Office Design — Part 1
The following is a reprint of an article entitled, “One Dozen Essential Elements of a Great Dental Office Design” by Dr. David J. Ahearn. The contents of this article are Copyright © 2000, Dr. David J. Ahearn. All rights reserved.
One of the most valuable and lasting improvements that any dentist can contribute to a successful practice is an investment in great office design. Whether remodeling an existing office or creating a brand new facility from scratch, there are several essential elements to focus on in designing an office that will help create a more productive, comfortable, quiet and user-friendly practice. There are many distinct styles of practice. Clearly, dental office design is an individual matter based on one’s needs and budget. Nevertheless, the following key issues are common to any office: esthetics; the empowerment of key personnel; controlling noise; and creating rapid access to key equipment and materials. The next two articles contain the 12 elements essential to your success. They will provide you with what you need to know- from creating a sense of excitement to the effortless integration of high tech equipment into your practice.
1. RIGHT SIZE YOUR PRACTICE
The new office should be large enough to comfortably accommodate the needs of your personnel and patients. This statement seems quite obvious, however, we are continuously asked to consult on new (sometimes completed) office designs that, upon evaluation of the practice and its future, reveal plans that are significantly under or oversized. A careful assessment of the practice numbers including a procedure analysis will provide a good indicator of the appropriate targets. The goal is to create a patient flow that allows high efficiency while preventing systems bottlenecks.
2. YOUR OFFICE AND YOUR LIFE
We all know that providing dental care can be stressful. You and your staff need a place to unwind and socialize. Leave room for a little fun. Ideally, this area should be as far removed from the clinical space as possible. Conversely, to stay abreast of those essential activities that pay the bills, consider locating your private office close to the clinical area. A conveniently located private office can help you keep your pulse on the comings and goings of your practice and allow clinical staff ready access to your services. Don’t hide the real office manager -you- from the practice. (See Figure 1.)
3. HUB AND SPOKE
Sterilization and resupply are the clinical hub of your production terminal. Think Federal Express! Make sure this area is central and fully equipped to both sterilize and restock the entire facility. If you are creating a facility with fewer than ten treatment areas, don’t even consider multiple sterilization locations- centralize. Also, don’t waste money on a pre-made so-called “sterilization center.” They are too compact for most offices and do not provide a good cost-to-benefit ratio. The design details of your sterilization area are crucial. Frequently doctors are sold sterilizing equipment that is faster and therefore supposedly more efficient. The concept of rate limiting steps has rarely been studied in dentistry. Simply stated, an entire process will flow no more quickly than its slowest step will allow. In the busy office, properly staffed for efficiency, the rate-limiting step in sterilization is how often a clinical staff member is able to move the sterilization technology cycle along, not how fast each individual piece of equipment is. Therefore, the fastest equipment is rarely quicker in achieving its actual objective of returning instruments back to treatment than is a well-organized high flow stericenter. While we are certainly not advocates of slow equipment, proper layout, ease of use and durability should be the key to purchasing decisions here. (See Figure 2.)
4. INVENTORY IS EASY
Centralize all of your storage not just your bulk purchases. Consolidate your active storage for rapid room resupply as well. Far too many offices that we visit are burdened with tens of thousands of dollars of supplies scattered throughout the office-making control of purchasing and rotation of stock impossible, thus inhibiting the adoption of new generations of products and allowing product outdates to occur. Your resupply system should be hidden from patient view yet immediately accessible to clinical staff for both rapid access and ease of just-in-time inventory control. Products should not be hidden to the staff. Products should not be allowed to remain in their bulky promotional containers and should not, when possible, be stacked vertically. (See Figure 3.)
5. LAB LINKS
Although every practitioner knows that the dental lab feeds resupply directly, too many designs completely isolate these closely integrated areas. The office design should facilitate a quick and convenient transfer between these locations, yet they must be physically separate if even a minor amount of model work (trimming etc.) is performed in office. Labs need doors. Sterilization and resupply must be open to the clinical space. Make sure that the steady stream of items flowing between these areas is unobstructed. Separate, yet united. (See Figure 4.)
6. SILENCE IS GOLDEN
The importance of creating effective sound barriers and sound cushions within the dental office cannot be overstated. In the past, it was acceptable to isolate a waiting room from the rest of the office. This is no longer appropriate as patients expect to be treated as guests and not as inventory or as part of the furniture! Accordingly, superlative sound isolation is imperative in order to provide a quiet atmosphere in what has become the combined front office/guest seating area. Patients hate the sound of dental drills (even more than we can imagine!). Fortunately, many acoustical techniques are available to assist with this problem. However, these soundproofing details need to be carefully evaluated given the reflectivity of high-pitched, air-rotor turbine sounds. Remember, acoustical planning involves not only physical barriers, it also includes the wall compositions, strategic door and window angulations, and, occasionally, state-of-the-art ceiling and wall coverings. Much needed sound attenuation coefficients can be obtained through a variety of different wall and floor design modifications. (See Fig 5.)