regulations address the security and privacy of
"protected health information" (PHI). These regulations put new emphasis on
acoustic and visual privacy, and may affect location and layout of
workstations that handle medical records and other patient information-both
paper and electronic-as well as patient accommodations. Flow diagrams
created in the beginning of the design process should address controlled
access areas.

Secure / Safe
o Emergency Backup Systems: Typically, this space type will require
emergency battery backup for 25% of lighting. Refer to individual utility
requirements for specific medical equipment.
o Fire Protection and Life Safety measures need to be addressed and
incorporated into the design as per local or state codes and specific
requirements of the clinic/health unit.
o Furniture should be washable and fire-retardant. To prevent falls, choose
carpeting that contrasts with the color of the clinic's reception furniture.
o Scale and Separation: When designing clinics for children, incorporate child-
sized seating and tables into reception area/check-in room. Allow a separate
seating area for children who are ill and contagious to prevent spreading
illness.

Sustainable
 o Use healthy indoor materials that do not off-gas and that meet no- or Low-
VOC requirements while also meeting hygienic and anti-microbial
requirements.
o Provide ample natural daylighting and views and access to nature wherever
possible.
o Consider the use of renewable energy sources to power the building or
spaces and integrate energy efficient equipment into the facility.
o Provide healthy indoor air quality.
o Consider the use of modular construction when renovating or remodeling to
reduce construction dust, debris, and waste. Some modular walls can be
customized without undermining hygienic requirements. Thoughtfully-
designed and aesthetically-pleasing interiors are not only good for patients
and their families; they improve the well-being of nursing staff as well.

The interiors of the VA Health Care Center in Butler, Pennsylvania. LEED points were earned for
sustainably sourced materials and products as well as thermal comfort and low-emitting materials. The
project earned LEED Silver. For more information on this project see the project overview.

Example Program
The following building program is representative of Clinic/Health Unit spaces.

HEALTH UNIT
DESCRIPTION SUM TENANT
TENANT OCCUPIABLE SF SPACE ACTUAL USABLE TENANT
AREAS QTY. EACH REQ'D. SF FACTOR USF

Entry Lobby 240

Waiting 1 120 120

Reception/Registration 1 60 60

Payee Window 1 60 60

General Patient Care 684

Physician Office/Consult 1 120 120

Exam Room 3 108 324

Nurse Work Area 1 40 40

Patient Toilets 1 60 60
DESCRIPTION SUM TENANT
TENANT OCCUPIABLE SF SPACE ACTUAL USABLE TENANT
AREAS QTY. EACH REQ'D. SF FACTOR USF

Clean/Supply Room 1 60 60

Medications Storage 1 20 20

Soiled Utility Room 1 60 60

Medical Records 60

Medical Records Files 1 60 60

Staff Support Spaces 216

Staff Toilet (Male) 1 60 60

Staff Toilet (Female) 1 60 60

Staff Break Room 1 60 60

DESCRIPTION SUM TENANT
TENANT OCCUPIABLE SF SPACE ACTUAL USABLE TENANT
AREAS QTY. EACH REQ'D. SF FACTOR USF

Housekeeping 1 36 36

Tenant Suite 1,200 1,200 1.53 1,840

Tenant Usable Areas 1,840

Example Plans
The following diagram is representative of typical tenant plans.
Example Construction Criteria
For GSA, the unit costs for the Clinic/Health Unit space type are based on the
construction quality and design features in the following table . This information is
based on GSA's benchmark interpretation and could be different for other owners.

RELEVANT CODES AND STANDARDS

The following agencies and organizations have developed codes and standards
affecting the design of health facilities, including clinics. Note that the codes and
standards are minimum requirements. Architects, engineers, and consultants should
consider exceeding the applicable requirements whenever possible:

o Americans with Disabilities Act

o Guidelines for the Design and Construction of Health Care Facilities by the
Facility Guidelines Institute, 2010.
o GSA's ABA Accessibility Standards
o GSA PBS-P100 Facilities Standards for the Public Buildings Service
o ICC IBC International Building Code
o Department of Veterans Affairs (VA): Office of Construction and Facilities
Management Technical Information Library contains many guides and
standards, including: Design Guides for planning hospital based ambulatory
care clinics, community based outpatient clinics, satellite outpatient clinics,
 and ambulatory surgery clinics. This information library also includes Design
Manuals of technical requirements, equipment lists, master specifications,
room finishes, space planning criteria, and standard details.

ADDITIONAL RESOURCES
WBDG
BUILDING TYPES
Community Services, Youth Centers, Educational Facilities, Child Development
Centers, Training Facility, Health Care Facilities, Office Building, Research Facilities

DESIGN OBJECTIVES
Accessible, Aesthetics—Engage the Integrated Design Process, Cost-
Effective, Functional / Operational, Productive, Secure / Safe, Sustainable

GUIDES & SPECIFICATIONS

Building Envelope Design Guide

PROJECT MANAGEMENT
Project Planning, Delivery and Controls

BUILDING COMMISSIONING
Building Commissioning

Others
o Building Research Information Knowledgebase (BRIK) Healthcare Facilities—
an interactive portal offering online access to peer-reviewed research projects
and case studies in all facets of building, from predesign, design, and
construction through occupancy and reuse.
o USGBC Leadership in Energy and Environmental Design (LEED) for
Healthcare