Keeping the practice revenue flowing during a remodel isnt easy, but its necessary. Heres what a 2019 dvm360 Hospital of the Year winner and his architect did to make it happen.
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You've decided to remodel rather than build a new practice. That can be a great choice, using space you already have. And you might assume it's going to go faster and cost less than a brand-new facility.
Maybe not, says architect Warren Freedenfeld, principal at Rauhaus Freedenfeld and Associates. It cost more time and money to phase construction while you stay open.
“A phased renovation will absolutely take longer than gutting the whole thing and doing it all at once,” Freedenfeld says. “The whole process could take 50 longer and cost 50% more.”
That said, a phased renovation is still definitely the way to go, he says, keeping business up and running throughout the process: “Nothing is more expensive than shutting the whole practice down, for many reasons,” he says. “Income stops, clients will likely go elsewhere in the process and they might never come back.”
Here's how Freedenfeld and one of his clients, Jeff Davidson, DVM, owner of West Kendall Animal Hospital in Miami, Florida-a 2019 dvm360 Hospital Design Competition Hospital of the Year-suggest making the process go smoothly.
How many phases are required, and what parts of the practice get attention first, depend on the existing configuration and where the points of entry are, Freedenfeld says.
“What we do is create a phasing plan that will keep the entire facility fully operational in such a way that critical areas can be either constructed or renovated,” he says. “At West Kendall Animal Hospital, we renovated the whole thing, starting with the back of the hospital and the new space being added from the tenant next door.”
They started in the back of the hospital and the 500 square feet of open space purchased next door, because it made the most sense, says practice owner Dr. Davidson. “The additional space was a blank space, and construction there wouldn't interfere with daily business,” he says. “And the back of the practice held the electric, phone and utilities-a logical place to get started.”
Many people think they want to get the front area done first, says Freedenfeld. But in reality, the best starting place depends on the overall goals and achieving them in a financially responsible way. If that means the front-the nicest part-comes last but that cuts cost way down, most clients choose that option, he says.
“One of the reasons it's more expensive to do a project in phases is because you have to call back your drywaller, painter, carpenter, electrician and so on multiple times,” says Freedenfeld. “Unlike a new build where you can have each contractor come in and knock out all the drywall, or all the plumbing, all at once, in a phased build each piece is dependent on the contractor before it. And each contractor has to come back when their piece is ready-in every part of the practice at different times.”
Keeping track of when each contractor will come starts with a complicated and very detailed item called the CPM (critical path method) schedule. (Here's a sample CPM Freedenfeld shared.) The contractor prepares this schedule at the outset of the project, Freedenfeld says, which helps keep the project on schedule. Each contractor knows when to schedule time to return to the project.
“Ultimately, this is a team effort,” says Freedenfeld. “We all have our own roles and responsibilities. If we do them properly, it all works.”
“A lot of making a phased project work comes down to knowing your contractor as well as the subcontractors who work for them,” says Dr. Davidson. He suggests you work from the beginning to choose contractors you already have a relationship with or those who already work with your architect and others involved in your project.
“Sometimes knowing the people on your team gives you leverage to get the project moving,” he says.
Next, it's important to clearly communicate with contractors to make sticky situations work. For example, Dr. Davidson's project was a total rebuild, taking down the walls and redoing plumbing and concrete.
“Part of the project required retrenching done with a jackhammer-a very noisy task that would disrupt our business if done during the day,” says Dr. Davidson. Thankfully, the contractor was willing to come in at 4:30 a.m. to use the jackhammer when it wouldn't bother veterinary clients or other tenants. And they moved all overnight pet guests to the far side of the hospital to minimize noise to sensitive ears.
Another issue was the need to install a second electric panel, which required turning off the power to the entire shopping center. Dr. Davidson and his construction team were able to work with the landlord, the other tenants and the power company to turn the power off at 6 a.m., again minimizing disruption to others.
One last example of how working closely with contractors eased the process: A construction project requires tons of extra materials. And a small practice crammed into 60% of its available space obviously doesn't have room to store more stuff. So Dr. Davidson rented a storage unit offsite but nearby for the construction team to store their materials as well as Dr. Davidson's extra animal cages.
Again, clear communication smooths the way. Throughout the process, Dr. Davidson's clients just went with the flow and seemed to enjoy watching the practice take shape-even when he had to walk them around to the back of the practice to enter or they had to walk through a plastic-walled corridor.
“Everyone was really happy to see a new project taking place, a fresh take on our practice,” he says. “They could feel our excitement, and they were excited for us.”
There were days that the practice looked closed because of all the construction taking place out front. Clearly posted signs as well as staff members welcoming clients and escorting them to the temporary entrance helped. The clients didn't seem to mind, Dr. Davidson says.
To make up for the extra time it took to walk to the back entrance, he scheduled appointments a little farther apart, he says: “We might have been a bit less efficient during that time, but we still were doing business all throughout construction. That was better than the alternative.”
Even with all the planning, the whole project took a little longer than Dr. Davidson hoped-and cost more in construction than if he'd temporarily shut down practice-but the benefits of staying open outweighed the minor inconveniences.
“Even now, a couple years later, we have clients still commenting on how great the practice looks, and our staff is happier working here,” says Dr. Davidson. “It was worth it all.”
Sarah A. Moser is a freelance writer in Lenexa, Kansas.