Columns , Practice Building

Successful Remodeling

Successful Remodeling
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Heather E. Lewis, AIA, NCARB

A veterinary hospital is more than a shell to house a practice. It is an important physical reflection of your practice philosophy.

Undertaking a renovation can be a huge financial and emotional leap, but it is also your opportunity to create a space that helps you practice better, more efficient medicine while increasing your revenue.

Figure 2

Atrium area between adopt-a-pet center and retail area at Carriage Hills Animal Hospital & Pet Resort in Montgomery, Alabama. Mark L. Wright Photography

Benefits of Renovating

While there are no firm studies on the benefits of renovating, most of our clients report that they see about a 20% increase in revenue after a renovation. There are no guarantees, but veterinarians who take the risk to renovate usually grow their practices.

Another good reason to renovate is the opportunity to energize and revitalize; even small changes can help you operate more efficiently and bring new life to your practice. A well-planned and executed remodel can go a long way toward projecting the same image of vitality, growth, and success that a brand new hospital can demonstrate.

Making Renovation Decisions

There are many factors that come into play when deciding to undertake a renovation, including cost, return on investment, how close you are to retirement, and whether or not you wish to grow your practice or add new services in the future. It is important to consider how much to undertake; your project can be anything from simply revamping your reception area to a full-scale overhaul of your hospital’s floor plan.

Elements from the following categories can be mixed and matched to create the approach that best fits your needs and your practice philosophy. Choose a renovation project that makes the most sense for your practice, and give priority to changes that will help your bottom line.

Figure 1

Bamboo greeter’s station at the front of Upstate Veterinary Specialists in Greenville, South Carolina. David Dietrich Photography

Reception/Waiting Finishes

The layout, look, color, and materials of your reception area should create a positive impression. Designs can range from a space where clients feel comfortable enough to take off their shoes to that of a high-tech medical center. Whatever style you choose, remember that your reception area must communicate to your clients the high quality of veterinary care you provide.

  • Space: Allow enough space around the reception desk for several people and their animals. Six to 7 feet of clear space between the desk and seating areas should be maintained. Consider space requirements for computers, telephones, printers, and credit card machines. Find solutions that minimize crowding and clutter on the surface of the desk.
  • Lighting: Provide adequate lighting at all work stations. Under-counter lighting can be very effective for task lighting. Overhead task lighting can help to highlight the desk.
  • Materials: Choose durable materials for the reception area, especially where you expect the most wear. Protect all outside wall corners in the reception room with corner guards, and choose easily cleanable, durable furniture. You may also need a more durable countertop material at the desk than you need elsewhere. In addition, keeping the side of the counter that clients use narrow will discourage them from putting pet carriers on the surface and scratching it. Remember that durable does not have to look clinical or unfashionable.
  • Color: Add color! A bright and cheery reception area sends the right message to your clients. Put the color where it is easy to redo, such as on walls, and keep the cabinets a neutral shade. Don’t limit color to the reception area. You, your staff, and your clients will appreciate color in examination rooms, treatment areas, the break room, and offices.
  • Conveniences: Provide conveniences for your clients, such as a coffee bar and internet access.

Here are some ideas for something a bit more radical:

  • Greeter’s Station: A greeter’s station removes the responsibility of answering phones from the frontline staff member. This creates more of a “concierge” relationship between staff and the client, making it possible to provide better service and minimize the size of the reception desk. Greeter’s stations work best in paperless practices because it is easier to physically separate the greeter, phone, and cashier functions while maintaining a virtual connection between them.
  • No Reception Desk: By removing the desk, your clients will feel like they are the first priority. Also, with your receptionist liberated he/she can provide other services, such as facilitating curb-side drop off and pick up and sitting with, comforting, or educating clients while they wait.

Expanding Finishes

Take the new colors and finishes from the reception area into the whole hospital.

  • Paint: Nothing is cheaper than a gallon of paint. A professional paint scheme can turn clinical, outdated, or worn walls into a current, cheerful, and fun space. Paint all the spaces in your hospital to tie your remodel together. You can use a high performance paint to cover old, dinged, dark wood items as well as cabinets and doors to give them new life. A word of caution: never paint a concrete slab. It is impossible to keep paint from chipping and peeling on any horizontal concrete surface.
  • Flooring: Replace your flooring with a more durable surface.
  • Lighting: Add new task lighting in the treatment and office areas.
  • Cabinet Facelift: For a quick redo of your cabinets, have them refaced instead of replaced. You will save on the cost of the new cabinet boxes.
  • Tile: Tile your floors. Nothing hides the sins and repairs of worn-out flooring like nice, nonslip porcelain tile with epoxy grout. Tile is one of the safest materials to use in a renovation, as it is not prone to failure and immediately adds class to a drab space.
Figure 3

A remodeled examination room at Upstate Veterinary Specialists, Asheville Clinic, in Asheville, North Carolina; note the computer monitor that allows clients to view digital radiographs. David Dietrich Photography

Rearrange the Floor Plan

There are numerous ways that tweaking your hospital’s floor plan can make your space more efficient, provide greater transparency, and improve the overall feel of your hospital. These changes can come in all shapes and sizes, from simply switching out a couple of rooms to knocking down walls and/or adding additional rooms.

  • Relabeled Rooms: It is sometimes easier to improve the layout and efficiency of your existing building by changing the functions of a few rooms. For example, if your surgery is far from your treatment area, but there is a large doctor’s office immediately adjacent to treatment, it may be possible to switch the room functions without a dramatic change to the building structure. If you take this approach, be sure that you will be able to easily update your mechanical and electrical systems for the new room functions. Remember, it is typically very difficult and expensive to move “wet” rooms, such as your dog ward or any other room that is plumbing intensive.
  • Examination Rooms: If your budget allows, look at ways to add one or two additional examination rooms. Adding examination rooms helps you justify the expense of remodeling by allowing you to see more clients or add another veterinarian to your practice.
    • Look at the configuration of your examination rooms. One-door rooms or pods of rooms can drive down square footage and minimize the number of steps walked between examination rooms, reception, treatment, and surgery.
    • Design an examination room that can double as a treatment space during nonpeak hours of the day. Add a sliding glass door to allow the room to open up to the larger treatment area. Other options are examination rooms that can be used for consultations or additional office space.
    • You can make your examination rooms into multipurpose rooms. By minimizing the number of built-in cabinets and creating optimum-sized rooms, these rooms can be used for other purposes, including ultrasound, endoscopy, and dental procedures.
  • Transparency: Some hospitals can be dramatically improved by “opening up” space with interior view windows or glass partitions. Well-placed interior glass openings will make your hospital feel larger and will reinforce the image that you are proud of the medicine that you practice. Also, views into other areas of the hospital from the reception area can reduce psychological barriers between client spaces and medical spaces and demonstrate that you have nothing to hide.
    • If you are installing new doors, use as many glass or partial glass doors as you can.
    • If you want a space to feel larger but you still want the ability to control views into other spaces, replace solid partitions with areas of frosted glass.
    • Consider creating views into surgery, special procedures rooms, and/or boarding areas.

Before
The reception area of Hulen Hills Animal Hospital in Fort Worth, Texas, prior to renovation:
Figure 4A    Figure 4B

 

After
The reception area of Hulen Hills Animal Hospital after renovation:

Figure 5A Figure 5B

 

Invest in Technology

Incorporating new technologies in and around your renovation can greatly improve your efficiency and give you the opportunity to provide new services to your clients while decreasing the amount of time specific tasks take. This also gives your staff more flexibility.

  • Paperless Practice: There are many new technologies, from tablet PCs to wireless credit card technology, that can readily enable you to take your practice paperless. If your receptionist is wired with Bluetooth and carries a tablet, he or she can easily schedule appointments, check patients in and out, and provide mobile assistance anywhere in the hospital.
  • Digital Radiology: Extra space for a darkroom is eliminated, you will no longer need to use, dispose of, and purchase chemicals; in addition, the extra space needed to file and store radiology images is no longer needed.
  • Monitoring Equipment: Install video monitoring and wireless telemetry to monitor patient status. A large, flat screen monitor can be centrally placed in treatment where staff can easily track patient progress and respond when necessary.
  • Dental Station: Build a two-table dental station that makes use of one centered dental radiology machine.
  • Imaging: Consider investing in better imaging, such as digital radiology, computed tomography, and ultrasound. Better diagnostic capability can give you an edge in providing better and less invasive medicine.
  • Thinking Ahead: Look ahead to the future. Minimally invasive procedures, such as laparoscopic surgery, are becoming increasingly common in veterinary medicine. You can set your practice apart by thinking ahead and accommodating space for new ways of providing this type of service to your clients.

Focus Your Remodel

  • Finishes: If you are planning to retire in a few years or if you want to increase practice appeal without incurring a huge expense or disruption, focus on updating finishes. Renewing a tired appearance will dramatically improve the perception of the quality and success of the practice.
  • Revenue: If you are remodeling to increase revenue, focus on expanding services that earn the most and renovate areas that no longer work toward building your bottom line. For example, many older hospitals have too much ward or hospital space for today’s wellness-focused medicine. If some “back of house space” can be converted to medical procedure space without moving a lot of plumbing, this investment will pay off.
  • Additional Rooms: Many hospitals are short on examination rooms. The rule of thumb is that you should have two to three examination rooms per doctor and about an equal number of procedural spaces. This rule can vary based on the type of practice you have, but it will give you an idea as to whether or not you are maximizing your potential.
  • Client Support: Help your clients buy in to your remodel by explaining how these improvements enhance the quality of care provided to their pets. It is important for them to understand that your goal is to improve the way that you care for and house their pets, which promotes wellness and prevents stress.
    Any combination of these renovation ideas can improve the client experience and create a more efficient workflow, with the final result being a successful practice, satisfied clients, productive employees, and an improved bottom line. Review your practice philosophy, compare it to how your facility is matching up, and look at renovation options that can help you achieve your goals. n

Go Green

Many sustainable design solutions can be included in your hospital easily and at minimal expense, thus helping you reduce long-term energy needs and showing your clients that you are committed to the preserving the environment.

  • Renewable Materials: Use products made from renewable materials. For flooring in medical areas consider linoleum instead of sheet vinyl. Consider a recycled glass top for reception desks and walls in bathrooms. Some floor tiles have 50% or more recycled content.
  • Safe Paint: Use low or no VOC paint to keep hospital air free of volatile organic compounds.
  • Heat Recovery: Incorporate a heat recovery system as part of your HVAC system. These systems, which can be installed as separate units, provide fresh air, improved climate control, and save energy by reducing the heating/cooling requirements of your building.
  • Lighting: Enhance lighting in your hospital. Put in skylights to add natural light to interior spaces. Consult with a lighting expert to choose high-efficiency fixtures that produce light in the same color range as sunlight, which will improve the building’s atmosphere for your staff and patients.
  • Plumbing: Install low water-use plumbing fixtures as well as on-demand water heaters at your sinks in lieu of an oversized and constantly running water heater.
    Landscaping: Try incorporating xeriscape and/or low water-use plants in your landscape.
  • Local: Use locally produced materials.

Heather%20Lewis-Partner_fmtHeather E. Lewis, AIA, NCARB, is a principal of Animal Arts (animalarts.biz), an architectural firm that has exclusively designed veterinary hospitals and animal care facilities since 1979. The firm has designed projects ranging in size from 2400 to 85,000 square feet in 40 states, Canada, Australia, and Japan and has earned 32 awards for architectural excellence from Veterinary Economics magazine. Ms. Lewis is a regular contributor to various veterinary industry magazines. She has spoken about practical and innovative design solutions at the CVC Hospital Design Conference, Wild West Veterinary Conference, American Association of Feline Practitioners Conference, and Humane Society of the United States Animal Care Expo.

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