Tight hospital design budget? Trim here

A cabinet upgrade here, a specialty countertop there, and, oh yes, those extra-tall windows for maximum sunlight-soon, your hospital design budget is out of control. Every single detail comes at a cost.

Whether you're designing from the ground up or remodeling an existing clinic, keeping costs in check is a constant struggle, but there are ways to save, and in most cases, you might not even notice the difference.

Finishes: Can you live with different surfaces?

Downgrading some of your finishes is one of the first places to start when trimming your budget, says Michael Matthys, VP of Linden Group Architects in Orland Park, Illinois. Matthys, who designed Coyne Veterinary Center, a 2019 dvm360 Hospital of the Year, says small changes in finishes can save a ton. Matthys suggests choosing your cabinet, countertop, tile, roofing and exterior glazing finishes carefully. 

Think countertops first. The team at Coyne Veterinary Center chose solid-surface countertops throughout the hospital, but Jamie Josephson, CVPM, regional director for the multi-hospital Coyne Veterinary Services, says in some of their other hospital builds and remodels, they've scaled back to a laminate countertop.

Coyne Veterinary Center, a 2019 dvm360 Hospital of the Year, chose solid-surface countertops throughout the hospital. But when your budget is tight, going with laminate countertops can save you money.

“We typically use a solid-surface countertop, like quartz or stone, because it wears well and looks great,” says Josephson. “But in a recent remodel, we downgraded to laminate, and you can pick and choose where to downgrade. We definitely use nicer materials in the lobby and exam rooms, with a still-nice-but-less-expensive finish for the kennel, laundry, grooming and kitchen areas.”

Coyne Veterinary Center is the company's flagship hospital, so the group spared few expenses in designing it. Other hospitals in the group worked on a tighter budget, and Josephson learned where to cut back. 

If you're building from the ground up, Matthys says to think twice about your exterior finish. Exterior glazing is expensive. Choosing a lower-cost brick could save you 20 to 30%, especially if you go to a local yard and choose something they have on hand. Another simple save starts on the roof. Metal roofs are popular, but sticking with a sloped roof with simple asphalt shingles costs much less, Matthys says. To add a bit of flair, you can add metal accents for a fraction of the cost.

The “cost per square foot” conundrum

Is there agreement about what your overall project should cost? Some HospitalDesign360 conference experts wrestle with it here.

Flooring: What a difference a tile makes 

Tile flooring has such a big range of costs-from $2 to $30 per square foot, or more, Matthys says.

“Stick with stuff that's under $4 a square foot,” he says. “Our allowance for projects is usually $3 per square foot. If you go to a big-box retailer and buy what's in stock, you can get it as low as $1 per square foot. It's all really durable.”

Matthys argues that there's no need to go much above that cost in most cases. You can even do epoxy flooring in back of house or across the board to save.

Cabinetry: How much to hold all that stuff?

“Veterinary hospitals are cabinet-extensive, and that can add a ton to your costs,” says Matthys. He's seen success with having cabinets built by a local builder rather than buying from a medical-specific company.

“Having a contractor with a relationship to a local builder, especially one who does numerous hospitals a year, can get you pretty good pricing for pharmacy and exam room cabinets,” he says.  

Josephson agrees that cutting the name-brand cabinets helps when the budget gets tight, but she cautions against it if you haven't considered your hospital volume.

“We might use laminate cabinets instead, but in our bigger, busier practices, it's not a good swap in the long run, because they don't hold up as well and need to be replaced more often,” she says. “You need to balance the cost savings with how often you'll need to repair or replace an item to determine if it's worth it.” 

Windows: View your options

At Coyne Veterinary Center, the doctors chose windows that extended nearly 30 feet up, for full dramatic effect. Not only did the windows themselves cost more than standard windows, but the curtain wall system required to house windows of that size added considerable cost to the project. 

The exterior windows at Coyne Veterinary Center extend 30 feet for dramatic effect. Keeping your windows to 12 feet or less will cut costs considerably.

“Keeping window height of 12 feet or less will save you a ton,” says Matthys. “Commercial vendors max out at 12 feet before you have to build a curtain wall system with structural glazing. That adds a lot more cost.”

Lighting: Finding fixtures

Want to cut your lighting costs in half? Matthys suggests checking with your contractor for fixtures within your budget. Often, you can find fixtures comparable to an engineer's recommendation but at half the cost. 

A $120 light fixture might not sound bad, but multiply that out by the many, many lights throughout your hospital, and it adds up quickly, Matthys says. Changing that out to, say, a $50 light fixture that does the same thing can save a bundle. 

The bottom line is that there are ways to cut costs if you're willing to look and you carefully consider what your priorities are and the savings that cutting a premium choice or two might save you.

“More times than not, if we make smart choices, the client won't even recognize the changes,” Matthys says. “I recommend making sure you know the price of something before you fall in love with it. Check local suppliers for similar but less-expensive items in stock, and make smart choices, not just what's new and exciting. We can do cool things in every price point.”

Sarah A. Moser is a freelance writer in Lenexa, Kansas.