should be checked. In 1991, the

your tenant improvements to re-

Objectives for the patients

inforce the existing structure of

Americans with Disabilities Act

should be that the entry

the building. This should be as-

was passed and the design impli-

be very obvious. The patient flow

sessed so the file room can be

through the facility should be di-

cations of that act are still being

properly located or proper struc-

rect and not through a maze of

studied. However, it is prudent to

tural alterations made.

hallways. Specific spaces, such as

design your space so it is acces-

When all these disparate ele-

a gallery, can be used to help pa-

sible to disabled patients as well

ments are brought together into

tients orient themselves to the

as disabled staff and physicians.

one integrated whole, the practice

major flow system for the office.

Another item for consideration is

ends up with an effective and ef-

For patients to feel that they are

floor loads on upper stories of

ficient office that has been created

in a human environment, the staff

office buildings. Certain pieces of

through a systematic process.

work spaces should be positioned

equipment, such as a laser, and

so the patients can see staff doing

certain systems, such as chart

Richard C.

is president of

their normal work activities as

files, can be extremely heavy.

Medical Design International, Atlanta,

they circulate through the facility.

These can sometimes exceed the

Georgia; Thomas C. Quirk is adminis-

In the design of office space

design floor loads for the building.

trator of

Eye Institute,

Chi-

some  special  considerations

It may be necessary as part of

cago.