Access & Arrival
Access & Arrival
MANDATORY
4 criteria
| Standard 1.1 NON-NEGOTIABLE · Standard 1: Access & Arrival Findable Before Arrival |
ASSESSMENT ASF-AMB-STD1-v3.0 |
| CR FULL | TR FULL | SM FULL | ST FULL |
| 1.1 NON-NEGOTIABLE L1 |
THE STANDARD Findable Before Arrival The clinic's name, address, phone number, and mapped location are correct, current, and independently verifiable by anyone searching as a patient would. |
| CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question. |
| 1 | Is the clinic name, address, and phone number correct on your own website and any public listing? Not the address on file years ago — what a patient searching today would actually find. Doc: Website screenshot, public listing |
YES | PARTIAL | NO |
| 2 | Does the phone number listed actually connect to your clinic when called? Tested directly, not assumed correct because it was correct when first published. Doc: Call log or test record |
YES | PARTIAL | NO |
| 3 | If a map location is used, does the pin match the real entrance, not a nearby approximation? A pin one block off sends patients to the wrong door, or ambulances to the wrong street. Doc: Map screenshot |
YES | PARTIAL | NO |
ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Blocks accreditation until resolved.
| WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks |
| OBSERVE Public search test |
Independently searches for the clinic exactly as a patient would — by name, address, phone — using only public information. |
| DOCUMENT Address cross-check |
Confirms the mapped or listed address matches what is physically found on arrival. |
| ASK Cold-call directions test |
Calls the listed number posing as a first-time patient asking for directions, and notes whether the answer is accurate without hesitation. |
REFERENCES
- [1] World Health Organization. Emergency care system framework. Geneva: WHO; 2018.
| Standard 1.1 · Standard 1: Access & Arrival Guidance & Learning |
GUIDANCE ASF-AMB-STD1-v3.0 |
| WHY THIS STANDARD EXISTS |
A clinic that cannot be found cannot be reached — a common, preventable failure that costs real time when a patient is trying to get care, or an ambulance is trying to find them for a home-to-clinic transfer.
| WHAT GOOD LOOKS LIKE ✓ Name, address, and phone number are correct and independently verifiable. ✓ A patient can cold call and reach the clinic within a minute. ✓ The mapped pin matches the real, physical entrance exactly. |
WHAT FAILURE LOOKS LIKE ✗ An old address is still listed on letterhead, alongside a correct current one online. ✗ Listed number rings out with no voicemail, no way to confirm this is the right place. ✗ A map pin one street over from the real building, with no correction requested. |
| MOST COMMON REASONS CLINICS SCORE PARTIAL |
1 The website was never updated after a move.
The clinical team changed but nobody told whoever manages the website — a common, low-cost, high-consequence gap.
2 The phone number is correct but nobody answers as "the clinic."
Calls connect to a generic switchboard that cannot confirm this is the right place.
3 The map pin was set once, years ago, and never checked again.
Map platforms occasionally shift pins during their own updates — nobody at the clinic owns checking it periodically.
| HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO |
Week 1 Search for your own clinic exactly as a patient would, across every platform patients actually use.
Week 2 Correct the address and phone number on your own website and any listing you control directly.
Week 3 Call your own listed number from an outside line and time how long it takes to confirm you've reached the right place.
Ongoing Recheck all public listings every six months.
| FOR SURVEYORS — WHAT IS NOT OBVIOUS |
Search cold, don't ask the clinic for directions first.
The whole point is testing what a stranger finds.
Call from a number the clinic won't recognise.
A number in the clinic's own contact list may get special handling a real patient wouldn't.
| E-LEARNING academy.gmj.ge/amb-std1-1-findability — 30 min · complete before self-assessment |
| Standard 1.2 NON-NEGOTIABLE · Standard 1: Access & Arrival A Genuinely Usable Entrance for Disabled Patients |
ASSESSMENT ASF-AMB-STD1-v3.0 |
| CR ADAPTED | TR FULL | SM FULL | ST FULL |
| 1.2 NON-NEGOTIABLE L1 |
THE STANDARD A Genuinely Usable Entrance for Disabled Patients At least one entrance is step-free or served by a compliant ramp, with a door wide enough for a wheelchair to pass through without difficulty and hardware operable with one hand. Where this does not yet exist, the clinic holds a specific, budgeted, dated plan to close the gap. |
| CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question. |
| 1 | Is there at least one step-free entrance, or a ramp meeting a genuine healthcare-grade gradient, not a makeshift board? A steep improvised ramp can be more dangerous than stairs — this means a real, safe gradient. Doc: Photo of entrance and ramp |
YES | PARTIAL | NO |
| 2 | Can a standard wheelchair pass through the entrance door without the user needing help to squeeze through? A specific, measurable width, not a visual impression that it looks wide enough. Doc: Door width measurement |
YES | PARTIAL | NO |
| 3 | Where full access doesn't yet exist, is there a specific, dated, budgeted plan to fix it — not a general intention to "look into it eventually"? A plan with a number and a date, the same standard applied throughout this whole framework. Doc: Written access improvement plan |
YES | PARTIAL | NO |
ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Blocks accreditation until resolved.
| WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks |
| OBSERVE Physical entrance check |
Directly tests the entrance and ramp gradient, and attempts entry as a wheelchair user would. |
| DOCUMENT Door width measurement |
Measures the actual clear door width against the healthcare-specific guideline threshold. |
| DOCUMENT Access plan review |
Where full access doesn't exist, reviews the specific plan for a real budget and date, not a vague aspiration. |
REFERENCES
- [2] International Health Facility Guidelines. Part C — Access, Mobility and OH&S. Sydney: Health Facility Guidelines; and United Nations. Convention on the Rights of Persons with Disabilities. New York: UN; 2006. Article 9.
| Standard 1.2 · Standard 1: Access & Arrival Guidance & Learning |
GUIDANCE ASF-AMB-STD1-v3.0 |
| WHY THIS STANDARD EXISTS |
Ambulatory clinics very commonly occupy repurposed ground-floor apartments or converted commercial units never originally designed as healthcare space — unlike a purpose-built hospital, physical accessibility here often has to be actively created, not assumed to already exist.
| WHAT GOOD LOOKS LIKE ✓ At least one entrance is genuinely step-free or ramped to a safe healthcare-grade gradient. ✓ The door is wide enough for a standard wheelchair to pass without assistance. ✓ Where access doesn't yet exist, a specific, funded, dated plan is in place and visibly being followed. |
WHAT FAILURE LOOKS LIKE ✗ The only entrance has steps with no ramp alternative at all. ✗ A ramp exists but is too steep to be genuinely safe, effectively decorative. ✗ No specific plan exists — only a general acknowledgement that access "should be improved sometime." |
| MOST COMMON REASONS CLINICS SCORE PARTIAL |
1 A ramp exists but was built to a residential, not healthcare-grade, gradient.
A ramp steep enough for general use can still be unsafe for a wheelchair user managing it alone.
2 The main entrance is accessible but a secondary or side entrance patients sometimes use is not.
Accessibility needs to hold at whichever entrance a patient is actually directed to, not just the primary one.
3 A plan exists but has no specific budget or date attached to it.
An intention without a number and a date tends to stay an intention indefinitely.
| HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO |
Week 1 Measure your actual entrance — door width, ramp gradient if one exists — against the healthcare-specific guideline.
Week 2 If full access isn't achievable immediately, write a specific plan with a real budget figure and completion date.
Week 3 If a temporary workaround is needed in the meantime, make it genuinely safe, not just present.
Ongoing Revisit the plan's progress against its own stated date.
| FOR SURVEYORS — WHAT IS NOT OBVIOUS |
Try to enter as a wheelchair user would, don't just look at the ramp.
A ramp that looks adequate can still be unsafe to actually use alone.
Ask for the specific budget figure and date in the access plan, not a general description of intent.
Specificity is what distinguishes a real plan from a good intention.
| E-LEARNING academy.gmj.ge/amb-std1-2-disability-access — 30 min · complete before self-assessment |
| Standard 1.3 NON-NEGOTIABLE · Standard 1: Access & Arrival Approach and Grounds Safety |
ASSESSMENT ASF-AMB-STD1-v3.0 |
| CR ADAPTED | TR FULL | SM FULL | ST FULL |
| 1.3 NON-NEGOTIABLE L1 |
THE STANDARD Approach and Grounds Safety The immediate approach to the clinic — parking area, entryway, path from the street — is safe, clean, and well lit, not merely the building interior once a patient has already arrived. |
| CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question. |
| 1 | Is the walkway from the street or parking area to the entrance free of trip hazards and adequately lit? Checked directly underfoot, not assumed safe because it looks fine from a distance. Doc: Photo of approach, day and evening if relevant |
YES | PARTIAL | NO |
| 2 | Is the approach kept clear of obstruction — parked vehicles, stored materials, snow or ice where relevant? A route that's sometimes blocked is not a reliably safe route. Doc: N/A — tested directly |
YES | PARTIAL | NO |
| 3 | Is there a specific, assigned responsibility for keeping the approach safe, not a general hope someone will notice a hazard? Specific ownership, not diffuse responsibility that belongs to nobody in particular. Doc: Role assignment record |
YES | PARTIAL | NO |
ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Blocks accreditation until resolved.
| WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks |
| OBSERVE Approach walk-through |
Physically walks the entire approach from the street or parking area to the entrance, checking for hazards. |
| OBSERVE Obstruction check |
Checks whether the approach is currently clear, and asks how recently it was last checked. |
| ASK Responsibility interview |
Asks who is specifically responsible for approach safety and maintenance. |
REFERENCES
- [3] Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, et al. A review of the research literature on evidence-based healthcare design. HERD. 2008;1(3):61-125.
| Standard 1.3 · Standard 1: Access & Arrival Guidance & Learning |
GUIDANCE ASF-AMB-STD1-v3.0 |
| WHY THIS STANDARD EXISTS |
A patient's first real safety risk of the visit is often the walk from the street or car park to the door, particularly for elderly or mobility-impaired patients — a hazard here undermines everything the clinic does correctly once the patient is actually inside.
| WHAT GOOD LOOKS LIKE ✓ The approach is free of trip hazards, well lit, and genuinely walkable. ✓ The route stays consistently clear of obstruction. ✓ A specific person or role owns approach safety and maintenance. |
WHAT FAILURE LOOKS LIKE ✗ Uneven paving or poor lighting on the approach has never been addressed. ✗ The entryway is regularly blocked by parked vehicles or stored equipment. ✗ Nobody can identify who is responsible for noticing or fixing a hazard on the approach. |
| MOST COMMON REASONS CLINICS SCORE PARTIAL |
1 The approach is well maintained during the day but poorly lit after dark.
A hazard assessment done only in daylight can miss a genuine evening safety gap.
2 Maintenance happens reactively after a complaint, not on any regular schedule.
Waiting for a complaint means at least one patient experienced the hazard first.
3 Responsibility is informally understood by long-term staff but not written down anywhere.
Informal knowledge disappears the moment that staff member is unavailable or leaves.
| HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO |
Week 1 Walk the approach yourself, including after dark if the clinic operates evening hours.
Week 2 Fix any immediate hazard found — lighting, uneven surface, obstruction.
Week 3 Assign specific, written responsibility for ongoing approach safety.
Ongoing Recheck the approach on a fixed schedule, not only after a complaint.
| FOR SURVEYORS — WHAT IS NOT OBVIOUS |
Walk the approach yourself rather than asking staff to describe it.
A route staff walk daily can become invisible to them even when a real hazard exists.
Ask specifically about evening conditions if the clinic has evening hours.
Daytime safety and evening safety are genuinely different conditions.
| E-LEARNING academy.gmj.ge/amb-std1-3-approach-safety — 30 min · complete before self-assessment |
| Standard 1.4 CORE · Standard 1: Access & Arrival Wayfinding Without Staff Dependence |
ASSESSMENT ASF-AMB-STD1-v3.0 |
| CR ADAPTED | TR FULL | SM ADAPTED | ST FULL |
| 1.4 CORE L1 |
THE STANDARD Wayfinding Without Staff Dependence Basic wayfinding allows someone with no prior knowledge of the clinic to locate reception and the relevant waiting area without stopping to ask for directions more than once. |
| CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question. |
| 1 | Can a first-time visitor find reception without asking for directions more than once? Tested directly by someone unfamiliar with the layout, not assumed from staff familiarity. Doc: N/A — tested directly |
YES | PARTIAL | NO |
| 2 | Is signage clear and consistent, not relying on informal or outdated labels? Signage that matches how staff actually refer to a space, not a leftover label from a previous use. Doc: Photo of signage |
YES | PARTIAL | NO |
| 3 | For a very small clinic where the whole space is visible from the entrance, is a lighter approach genuinely sufficient? A one-room clinic may not need formal signage at all — this asks whether that's a genuine fit, not an excuse. Doc: N/A — tested directly |
YES | PARTIAL | NO |
ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Requires improvement plan.
| WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks |
| OBSERVE First-time visitor test |
Approaches as a first-time visitor would, checking whether reception can be found without repeated direction-asking. |
| OBSERVE Signage consistency check |
Checks that signage is current, consistent, and matches actual space use. |
| ASK Reception burden interview |
Asks reception staff how often they are asked basic directional questions during a typical day. |
REFERENCES
- [4] Carpman JR, Grant MA. Design that cares: planning health facilities for patients and visitors. 3rd ed. San Francisco: Jossey-Bass/Wiley; 2016.
| Standard 1.4 · Standard 1: Access & Arrival Guidance & Learning |
GUIDANCE ASF-AMB-STD1-v3.0 |
| WHY THIS STANDARD EXISTS |
A confusing arrival sequence adds avoidable stress to a visit that may already be stressful for the patient, and forces reception staff to spend time on basic navigation questions instead of the tasks their role actually requires.
| WHAT GOOD LOOKS LIKE ✓ A first-time visitor reaches reception without confusion. ✓ Signage is current, clear, and consistently used. ✓ Where the clinic is small enough that formal signage is genuinely unnecessary, this is a real fit, not a gap being excused. |
WHAT FAILURE LOOKS LIKE ✗ Visitors regularly get lost or need multiple directions from staff. ✗ Signage is outdated, inconsistent, or missing at key decision points. ✗ A larger, layout-complex clinic has no signage at all, relying entirely on staff to guide every visitor. |
| MOST COMMON REASONS CLINICS SCORE PARTIAL |
1 Signage exists for the main path but not for less obvious secondary routes.
The most complex parts of a layout are exactly where clear guidance matters most.
2 Signage was accurate when installed but hasn't been updated as rooms changed use.
A label pointing to a room's old purpose actively misleads rather than helps.
3 Reception staff have become so used to giving directions that the underlying confusion is normalised rather than fixed.
Staff adapting to a problem isn't the same as the problem being solved.
| HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO |
Week 1 Ask someone unfamiliar with the clinic to find reception unassisted and note where they hesitate.
Week 2 Add or correct signage at the specific points of confusion identified.
Week 3 Confirm with reception staff whether directional questions have genuinely decreased.
Ongoing Recheck signage accuracy whenever room use changes.
| FOR SURVEYORS — WHAT IS NOT OBVIOUS |
Use a genuinely unfamiliar person for the test, not clinic staff.
Staff familiarity makes it impossible to judge wayfinding as a real first-time visitor would experience it.
Ask reception staff directly how often they field basic directional questions.
A high frequency is itself evidence of a wayfinding gap, regardless of how staff have adapted to it.
| E-LEARNING academy.gmj.ge/amb-std1-4-wayfinding — 30 min · complete before self-assessment |
Ambulatory Clinic Standards — overviewFacility Classification — Which Type of Facility Are You?Standard 1 — Access & ArrivalStandard 2 — Reception & InformationStandard 3 — Environment & Shared SpacesStandard 4 — Care & TreatmentStandard 5 — Safety & Emergency PreparednessStandard 6 — Aftercare & Follow-upStandard 7 — Governance & ManagementStandard 8 — Dental PracticeStandard 9 — Aesthetic & Injectable MedicineStandard 10 — Longevity & IV TherapyStandard 11 — Oncology & Infusion TherapyStandard 12 — Dialysis & Renal Replacement TherapyStandard 13 — Fertility & IVFStandard 14 — Cardiology & Cardiac CatheterizationStandard 15 — Ophthalmology & Day SurgeryStandard 16 — Diagnostic ImagingStandard 17 — DermatologyStandard 18 — Allergy & ImmunotherapyStandard 19 — Plastic & Cosmetic SurgeryStandard 20 — Psychiatry & Mental HealthStandard 21 — Narcology & Addiction TreatmentStandard 22 — Gastroenterology & EndoscopyStandard 23 — Pediatric Ambulatory CareStandard 24 — Medical TourismStandard 25 — Refugee & Migrant HealthReferences & Index
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