Tripled your square footage? Heres how to adjust workflow

Exterior shot of the Petersen Pet Hospital (photo courtesy of Read Photography)

Small veterinary facilities often mean cramped quarters and never being more than two steps away from anyone at any time. So when the opportunity comes to work in a spacious hospital-whether a new build or an enlargement-it feels great to spread out and claim a bit of space for yourself. But what doctors and their teams might not expect is the growing pains that come with newfound square footage.

Much like winning the lottery and not knowing what to do with the sudden wealth, having an excess of space without a plan is a recipe for disaster. Thankfully Bradley Petersen, DVM, owner of Petersen Pet Hospital in Hiawatha, Iowa, planned for the inevitable growing pains when his practice doubled its size, then again grew to eight times the original size within 15 years.

Petersen Pet Hospital opened in a 1,200-square-foot strip mall practice in 2003. In 2007, Dr. Petersen more than doubled the facility size to 3,000 square feet. Then in 2018, he jumped to 9,500-square-feet in a brand new practice and earned a 2019 dvm360 Hospital Design Competition Merit Award. His advance planning, along with the careful design of his architect, Brad Lang of Solum Lang Architects, eased the transition of moving to a practice more than eight times the size of the original practice. Here are Dr. Petersen and Lang's tips for a successful expansion:

1. Design for efficiency

Before putting pen to paper, Lang says his architects “date” clients to find out what they want, how they currently do things and how they hope to work in their new space. “A big part of that programming phase is touring other similar facilities to see what the veterinarian likes and doesn't like, and asking the owner of that facility what works and doesn't work for them,” says Lang. Seeing how others work helps narrow down a client's plan.

Dr. Petersen agrees that talking with others is an essential part of making a design work for you, especially when making such a big change. “Ask advice from colleagues and friends in bigger facilities before you make the jump,” he says. “It's important to not reinvent the wheel.”

Design elements that helped smooth the transition for him included two-door exam rooms and a clear delineation between public and private spaces. However, staff members and veterinarians often need to communicate with the reception staff but don't want to be intercepted by pet owners. To prevent them from being “caught,” Lang designed a discreet private hallway that comes in the back side of the reception desk with a wall that extends only partway behind the desk. Staff members can get a receptionist's attention to pop around the corner for a private chat, then head back to the exam or treatment area. 

2. Focus on communication

Speaking of quick chats with staff members, keeping communication front of mind is key when moving from a tight space to one where people aren't always in sight of each other.

“Before, we just had to peek our head out the door and call for assistance,” says Dr. Petersen. “Someone was always within earshot, if not standing right next to you. Our biggest challenge was figuring out just how we would communicate the various needs of the practice once we had so much space. I didn't want to have to track people down all day.”

He says many options exist, from phone systems to a whiteboard scheduler to pricey hands-free systems. Picking the right one for your communication style and budget is key. He chose to upgrade his phone system allowing the receptionists to buzz back to the pharmacy area, where generally a technician or assistant is present, to announce client arrivals. If it's a private matter, the receptionist will ask the technician to pick up the phone. Otherwise, the message is broadcast via speaker to allow the tech to remain hands-free while working on other things.

A veterinary software whiteboard with a big screen in the pharmacy area notifies staff of appointment times, who's needed in each room, current wait time for clients and more. His staff members also like using Slack, an instant messaging system, for quick messaging between workstations. 

Dr. Petersen also had a nurse call system installed, with lights outside each of the seven exam rooms. While he would have loved the pricey hands-free communication system that allows techs to text doctors, among other things, he said the cost was prohibitive. For his practice it didn't make sense, but he thinks it's a great option for those who can afford it, especially much larger facilities. 

“There is definitely a learning curve for communication in a bigger facility,” he says. “We installed the nurse call system in the old practice six months before we moved, so everyone was used to it. We were pretty well prepared, but there's always a learning curve.”

To further maintain communication, he suggests morning huddles to make sure everyone is on the same page each day. His doctors, client care specialists and managers also meet separately once a week to handle issues that come up. “We've found that one person can manage about five people under them effectively,” says Dr. Petersen. “So we have teams of about five people with a lead supervisor over them, establishing a chain of command. Again, we started these groups and meetings about six months prior to moving, to have as much in place as possible before the big day.”

While Dr. Petersen handled the logistics of verbal communication, Lang worked to design a practice that would keep staff members and doctors in visual communication with one another. “Most of the associate veterinarians and technicians work in a glass space that looks into the main hub of the hospital, so there is immediate eye-to-eye contact,” says Lang. “If someone needs help, they can quickly get someone's attention, but the glass design allows for quieter and more private work when needed.”

The key, Lang says, is determining how a team uses their space and how they interact with one another, then designing to enhance efficiency in what they already do.

3. Stockpile supplies

In a small facility, it's easy to share supplies between exam rooms and treatment areas. But once you have more space, it makes sense to stock all needed supplies in all exam rooms, including needles, blood tubes, cotton and more. The only things not stored in Petersen Pet Hospital's exam rooms are medications, vaccines and an ear cleaning kit, which sit on a cart in the pharmacy that travels from room to room. A large scale sits in the lobby, and two smaller scales travel between rooms as well.

4. Plan for everything

One thing Petersen Pet Hospital still hasn't quite figured out-and he warns others to consider-is how to clean the new space. “Up to now, our staff has done a great job sweeping, mopping, emptying garbage and all the other deep cleaning,” he says. “Now it's getting a bit cumbersome. Do I make my staff members keep doing it, even though it's weighing them down? Do I hire a janitorial service or just employ more staff members to take on this task? I'm still figuring this one out.”

The key to it all, Dr. Petersen says, is to make a plan well before you move for as many eventualities as you can think of. Pick the brains of colleagues, and Lang suggests bringing team members into the conversation as well. “You'll learn more about how your hospital should run than you ever expected by just asking the people who do it every day,” he says. “Then let their ideas help guide your design.”

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