A PRACTICAL GUIDE TO VETERINARY HOSPITAL PLANNING & DESIGNING

December 30, 2022

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A PRACTICAL GUIDE TO VETERINARY HOSPITAL PLANNING & DESIGNING

Designing the Clinical and Diagnostic Areas of the Veterinary Hospital

In veterinary hospital design, we often focus on the “front of house” client spaces, such as the reception area or the exam rooms. While these areas define your practice to the outside world, it is equally important to thoughtfully design the clinical spaces, where you will make your money.

TREATMENT ROOMS

The earliest treatment rooms in veterinary facilities were simple, a stall in a barn, the barnyard, or a kitchen table. As medical skills and technology expanded and client expectations evolved, veterinary facilities became more complex. In 1960, many of the state-of-the-art veterinary facilities did not differentiate between exam rooms and treatment spaces. It was all one, but now things are different.

The treatment room is often both figuratively and physically the center of a veterinary hospital’s universe and almost every other significant room touches it. In a very real sense, the length of the perimeter or circumference of the treatment area determines how many rooms can effectively adjoin it. We have learned that while an exterior window in a treatment bad, it is not a very cost-effective way to spend your money. Amazingly enough, a single medical treatment station requires about 150 square feet of floor space. Any less than this and things are going to feel tight; any more and you will be wasting money.

To effectively use the allocated 150 square feet of floor area per treatment station, you will want a horizontal surface on which to place an animal. This can simply be a table, or it can be a folding, rolling table or a tub table. You will also need back layout space for supplies, shelves, or carts to hold equipment, more shelves to hold immediately needed medical supplies, a good light source, and available and adequate power.

Beyond the immediate medical work station environs, a treatment room should also contain space for the following related functions:

An administrative work space for charting, invoicing, phone answering, etc.
A patient status board
A surgery schedule board
An x-ray viewing station
A bank of cages
Optional recovery runs
Storage shelving or cabinets for medical supplies, paper products, etc.
A place for trash and disposables

DENTAL AREAS

Years ago, dental services were considered special or ancillary. Today, in virtually all animal hospitals we integrate space that is specifically designed for dentistry. Dental care is different for doctors and staff; it is very stationary, so ergonomics become a more important consideration. Your equipment may be very specialized as well.

Treatment Tables

Custom tables with solid surface countertops may be built into your dental treatment station, or you may choose to use a manufacturer’s standard tub table. Ideally, tables will have adjustable height and tilting tops to achieve the best ergonomics. Wet lift tables are still rare, but they have made doing dentistry much more comfortable.

Radiography Equipment

One of your first decisions will be choosing between a wall-mounted or floor-standing x-ray unit. With a wall-mounted unit, careful placement and selection of the swing arm length is necessary when serving multiple tables. Digital radiography is becoming very common, eliminating the need for a tabletop processor.

Anesthesia and Medical Gas

Ideally, the anesthesia and gas scavenger system should have convenient connections at the end of the table. The best options are a ceiling track-mounted anesthesia system with ceiling connections for active gas scavenging or a stand-mounted system.

Centralized storage closets for oxygen tanks typically require special construction for fire safety. It is always best to locate medical gas closets on an exterior wall for fire safety reasons and for convenient tank delivery.

Scalers and Instruments

In new construction, you may want to locate your dental compressor in a remote location to reduce noise. Regardless of your choice for compressor location, it is likely that you will still need to “park” a cart in your treatment station. Specialized dental carts that include the compressor may be moved between several workstations, or swing-away arms may be mounted near the end of the table for easy access. All equipment should be within easy reach.

Lighting

Quality overhead lighting should be provided in the dental suite with the addition of a ceiling-mounted exam light at each treatment station. A head-mounted halogen light will provide optimal directional lighting to facilitate detailed dental work.

INTENSIVE CARE

The ICU is a relatively recent phenomenon. Much like the evolution of the treatment room, the ICU grew as medical skills and technology expanded, client expectations started changing, and there was a need to separate animal caging/housing areas from the commotion and infectious conditions of the treatment room. The present day ICU is also a reflection of how and why animals are being housed in veterinary facilities today. In years past, most animals that were being treated or cared for could look forward to an extended stay. This is no longer the case. Due to quicker and more effective treatment, many animals do not stay as long as they did in the past. Additionally, most practices now refer their overnight cases to emergency clinics, reducing or eliminating the cost of staffing and eliminating the need to get up in the middle of the night to care for housed animals. Finally, many veterinarians have come to depend on the medical expertise that an emergency clinic and a “criticalist” can provide. This means that in many cases the total amount of animal housing in the typical veterinary facility has been reduced. Housing is now found near the treatment area and/or up front and accessible, because only the most serious animals are kept for extended stays. The creation of the ICU is a direct product of this trend.

While the well-designed ICU is very much akin to the treatment room, there are several differences. The ICU typically maximizes the number of animals held in relation to the treatment work stations instead of the other way around. The perimeter of the ICU is usually made up of walls of cages or runs, most of which are positioned so there is immediate visual access and supervision of each and every cage. Open floor space is also important in the ICU because often there is a high level of traffic and commotion in these rooms. Open space also may be needed to get around animals and staff that can be on the floor.

With the ICU typically an adjunct to the treatment room and immediately accessible from surgery, there is the question of whether or not the ICU should be a distinct and enclosed space. The ICU can be created as an open alcove off of the treatment area, making it very immediately accessible and visible, or it can be behind glass to attempt to minimize infection and commotion. There is no right or wrong design. It is a function of your practice style, your staffing, the type of medicine you practice, and the economics of construction.

The ICU is a reflection of veterinarians offering, and billing clients for, different levels of medical care. Just as cost and level of care varies in human medicine from the ICU to the generic hospital room, veterinary practices are trending in the same direction. We are also designing large-scale specialty practices that include an Intermediate Care Ward, which falls someplace between the normal, generic hospital ward and the ICU.

INTEGRATION OF EQUIPMENT

It is easy to get fixated on the bigger aspects of hospital design, like the overall look of the building or how spaces work and flow together. But it is the successful coordination of equipment requirements that makes clinical and diagnostic spaces work. Coordination of equipment is an essential component that is often overlooked or left until the end. But the sooner you can begin to plan around equipment, the more successful your design will be.

As a simple example, let’s consider the pack/prep area. Every veterinarian has different needs in their pack/prep. Specialty hospitals might require a large floor model autoclave, but a standard veterinary practice may only utilize a countertop model. Either way, there are design considerations.

With a floor autoclave, considerations include the overall size of the unit, required floor clearances around the autoclave, and even the coordination of a floor sink and built-in hot and cold water plumbing for the unit. As one can imagine, these requirements will quickly begin to dictate the overall size of your pack/prep area.

On a smaller scale, a general practice hospital will likely use a countertop autoclave, which might not seem like a big deal. However, most countertop autoclave models are actually deeper than a standard 24-inch counter. So building a deeper cabinet base might be imperative to the design. In addition, the manufacturers of these countertop models typically recommend the use of distilled water. These are all examples of the everyday equipment decisions that are important to consider during the design of the clinical and diagnostic areas of your hospital.

A ‘Veterinary Hospital’ or ‘Animal Hospital’ is defined as a place used to diagnose animal diseases or disorders, surgically or medically treat animals, prevent animal disorders etc. Treatment may include keeping the animals on the premises for treatment.

Designing of Veterinary Hospital

Departments

The following is a list of the rooms and facilities usually required in a Veterinary Hospital:

Reception room

The reception room is planned to seat four to five people and their animals per veterinarian. This number will decrease per veterinarian as the number of veterinarians increases.
It is extremely important that in the original planning this room not be made too small, for in the case of future expansion, this space, with additional furniture, should be adequate to accommodate the additional patients.
Many animal hospitals use a system of stalls in the waiting room. This stall is usually 2′-6″ wide and 4′-0 ” deep, in which the owner and the animal sit and wait until called by the veterinarian.

Business office

The business office should be accessible to separate entrances from the reception room and the hospital in general. It may well adjoin the staff room.
In the business office should be kept the inactive records. Space in the business office or the staff room should be available for staff members to use while completing medical records.

Private office

This room is a small space where the veterinarian can carry on private conversation, study and relaxation.
The office should be isolated from the clients, but readily accessible to the business office and the examination room.
The veterinarian should be able to reach this room by a secondary entrance in the building and not be forced to walk through the reception room.

Examination room

The examination room is an area where veterinarian and client can discuss and examine the patient, as well as treat minor ailments. 90 to 120 sq. ft. of floor area are usually adequate for this room.
Efficient operation requires that 1-1/2 examination rooms per veterinarian should be provided. This room should contain an examination table, supply cabinet, and sink; it may also contain chairs for the client and a writing desk for the veterinarian.
The examination room should be made as quiet as possible to facilitate examinations. It should be easily darkened so that the eyes may be examined.

Work room – laundry

The work room is usually provided in large hospitals.
It is used for dressing wounds, taking fecal, blood, or urine samples, and other miscellaneous tasks.

Preparation Room

The preparation room is used to prepare the animal for surgery.
This room is also used for setting broken legs and applying splints, both wooden and metal. Therefore, it should be equipped with a small band-saw vise and a work bench on which both wood and metal may be worked.
It should be adjacent to the surgical ward, recovery ward and X-ray room.
The wall between the preparation room and the recovery ward should be of clear glass so that the person working in the preparation room can watch the dogs in the recovery room in case they regurgitate.
The wall between the surgery and the preparation room should be equipped with a clear glass panel also so that the veterinarian can supervise the work going on in the preparation room from the surgery.

Surgery Room

The surgery should be adequate to accommodate major operations.
The surgery room should be air-conditioned, and if separate units are used, temperature and humidity should be the same as that in the preparation room and recovery ward.
Adjacent to the surgery should be a scrub-up room where those concerned with the surgery may cleanse themselves properly.

Dark Room & X-Ray Room

In a small hospital, X-ray equipment may be small and may be placed in a room which is not used to a great extent. However, in a large hospital a separate room is necessary.
The X-ray room should be so located to be readily accessible to the in-patient areas and as close as possible to the preparation room and surgery.

Scrub-up Room

The scrub-up room should contain two scrub-up sinks equipped with knee operating faucets and disinfectant material nearby, operated by either foot, knee or elbow.
Also, there should be a place where sterile brushes may be stored adjacent to the sinks.
There should be a small window between the scrub-up room and the operating room. This is desirable for the veterinarian to observe what takes place in the operating room while he scrubs.

Laboratory & Pharmacy

The space allotted for the laboratory work depends upon the size of the hospital and the amount of actual laboratory work that the veterinarian plans to do. Many hospitals combine this room with the pharmacy, and sometimes it is also the work room.
From this room much of the basic information on the patients’ health and well-being is brought forth. Therefore, it should be well planned and well equipped.
The pharmacy should be convenient to the examination rooms and the main hospital area. Space will be required for a small refrigerator and a safe if narcotics are to be used. The pharmacy should be placed in the care of a responsible person so that sufficient drugs and stocks are kept on hand.

Wards

The recent trend in wards has been that the wards be kept small. A ward of ten to twelve animals is considered ideal.
In a small ward the animals are less likely to be disturbed and there is less contact between patients.
Much of the noise can be eliminated if the cages are arranged so that the animals cannot see one another.
It is recommended that a space of at least 41-6″ to 5′-O” remain in front of the cage for access.

The exact number of wards in a hospital can fluctuate greatly. Two general wards and an isolation ward compromise a minimum. Some hospitals have included all of the following:

Recovery ward
Medicinal ward
Surgical ward
Skin ward
Isolation ward
Cat ward

Exercise Runs

Adjacent to all wards a place should be provided where the dogs may be allowed to exercise. In the isolation ward where the animals are confined, an area should be provided for their exercise.

Grooming & Bathing Room

The size of this room will fluctuate considerably in accordance with the veterinarian’s attitude toward this phase of practice.
This room should be adapted into the plan in such a manner that the animals using this service must not use the reception room. The animals could be taken to this room and placed in a cage and left.

Cages

There is no one answer as far as the ideal cage is concerned. There are as many cage designs as there are veterinarians.
The materials used for the cage construction should be easily maintained, tough, hard surface, and scratch resistant.

Conclusion

To conclude, Specific area must be provided to different departments of veterinary hospital. Day to day functioning of veterinary hospital becomes easier due to appropriate planning & designing of hospital.

Designing the clinical and diagnostic areas of your hospital is a detail-oriented and intensive exercise that requires the coordination of your team. Start with the big picture layout issues, and once those are under control, develop a rigorous process to successfully integrate your numerous pieces of owner equipment.