A hospital’s admissions unit is the first point of contact for patients and their families, setting the tone for their entire healthcare journey. A well-designed admissions unit is not just about aesthetics—it plays a crucial role in ensuring smooth operations, patient satisfaction, and overall efficiency.
The purpose of the Admissions Unit is the admission of patients, interview of patients as required and completion of the necessary documentation.
The Admissions Unit will perform the following functions:
- Patient pre-registration prior to admission
- Patient admissions
- Patient discharge planning
- Handling of patient transfers from other facilities
- Demand Management
- Management of medical records for admission purposes
- Collection of financial information for the Finance section
These optional services may be considered:
- Making appointments of patient for admission
- Cashier (alternatively, a centralised Cashier for the entire facility may be located near the Admission Unit)
- Allocation of beds (or there may be a dedicated Bed Manager located elsewhere)
Other clinical functions required during assessment phase which may be located in a separate Pre-admission Clinic include:
- Collection of patient information (eg. clinical condition and medical history)
- Processing of all relevant paperwork relating to admissions
- Providing referrals for diagnostic consultations (eg. X-ray, blood test, ECG)
- Providing referrals to anaesthetist, allied health professionals where necessary
- Providing education to patients regarding the anticipated clinical pathway
The range of facilities provided for Admissions will vary depending on the size of the proposed facility and the range of services prescribed in the Operational Policy. Admissions functions may also be accommodated in the Main Reception area.
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1) Planning of admission unit
Proper planning of the admission unit in a healthcare facility is essential for efficiency, workflow optimization, and patient satisfaction.
i) Operational Models
There are two types of admission to a healthcare facility:
- Planned patients who have made pre-bookings at the facility
- Unplanned patients who usually require immediate care at the Emergency Unit.
Planned admissions can be either multiday inpatients or day-only patients. Unplanned admissions (after-hours emergency care) are commonly handled by the Emergency Unit directly.
Currently, the provision of a Pre-admissions Clinic is becoming common in many health facilities. This can streamline the admission process for all pre-booked admissions where clinical pre-assessment is required. This shall be designed as an outpatient service.
ii) Planning Models
The Admission Unit may be a stand-alone Unit or co-located with the Main Reception area near the Hospital entrance.
Where Pre-admission Clinics are provided, they shall be located in the Unit where the procedure will occur. An alternate option is to co-locate this unit with other outpatient services.
There shall always be close access to public amenities and waiting areas.
Admissions unit
The size of the Admissions Unit can vary greatly depending on its location, the size of the facility, and operational policies. It is possible to combine counters, offices, cubicles and workstations in an open-plan environment to interact with clients. However, privacy (acoustic and visual) is the major concern to be considered when designing the Unit.
The front counter area (reception area) shall have an area behind to organise and complete paperwork. This area will require easy access to printer, fax (if applicable), photocopy, record storage and stationery storage.
Workstations and offices for staff shall be located in close proximity but separated from the front counter. Private and enclosed interview rooms shall be provided to conduct confidential interviews with clients. Space within interview rooms shall be adequate to accommodate patients with different levels of mobility.
Pre-Admission Clinic
Pre-admission Clinics when provided will vary in size and configuration. It can range from a small clinic with a few consulting and interview rooms to a much larger clinic to perform examinations of patients by clinical staff.
In all occasions, they shall have access to other diagnostic testing units. Access to Allied Health service will be required in larger facilities. A reception area for initial patient consultation and separate waiting areas must be provided.
iii) Functional Areas
Functional areas in Admissions Units shall include:
- Reception area
- Interview rooms for patient admissions and interviews; interview areas shall allow for private discussions
- Patient waiting areas
- Public Amenities (may be located in adjoining areas)
- Staff and support areas (offices and amenities)
- Cashier (may be located elsewhere)
Functional areas in Pre-admissions Clinics shall include:
- Reception area
- Patient waiting areas
- Interview/ Consult rooms for private patient interviews
- Consult rooms for patient assessment and examination
- Staff and support areas (utilities, store rooms, offices and amenities)
- Public Amenities (may be located in adjoining areas)
Patient Waiting Area
Waiting areas for patients shall be provided and sized accordingly to the expected number of patients on a daily basis. There shall be sufficient space for wheelchairs, prams, trolleys etc.
A separate waiting for families including a play space for children may also be appropriate. Facilities to display reading materials, information pamphlets, and entertainment system (TV, speakers for music) shall be provided.
Patient interview / Cubicle rooms
Configuration and design of Interview Rooms shall provide a high level of visibility from outside without compromising privacy. The rooms will require acoustic privacy, for confidential discussion between staff and patients.
Cashier
A Cashier may be incorporated within the Admission Unit if required by the operational policy.
If such is provided, the following factors shall be considered carefully during planning stage:
- Accessibility during normal business hours and after-hours
- Safety provisions for Staff
- Secured storage where money is handled.
iv) Functional Relationships
External
Admissions Unit shall ideally be located adjacent to the Main Reception area with close access to public amenities and waiting areas.
The Pre-admissions Clinic, where provided, may be located in the Ambulatory Care Unit or other Units where procedures will be performed such as Day Surgery Unit, Peri-operative Unit etc.
Pre-Admissions will require readily available access to Diagnostic Units including Pathology, Medical Imaging and Pharmacy.
Internal
Decentralised admission areas and pre-admission areas shall be configured to be clear and prominent for easy way-finding by patients and visitors.
If the Cashier is to be located with an Admissions Unit, access to security is recommended. The Pre-Admission clinic Reception area must be designed in an efficient way to permit easy circulation to and from consultation areas for patients.
Staff areas shall be sized accordingly and provide sufficient level of both visual and acoustic privacy.
3) Design of admission unit
Admissions Unit and Pre-admission Clinic shall be located with easy access to a vehicle drop off zone. The Admissions Unit and Pre-admission Clinic shall be designed to accommodate all types of patients including elderly, wheelchair-bound, patients using mobility aids, and children.
i) Environmental Considerations
Natural light
Natural light is recommended in the Admissions Unit but not essential. Presence of natural light can promote a pleasant environment for patients, visitors and staff.
Privacy
Careful consideration of privacy and patient comfort is required to reduce discomfort and stress for patients. Provision of private interview rooms to conduct confidential discussions between patients and staff shall be considered.
Location of the Unit within the Facility and workstations within the Unit shall be placed away from public corridors and thoroughfares to ensure privacy.
Acoustics
In area where confidential patient information is shared, acoustic privacy must be maximised. If Admissions Unit is collocated at the Main Reception, the interior design of these areas shall include measures to control ambient noise.
In the Admissions area, provision of an augmented hearing loop for patients and visitors with hearing impairment may be considered.
ii) Space Standards and Components
The Admissions Unit shall be appropriately sized to give a sense of space and avoid congestion. This is especially important in the waiting areas.
Ergonomics
Design and dimensions of counters and workstations shall ensure privacy and security for patients, visitors and staff.
Counter heights should be made identical for both patients/ visitors and staff to enhance communication and minimise aggressive behaviour.
Seating in waiting areas shall be provided at a range of heights to cater for the different mobility levels of patients.
iii) Safety and Security
A sympathetic, pleasant, and friendly environment can be created with the appropriate type of security measures included in a facility. A risk assessment relating to security aspects shall be carried out in consultation with staff during the design stage.
The following factors shall be taken into consideration:
- demographic population
- capacity, location and type of the facility
- availability of security staff
- responsive timing of the security unit
- expected impact of incidents and their severity.
The following security issues shall be addressed when designing the Admission Unit:
- counters shall be designed in such a way to enable unobstructed vision to waiting areas
- duress alarm and access to egress points must be provided at reception counters
- waiting areas shall have no visibility to the staff and/or cashier area behind the counter
- controlled after-hours access to prevent unauthorised entry and theft
- provision of CCTV to monitor movement and behaviour within the Unit
- provide training to staff on procedures to follow during an armed hold-up
If a Cashier is provided within the Admissions Unit, the following shall also be considered:
- security glazing shall be provided at the Cashier’s counter; an after-hours chute may be required
- a fire proof safe shall be located within the Cashier area and sufficient in size to hold adequate cash; it shall be concealed visually from patients, visitors and others.
If Admissions Unit is located on the perimeter of the building, all external doors must be locked (preferably electronically) after hours and alarms installed which are linked to the Security unit.
For the Pre-admission Clinic, the following security issues shall be integrated in the design:
- duress alarms and emergency egress point shall be provided as required
- design shall permit entry and exit points from the Unit to have controlled access
- secured control for after-hours access
- restricted access from the waiting area to the rest of the Unit for patients and visitors
- Design shall maximise observation of waiting area for staff.
iv) Finishes
Selection of materials in the Unit shall ensure durability particularly for heavy pedestrian utilisation.
v) Fixtures and Fittings
If the Cashier is located within the Admissions Unit, then an appropriate barrier shall be provided to the Cashier’s counter.
Depth of counters is recommended to be between 900mm to 1200mm and not exceeding 1400mm. The counter height shall be suitable for standing interactions at 850mm (+/- 20mm); high stools may be provided for staff.
If a seated position is required, there shall be a section to be reduced to 720mm, with standard height chairs for staff and patients.
vi) Building Service Requirements
The following IT/ Communications systems shall be provided within an Admission Unit or Pre admission Clinic:
- voice and data points for telephones and computers/ internet
- data provision for electronic medical records and patient management systems as required (optional)
- duress alarm system (in reception area, patient treatment areas, interview rooms etc.)
- access to a PACS system (if applicable in the Pre-admission Clinic only)
Emergency call facility for staff and patient shall be installed in all clinical areas such as patient toilets and bathrooms.
vii) Infection Control
Precautions shall be taken while handling body fluids of patients during the pre-admission process as the infection status may be unknown. Personal protective equipment, sharps containers, clinical waste spill kits must be provided. Training in first-aid and injury management procedures must be provided to staff for body substance exposure and sharps
injuries.
Hand washing facilities for staff must be readily available. Disposable paper towels must always be provided at hand washing facilities.
In terms of Waste Management, common clinical waste management shall be provided within the Pre-admission Clinic. Provision of sharps containers shall be in compliance to the Hospital’s Infection Control Policy.
4) Components of the Unit
The Admission Unit will contain a combination of Standard Components and Non-Standard Components.
i) Non Standard Components
Interview Cubicle
Description and Function – An Interview Cubicle may be provided for private and confidential discussion with patients, as an open space, visually separated from adjacent spaces.
Location and Relationships – Interview cubicles may be provided as part of the Reception counter or in a separate area easily accessible to patients and staff.
Considerations – Privacy is a major consideration particularly acoustic privacy; partitions between cubicles should reduce sound transmission to adjacent spaces. Access will be required for patients in wheelchairs.
5) Schedule of Accommodation
Admissions Unit Generic Schedule Of Accommodation
Note 1:
Waiting areas may be shared with Main Reception in smaller Health Facilities. Actual size will be determined by the size of the unit and the projected number of people waiting at any one time. Allow 1.5 m2 per person/chair.
Note 2:
For anaesthetists, nurse specialists and allied health professionals. Number is dependent on size of the clinic. If ECGs are to be performed in the consult rooms, then the rooms will require space for equipment to be stored and used.
Please note the following:
- Areas noted in Schedules of Accommodation take precedence over all other areas noted in the FPU.
- Rooms indicated in the schedule reflect the typical arrangement according to the Role Delineation.
- Exact requirements for room quantities and sizes will reflect Key Planning Units identified in the service plan and the policies of the Unit.
- Room sizes indicated should be viewed as a minimum requirement; variations are acceptable to reflect the needs of individual Unit.
- Office areas are to be provided according to the Unit role delineation and staffing establishment.
6) Functional Relationship Diagram
The typical Functional Relationship Diagram for the Admission Unit is shown below.
7) Conclusion
The admissions unit is the backbone of a hospital’s operational efficiency. From seamless patient registration to efficient triage and financial processing, every aspect must be designed for speed, accuracy, and patient comfort. Advanced technology, digital record-keeping, and interdepartmental coordination further enhance the effectiveness of the admissions unit, ensuring better healthcare delivery.