Opening that new office is one of the most anticipated events for a physician or group of physicians. It gives them an opportunity to start fresh with a new office and redesign their work flow. Space planning is extremely important since it is where new layouts can lead to increased efficiency and productivity and can be a wonderful time to make those changes they've always wanted, but those changes are extremely important as many doctors will be in that space for 10 or more years.

 

 

#1  Start with a clean slate. While moving into existing office space may be cheaper, it often has the disadvantage of working with existing layouts. If possible start with a clean slate. Most existing spaces will have the disadvantage of fixed layouts that you have to work with and often leading to less efficiency. With large open shell space one can create new space that allows the most flexibility in office layout and smooth patient flow.

 

#2  Know your needs. The basics of any office design is to understand your needs in terms of how many exam rooms you will need per doctor (usually 3 to 5).  Patients don't like to wait in exam rooms, so too many will encourage longer waits in a place where they are less comfortable. The number of physicians you have multiplied by the number of anticipated clinics per week help determine the number of clinical stations or pods needed.

 

#3  Make the wait worth it.  This is the first thing a patient sees in a practice and it needs to be pleasant to reduce stress levels. Don't have a lot of clutter around or business operations out in view. It needs to have comfortable furniture with breaks in the seating so people don't feel like they're at an airport. Design the floor layout so there is no congestion or bottlenecks. Art work should be neutral without being provocative. If a television is located it the room, it should not be on the news channel or a program that raises stress levels. Natural light is very important, and if there are no windows, have a glass door entry. A positive first impression is critical.

 

#4  Decorate with patients in mind.  Many physicians often ask one of their wives to do the "decorating." This has led to some disastrous color schemes like black or blood red walls along with the latest abstract art that no one can figure out. Keep to pastels or earth tones for the walls and don't use wallpaper. It is the hardest to maintain and expensive to remove and repaint. Having accent walls with color breaks that are low contrast will have the visual effect of shorter hallways and a more pleasing look. Avoiding a warehouse or government building look is important. If possible engage the services of a designer with experience in medical offices to select compatible wall colors and flooring that flow well with any countertops, tile, or millwork. 

#5  Back office belongs in the back.  Staff and administrative space should not be visible to the patients. Employees working collections or other administrative or secretarial staff should always be in the background and away from the clinical area.  (A corollary to this is to discourage accounting staff from bringing their work or questions for the doctor to the clinical area.) Their appearance detracts from the "clinic" atmosphere and makes things seem more like a business office rather than a place that deals in health care.   

 

#6  Design by democracy. After making a preliminary floor plan, ask for feedback from nurses, physicians, and other administrative staff. Often they can pick up on more subtle flaws and bottlenecks. Some physicians may have different needs than others such as x-ray view boxes or sinks and storage.  Experienced personnel often can visualize patient flow patterns from entry to exit better than physicians who are always trapped in the clinical area.

 

#7 Don't forget the billing needs.  Billing and collections are a part of any practice. Consider having at least one small room with a desk and chairs for three people for private discussions. Occasionally unwieldy or upset patients can speak with the manager in this room. Cash collections and balances are more frequently addressed at the time of a patient's visit but need to be away from the clinical area or waiting room so it doesn't violate #5 above. Check out desks located near the exits could include personnel that can address minor balances or copays following the visit.

 

#8  Data Data Data.  The modern medical office is often a marvel of data networking. From computer monitors located in the clinical pods or patient rooms to data transferring and networking, a well wired clinic is a must. If anything, data demand and processing is growing. Most medical imaging including MRI and CT studies are available on line. The trend for electronic medical records and imaging can go no where but up with government mandates.  Plan for the future and put in as much prewiring as possible and more than you need. It gets very expensive to retrofit an older office.

 

#9  Where are the supplies?  Most clinical offices underestimate the need for storage space for supplies and equipment. Carefully determine what the supply needs are at each clinincal area and include enough storage space. Consider storing supplies in exam room cabinets for easy access but be careful not to overdo it on millwork since that can be one of the most expensive build out costs.  Instead, plan for large storage rooms for bulk supplies with open shelf space.  Most clinics wish they had more storage after they get up and running.

#10  Everything else.  I could go on and on and not get everything else. Make sure you are HIPPA compliant. Take all sensitive data as far away as possible.  Break rooms for staff and doctors need to be large enough to be comfortable to eat in. Limit kitchen appliances to microwave, fridge and sink, no stove or dishwashers. Protect yourself from being overcharged on rent. Get an appraiser to remeasure rentable area space to avoid paying for larger square footage than you actually have. (Some common area space unfortunately must be included.)  Have enough bathrooms for staff and, if possible, have them separate from patient bathrooms. All have to be ADA compliant. Consider using a professional design team to assist you in all phases. They can keep you on track and help you efficiently work through the process.