Here’s a statement that applies to just about anything in life: “The best way to do something is the way that works best for you.” That advice also applies to the design and flow of veterinary emergency hospitals. The fact is, emergency medicine looks different from one provider to the next. Some offer emergency services only, while others augment with specialty services. The design and layout of the facilities — and what works best — look different at each one.
So, if you manage a veterinary ER practice or your small animal clinic offers ER services, the following insights from two design professionals might open your mind to what’s possible.
Open Floor Plans
Ashley Shoults, AIA, NCARB, is the director of design at Veterinary Emergency Group, which operates nearly 50 ER hospitals from Massachusetts to California and handles more than 300,000 pet emergencies each year.
All VEG locations are open concept, Shoults said, meaning clients (“customers” in the company’s vocabulary) can access the entire hospital from the front door to the back.
While VEG hospitals feature a small lobby at the front, they don’t have exam rooms directly off the lobby.
“Upon arrival, customers and patients are both immediately taken back into treatment, and the customers speak to a doctor right away,” she said. “While this may not be the typical approach in emergency veterinary medicine, we find it works extremely well for our staff and customers.
“The openness and transparency allow our customers to feel fully involved in the entire treatment process of their pets, which is especially helpful and even somewhat calming during a stressful time. Our customers never have to wonder what is happening to their pets when taken ‘into the back.’”
The VEG open floor plan also allows for flexibility in managing care. For instance, during the peak of the COVID-19 pandemic, VEG clients couldn’t go inside the building. The open design and liberal use of windows helped maintain pet owner involvement and interaction.
“Because all our treatment tables are mobile, we were able to move the tables to exterior windows and perform exams in front of the windows while the customers watched from outside and were on the phone with us to hear everything being discussed,” Shoults said. “The flexible and mobile environment that we created allowed us to still allow customers to be a part of the treatment process of their pets.”
Another benefit of the open floor plan, she said, is that it allows clients to see what other pet owners experience and bond with them.
“We have had multiple occasions where one customer pays another’s bill,” Shoults said. “That type of thing wouldn’t happen in a traditional veterinary setting where everyone sits in their own private exam room.”
Richard Renschen, AIA, LEED AP, is the president of MD Architects, which has designed veterinary hospitals for over 15 years. The firm is known for its work with industry leaders such as VCA and BluePearl Pet Hospital.
MD Architects’ designs encompass traditional and flexible floor plans.
“Experienced veterinary design firms are breaking the preconceived boundaries of traditional hospital layouts,” he said. “Adjacencies of spaces like exam rooms, treatment spaces and waiting areas are being reinvented to maximize the experience of clients, both human and animal.”
One example is the open concept, where clients maintain physical or visual contact with their pets.
“Consider the path of travel with the gurney. Ramps, bumps and rough floor finishes can hinder the travel experience,” Renschen said. “The travel distance to the ER area from the front door should be as minimal as possible for speed.”
He also noted that hospitals benefit from integrating architectural design and branding.
“If you engage your architect at that level, you will have a much more cohesive product,” he said. “For instance, ‘Who are you? What are you trying to project to the customer and staff?’ Questions like these are the basis of a strong design. Our clients were very front-of-house and client-focused in the past, but now we’re designing from front to back door.”
What’s in Vogue
Both hospital design experts weighed in on today’s trends in emergency care. What do providers look for in layout and function? Shoults had a one-word answer: convenience.
“Both digital and physical convenience are huge drivers right now in our world,” she said. “One of the biggest issues we hear is there aren’t enough emergency vet options. Or even when there are, wait times are often four to five hours.
“In our society, where everything is typically available right at your fingertips, hearing that you have to wait multiple hours in an emergency situation is less than ideal. Providing opportunities to speak to or see a doctor right away, view your pet’s care plan and the associated costs right on your phone, and provide opportunities to FaceTime or see your pet while they’re hospitalized are all convenience factors that customers want and need today.”
Renschen sees a stronger focus on staffing and team well-being these days. His team designs spacious break rooms with outdoor space, eye-catching doctor offices with separate lounges, nursing rooms for moms and even mental break areas. There’s also a strong focus on exposing the inside to natural light.
Another item that can affect the floor plan is security.
“How can you lock down certain parts of the hospital after hours?” Renschen said. “Keeping all this in mind during the design process will benefit your final layout.”
More Words of Advice
Consider the following tips if you operate an ER hospital or are considering a renovation or new build.
“Emergency medicine is fast-paced and usually more physically demanding than general practice,” Shoults said. “So, your emergency hospital needs to be designed to accommodate the rapid pace, urgency and sudden changes that come with emergency medicine on a day-to-day basis. That might look different for each practice, but it should be thought about and accounted for in the hospital’s design.
“Think about your clients and find ways to provide a high level of customer service,” she said. “Your customers are stressed and worried about their pet, so the more open, transparent and customer-focused you can be, the more likely they are going to be understanding and satisfied with their pets’ care, and the easier and more fulfilling your job will be.”
Renschen’s top tip: “Bring in an experienced veterinary architect early in the process.”
Design professionals can assist with:
- Site evaluation
- Lease review
- Building requirements and code compliance
- Assessment of an existing building
- Space planning
- Preliminary construction considerations
“In today’s difficult job market, it has become imperative to do everything you can to attract new talented doctors and techs,” Renschen said. “Because of this, we have seen more practices than ever choosing to relocate to a brand-new location rather than renovate their existing practice.
“Renovations are very expensive and long. Staying open for business during a renovation is hard on the staff, and the potential loss of revenue through a lengthy construction process can deter those considering renovation.
“Tying branding of a practice into the design has also become much more prevalent.”
A CASE STUDY
MD Architects designed Metropolitan Veterinary Hospital Cleveland East, a 39,787-square-foot facility in Highland Heights, Ohio. The hospital’s director of operations, Jessica Cleckner-Peters, RVT, explained the project.
- “Many factors were taken into consideration when designing the new location for our 24/7 emergency and referral hospital. Using the existing footprint, MD Architects transformed the building into a highly functional, efficient and creative space.”
- “Separate entrances for specialty and ER allow for a more efficient workflow, improved security and better client experience.”
- “The emergency entrance is clearly defined with eye-catching signage. It has a drive-under canopy for clients with critically sick or injured pets, and the oversized vestibules allow for gurney storage.”
- “In addition, the reception desk is in direct sight of the drop-off area, and an automatic door designed to open with the swipe of a badge was installed between the triage area and the lobby.”
- “The ER triage area is conveniently located near the lobby and exam rooms. This space was designed with kennels and cages, which enables the emergency staff to visualize their patients at all times during work-up and treatment. The in-house laboratory and digital X-ray rooms are centrally located near the triage room.”
- “All these elements allow the veterinary team to access and triage their patients more quickly.”