It might be hard to believe, but architects say veterinarians almost always wish they had built a bigger hospital or altered something in their well-thought-out construction plans.
The top post-construction regret of veterinarians, experts say, was not hiring an experienced veterinary architect for the job.
“Veterinarians who have a friend or family member in the construction business are always tempted to use those connections in order to get a perceived deal, but in the end the lack of experience can cost the owner time, money and delays in opening the new practice,” says Peter Hill, AIA, president of Hill Design Associates Architects Inc. of Dawsonville, Ga.
“When it comes to safety design, just because a code isn’t currently enforced doesn’t mean the precaution shouldn’t be incorporated anyway, because it’s the right thing to do and it may eventually require changes anyway,” Hill says. “Doing things right the first time is always best.”
For example, the laws governing veterinary hospital safety design are generally more lenient than those for human hospitals. Still, some municipalities have adopted parallel safety precautions for veterinarians. An architect new to veterinary practices may overlook these legal necessities and other structural and design factors unique to the profession.
Rules regarding medical gas installation aren’t enforced for veterinary facilities under the National Fire Protection Association, an authority on fire, electrical and building safety, but Hill says this isn’t an area to skimp on.
Extra thought also needs to be given to X-ray rooms. Because of radiation scatter, a certain wall thickness might be necessary depending on the state.
Ventilation is another key area, Hill says.
“Things burn fast in an oxygen-rich environment like a surgical suite, so proper ventilation and filtration in the different areas of the hospital for safety and odor reduction are a must,” he says. “You want filtration to clean air out of dirtier areas of the hospital like boarding rooms and bring in fresh air to other areas."
“Veterinarians have regretted not having installed proper ventilation.”
Bigger Is Better
Builders say veterinarians sometimes underestimate their practices’ growth potential. There’s nothing wrong with having vacant rooms. The alternative, Hill says, is having “a relatively new practice and not enough space.”
“If you want to incorporate a dental cleaning area, grooming area or add a modality to the practice, you should make space, if possible, even if you don’t know when you’ll be going forward with those plans,” he says. “Sometimes financial restraints are the reason or lack of land to build on is the issue, which there’s not much to do about. But in cases where the veterinarian is trying to simply be conservative, they should re-evaluate the situation and weigh future construction.”
Evolving technology is another consideration. A veterinarian thinking about an equipment purchase at a later date may not be able to house the piece without planning for it now.
Veterinarians also need to think about when the time comes to sell the practice. Though the hospital’s design should fulfill the owner’s needs, it needs to be attractive to a potential buyer, too.
The ability to pay for construction can’t be ignored, of course.
“In most cases, some spaces have to be reduced to make the project fit within the budget,” says Sal Longo Jr., AIA, of Crosby Architecture Studio LLC in Lafayette, La. “Careful thought has to be put into what should be eliminated or reduced and by how much. There may have to be sacrifices, so it comes down to what you feel you can do without and what you are willing to add in the future.”
Sometimes a fine line exists between what an owner wants and what he or she needs, the experts say. Envisioning the workplace and how the staff will function is an essential step when deciding what stays and what goes.
Areas of the hospital the veterinarian doesn’t personally oversee can be inadvertently skimped on in new construction if the owner doesn’t involve the staff during the planning. The needed space for grooming, storage and cleaning rooms can easily be underestimated.
“We forgot to add space for cadaver freezers during our first design,” says Dermot Jevens, DVM, of Upstate Veterinary Specialists in Greenville, S.C. “A contractor should push you to carefully consider necessary changes and include your staff in the design process. No matter what you do, the hospital will never be perfect, but the goal is to minimize things you wish you’d done differently.”
Dr. Jevens’ original hospital was 12,760 square feet and won the Veterinary Hospital of the Year award in 2003 from Veterinary Economics magazine. He realized he wanted to add more specialty services, so the hospital doubled in size and earned the honor of Best Specialty Referral Hospital in 2007.
“We didn’t anticipate our desire to get into more aggressive cancer care,” Jevens says. “We added a linear accelerator and 13,000 more square feet.”
More often than not, veterinarians wish they had paid more attention to details such as corner guards, storage space, electrical outlets, paints and finishes, power supplies and electrical wiring.
“Making sure the mechanical and electrical engineers appear on the job site to check the contractors’ work is essential,” Hill says. “Many projects are thought to be complete, only to find that something isn’t working right when someone tries to use it.”
It’s a mistake not to prewire a room, even if you don’t see the need for it, Longo says.
“A common trend veterinarians have been incorporating in new design is HD televisions in exam rooms,” he says. “When this is suggested prior to construction, some veterinarians say to forgo it because they don’t want it right now, but this is an example of incurring some expense now to avoid a bigger future cost.”
Oops, Wrong Place
Last on the do-over list, the experts say, are regrets over not thinking about the placement of stationary fixtures like faucets and doors and how that might impede day-to-day functionality.
Before construction, designers encourage veterinarians to think about where things like hose bibs should go and whether a door could get in the way of the hose. If the waiting room will have a wall- or ceiling-mounted TV, the electrical outlet should be very close to avoid patient mishaps with the cord.
“Entering a project, veterinarians don’t often know the amount of square feet they need, they just know what they want in the new clinic,” Longo says. “Building the facility for easy future expansion is a smart move.”
The poor selection of paints and finishes often isn’t realized until the practice has been in use. Some veterinarians find out the hard way that cleaning agents aren’t kind to many finishes.
“Sometimes veterinarians have a do-it-myself mentality that may initially save them money, but the independent streak costs money down the road,” says Mark Hafen, AIA, of Animal Arts, a veterinary design firm in Boulder, Colo. “It’s always less expensive to do it the right way the first time.”
Building a new clinic can take two years from start to finish, so during that time the blueprints will have aged and the current practice will have evolved.
“Veterinarians know what they need now, but they aren’t familiar with what the right products are,” Hafen says. “It is the architect’s responsibility to be the veterinarian’s advocate.”
After building 350 animal care facilities, Warren Freedenfeld, AIA, of Rauhaus Freedenfeld and Associates in Boston, says communication must be clear between the architect and owner.
“There is a lot of going back and forth with the veterinarian,” Freedenfeld says. “After almost 35 years of building veterinary hospitals, I’ve learned through experience the technique to avoid ‘situations’ after construction. Veterinarians should have a sit-down conversation with the builder and go through every function they do.
“If doing all construction in the current build isn’t possible, the biggest thing to avoid is building in a way that makes future expansion difficult.”
This article first appeared in the February 2010 issue of Veterinary Practice News