growing pains - cdn.ymaws.com

Where there’s a problemThere’s a solution.Copyright PFS 2016 PracticeFlowSolutions.com

Satellite and Expansion and Designing the Efficient, Productive ENT Space

Growing Pains:

Tim Griffin, [email protected]

Where there’s a problem.There’s a solution.

2016 AOA Course 303Friday Sept. 9, 2016

9:00-10:00am

303 Growing Pains –Designing the Efficient, Productive ENT Space

Tim Griffin, AIAPractice Flow Solutions

www.PracticeFlowSolutions.com Page 1

AOA Course # 303Friday, Sept. 9, 20169:00am – 10:00 am

Where there’s a problem. There’s a solution.Copyright PFS 2016 PracticeFlowSolutions.com

Growth & Expansion

Reasons for growth

•Adding Doctors

•Adding services

•Current spatial problems


Growth

Think short term and long term.

“Nothing is as permanent as a temporary solution.”

Growth & Expansion


Philosophy of Design

Medical Practice Planning

All decisions of the design should center around improving the practice flow.

“Form Follows Function”

If a building/space has a specific function the design should be guided by and support that function.






Successful Planning Process

•Assess Current Flow

•Doctor’s Patient Volume Potential

•Project Growth - Future Schedule

•Space Needs Assessment

Pre-Design Phase

•Design Space

Design Phase


Observe the flow

Magnitude of logjams

Improve

Time Study

Assess Current Flow


+No patient ready for provider

+Provider looking for staff, next patient, …

+Provider leaving Exam Pod

+Receptionist away from check-in

+Patients escorted out or lost

Identify – Assess Flow






Identify

Doctor’s Potential

Compare current hourly output with the actual potential for each provider.

Observations / Time Study

Base Space/Staff need on Potential


Identify Need

Current Schedule

CURRENT SCHEDULE

Pods 1 2 3 1 2 1 2

AM HK AL MAB CS MB 1 1 1 1 1 5

PM HK AL MAB MB CS 1 0 1 1 1 4

AM AL MB CS MAB HK 0 1 1 1 1 4

PM HK MB CS MAB AL 1 1 0 1 1 4

AM HK CS AL MB MAB 1 1 1 1 1 5

PM HK MB AL MAB CS 1 0 1 1 1 4

AM CS MAB HK AL 1 1 0 0 1 3

PM CS MAB AL HK 0 1 1 0 1 3

AM CS HK AL 1 1 1 0 0 3

PM CS HK AL 1 1 1 0 0 3

Pod Utilization 100% 80% 30% 80% 60% 8 8 8 6 8 38

Monday

Tuesday

Wenesday

Thursday

Friday

Doc # 5

Doc # 4

SATELITE SURGERY

Total Doctor Sessions

MAIN

HK

CS

AL

MB

MAB

Practice A

Doc # 1

Doc # 2

Doc # 3


Identify Need

Projected Schedule

PROJECTED SCHEDULE - Long Term

Pods 1 2 3 4 1 2 1 2

AM HK AL MAB dr6 CS MB dr7 1 1 1 1 1 1 0 6

PM HK AL MAB dr6 dr7 MB CS 1 0 1 1 1 1 1 6

AM AL MB dr7 dr6 CS MAB HK 0 1 1 1 1 1 1 6

PM HK MB dr6 CS MAB AL 1 1 0 1 1 1 0 5

AM HK CS AL dr7 MB MAB dr6 1 1 1 1 1 0 1 6

PM HK MB dr7 dr6 AL MAB CS 1 0 1 1 1 1 1 6

AM CS MAB dr6 HK dr7 AL 1 1 0 0 1 1 1 5

PM CS MAB dr6 AL dr7 HK 0 1 1 0 1 1 1 5

AM CS dr7 HK AL dr6 1 1 1 0 0 0 1 4

PM CS dr6 HK AL dr7 1 1 1 0 0 1 0 4

Pod Utilization 100% 100% 70% 60% 100% 100% 100% 8 8 8 6 8 8 7 53

Thursday

Friday

MAB

dr6

dr7

Monday

Tuesday

Wenesday

future doc

future doc

Total D

octor Sessions

MAIN SATELITE SURGERY

HK

CS

AL

MB

Practice A

Doc # 1

Doc # 2

Doc # 3

Doc # 4

Doc # 5






Identify Need

Space Needs AssessmentBASIS OF SPACIAL ALLOCATIONS

Practice Data

Providers in the practice

4 MDs

4 PAs / NPs

Providers seeing patients at once

2 MDs seeing patients at once (pods)

2 PAs/NPs seeing patients at once (pods)

Anticipated Productivity

6 patients seen every hour per MD pod

3 patients seen every hour per PA/NP pod

18 total patients seen by all providers every hour

Clinic Space

3 exam rooms per MD pod

2 exam rooms per PA/NP pod

1 MA station per pod

1 Provider alcove per pod

Front Office

4 minutes on average to check-in patients

4 minutes on average to check-out patients

1.2 check-in staff (total patients x min. check in / 60 min.)

1.2 check-out staff (total patients x min. check in / 60 min.)

Waiting

1.5 family that accompany each patient

45 total patients and family entering practice every hour

10 exam rooms

14 1/2 of family to exam room

22 waiting chairs


Identify Need

WAITING

# of Description of area sf/per

1 vesitbule 100 100 100

22 clinical waiting chairs 20 440 440

1 child play area 100 100 100

1 coffee/water 25 25 25

1 patient toilet 55 55 55

Subtotal 720 720 -

Hallway Factor 30% 216 216 -

WAITING Total 936 936 -

FRONT STAFF


2 check-in spaces 65 130 130

1 staff work area 50 50 50

2 check-out spaces 65 130 130

Subtotal 310 310 -


FRONT STAFF Total 403 403 -

Total Area

(sf)

First Floor

(sf)

1st floor

Area (sf)

First Floor

(sf)

Attic Space

Storage (sf)

Attic Space

Storage (sf)


Identify NeedCLINICAL AREAS


2 MD PODs

6 exam rooms 108 648 648

2 MD work station 42 84 84

2 nurse station 65 130 130

-

2 PA PODs -

4 exam rooms 108 432 432

2 PA work station 42 84 84

1 nurse station 65 65 65

-

1 CT 120 120 120

1 photo room 80 80 80

1 samples closet 15 15 15

2 patient toilets 55 110 110

1 clinical storage 36 36 36

1 post-op entry / sub-wait 80 80 80

Subtotal 1,884 1,884 -


CLINICAL AREAS Total 2,449 2,449 -

1st floor

Area (sf)

First Floor

(sf)

Attic Space

Storage (sf)






Identify NeedALLERGY


10 waiting area seats 20 200 200

1 tech station/reception 100 100 100

1 shot stations - chair 36 36 36

1 shot stations - reclined 56 56 56

2 allergy testing rooms 108 216 216

1 mix lab 120 120 120

1 storage 20 20 20

Subtotal 748 748 -


ALLERGY Total 972 972 -

AUDIOLOGY


2 audiology booths 120 240 240

1 VNG room 120 120 120

1 hearing aid fitting 90 90 90

1 hearing aid storage 20 20 20

4 sub-waiting 18 72 72

1 audilogist work area 144 144 144

Subtotal 686 686 -


AUDIOLOGY Total 892 892 -

1st floor

Area (sf)

First Floor

(sf)

1st floor

Area (sf)

First Floor

(sf)

Attic Space

Storage (sf)

Attic Space

Storage (sf)


Identify Need

PROCEDURES SUITE


1 prep area 120 120 120

2 procedure room 252 504 504

1 scrub sink area 15 15 15

1 post procedure area 120 120 120

2 patient toilets 55 110 110

1 patient lockers 12 12 12

1 nurse station (pre and post areas) 150 150 150

1 instrument cleaning 65 65 65

1 sterilizer room 80 80 80

1 clean linen storage 20 20 20

1 sterile storage 80 80 80

1 dirty linen 20 20 20

1 bio-hazard waste 20 20 20

Subtotal 1,316 1,316 -


PROCEDURES SUITE Total 1,842 1,842 -

1st floor

Area (sf)

First Floor

(sf)

Attic Space

Storage (sf)


Identify NeedSPA / COSMETIC AREAS


10 waiting seats 25 250 250

1 refreshements 36 36 36

1 cosmetic coordinator 90 90 90

2 treatment rooms 132 264 264

1 product display/store 100 100 100

1 staff work area 80 80 80

1 patient toilet 55 55 55

Subtotal 875 875 -


SPA / COSMETIC AREAS Total 1,138 1,138 -

Attic Space

Storage (sf)

1st floor

Area (sf)

First Floor

(sf)

PROVIDER PRIVATE AREAS


4 doctor office spaces 120 480 480

1 doctor lounge 120 120 120

1 doctor toilet/shower 100 100 100

1 PA/NP shared office 120 120 120

Subtotal 820 820 -


PROVIDER PRIVATE AREAS Total 1,066 1,066 -

1st floor

Area (sf)

First Floor

(sf)

Attic Space

Storage (sf)






Identify NeedBUILDING SUPPORT AREAS


1 conference room 240 240 240

1 staff lounge 150 150 150

2 staff toilets 55 110 110

1 laundry room 80 80 80

1 janitor closet 36 36 25

1 electrical room 48 48 48

1 computer server room 36 36 36

1 bulk storage room 120 120 120

1 stair to attic 60 60 50

Subtotal 880 739 120

Hallway Factor 30% 264 222 36

BUILDING SUPPORT AREAS Total 1,144 961 156

SUBTOTAL USEABLE AREA 11,578 11,332 218

Secondary Circulation 5% 579 567

TOTAL USEABLE AREA 12,157 11,899

Exterior wall factor 5% 608 595

TOTAL GROSS AREA 12,765 12,494

1st floor

Area (sf)

First Floor

(sf)

Attic Space

Storage (sf)


Identify NeedPARKING SUMMARY

Description of area TOTAL

Clinic Patients 25

Clinic Staff / Providers 30

Spa (patient and staff) 8

Sleep Lab

Total Parking Spots 63

LAND SUMMARY

Description of area TOTAL

Building Pad 12,756

Parking 350 sf / car 63 cars 22,050

Subtotal Gross Area / Floor 34,806

Land Coverage Factor 50% 17,403

Total Gross Area (sf) 52,209

Total Gross Area (acres) 1.60


Find Space

Work with a realtor

•Location•Geometry•Parking•Due Diligence






Find Space

Due Diligence

•Proper Parking•Proper Zoning•Building Integrity•Building Systems•Fare Rent•Landlord Reputation•LOI•Attorneys and Realtors


Find/ Assess Space

Geometry – too long and narrow


Geometry – effectively long an narrow

Core

Find / Assess Space






Geometry – Good

Find / Assess Space

Core


Find / Assess

Identify Entrances


Find / Assess

Identify Entrances






Design

Exam Pod Layout

E E E EMD

+/- 40’

“Straight Line”

• Too much walking

• Too much traffic on exam hall


Design

Exam Pod Layout

E E

E EMD

+/- 20’

“Nested”

Hall cut in half


Design

Exam Pod Layout

E E

E EMD

+/- 20’

“Nested”

Hall cut in half

Private hall

Connection at MD

E

E EE

MD






Where there’s a problem. There’s a solution.

Tim Griffin, [email protected]

678-982-2965

growing pains - cdn.ymaws.com

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