A building is the largest single investment for a veterinary practice. Even the smallest structures require significant time and money to plan and construct. This is why we spend a lot of time with our clients to create hospitals that are as efficient as possible, so every veterinary practice that we design can reap the most benefit from this investment.
Hospitals are function driven, which means they are floor-plan driven. Imagine a veterinary hospital as a building that is often designed from the inside out. Equine hospitals are unique buildings, however, because they must also connect back outside to the barns and circulation areas in order to work well and to expand easily over time.
Fortunately, the principles behind a good floor plan are simple to explain and easy to share. In this article, we will walk you through the basics of equine floor planning. Armed with these organizing concepts, you will be able to direct your team and spend your money wisely.
Start with the Site
Because equine hospitals are by their nature indoor/outdoor buildings, a well-thought-out site plan. As you begin to plan the placement of the structures on your site, use the following guidelines:
• Survey all legal and physical restrictions to your property and have your design professional clearly note these on the site plan. These restrictions may include easements, setbacks, right-of-way restrictions, flood plain limitations, areas of steep topography, etc. Never place buildings so close to these restricted areas that you cannot expand the buildings in the future.
• The lowest portion of the site will become a storm-water management area. Restrict development in this area.
• Plan the main hospital building where it can be seen easily upon driving onto the property. The front entrance should be readily apparent. This will prevent your clients from getting lost and wandering around the property.
• Place turnout areas and arenas on higher portions of the site so they drain properly.
Plan Your Circulation
Circulation is extremely important for equine facilities. For the safety of your clients and patients, provide separate and distinct traffic flow patterns for vehicles, horses and staff. Design your client vehicular circulation area for simple maneuvering. Circle turnarounds are best. Anxious clients cannot be relied upon to safely back up horse trailers.
In addition to the front turnaround, provide a simple loop or something similar for authorized vehicular circulation to the rear of the site. Encourage one-way traffic flow to prevent confusion.
Placement of Equine Isolation Facilities
One specific site-planning consideration warrants extra attention: isolation facilities. Isolation of communicable disease is a significant concern for most equine facilities. Even if you see a small number of horses, you should provide a disease quarantine area that is separated from other horse-holding spaces. Locate the isolation facility out of the traffic flow. Include room nearby for temporary storage of contaminated bedding.
Placement of Barns Relative to the Hospital
In addition to locating the hospital, you will need to locate the medical barns. These barns should be close to the hospital, but on a quieter part of the site. It should be possible for clients to drive up to the barn in the event that a disabled horse needs to be loaded or unloaded close to a stall.
Orient Your Barns Properly
Recent research from the University of Kansas has reinforced the traditional knowledge that dairy barns oriented on an east/west axis ventilate better and remain cooler. This orientation works best for cow and horse barns in most of the temperate and hot climates in the United States, where exposure to the western sun should be minimized. It has been proven to have less effect in northern climates. For example, in Ontario, barns are often traditionally oriented north/south.
In the above compressed site plan for an equine hospital, designed to provide services to private and racehorse clientele adjacent to a track in Australia, it is easy to see the relative placement of barn, hospital and isolation facilities (bottom left) within a small footprint. Note the following:
• The front door is prominent and readily apparent to approaching clients.
• A circular drive allows horses to be dropped off at the back of the facility.
• Barns are oriented on an east/west axis. In Australia, the north exposure is similar to the south exposure in the northern hemisphere. It is still important to minimize east and west facades when possible.
Floor Plan Basics: Zoning
Once you have a clear vision of your new hospital and you have organized the layout of your site, the next step is to develop the floor plan. An efficient floor plan divides the hospital into three distinct zones: human, medical and patient. The purpose for dividing the hospital is threefold: to create simple traffic patterns, to reduce the number of transitions from one floor or wall finish to another, and to consolidate functions that have similar ventilation requirements.
The Human Zone
The human zone includes the client reception and waiting area, the lab, the pharmacy, offices, restrooms and resource rooms. This zone also includes storage and support spaces such as laundry and utility. We often locate pack/prep and surgery scrubs within the “human zone” even though they have the sanitation requirements of the medical zone. This allows doctors and techs to access this area from offices and the lab without crossing treatment and exam spaces.
The Medical Zone
The equine exam areas form the transition between the human and the medical zones. Smaller hospitals often combine the exam area with treatment, imaging, dental and standing surgery, in which case the exam area must be finished and ventilated to meet medical zone standards.
Larger facilities often separate the exam areas from the rest of the medical zone. In that case, the exam areas can be finished with fewer industrial materials and may have reduced ventilation requirements.
In addition to patient exam areas, the medical zone often includes imaging, surgery prep, induction, surgery and recovery.
The Patient Zone
Equine wards and their support
spaces make up the patient zone. Larger hospitals might need to separate their wards from the main body of the hospital. If you take this approach, remember that you will still need to be able to monitor some patients, such as critical neonatal cases and horses in ICU. It is best to locate at least a few stalls within the hospital where these patients will benefit from continuous monitoring and a climate-controlled environment.
Case Study 1
The test of a good floor plan is to clearly zone the plan so there is no unnecessary crossing of circulation paths. In the small hospital layout above, each of the three zones is clearly defined. The treatment/exam areas face south and are indoor/outdoor.
Organizing Larger Equine Campuses
The basics of organizing small and large equine campuses are the same, but the issues themselves become greater as the hospital size increases.
For example, isolation facility placement becomes critical in large equine facilities because of the risk of spreading infectious disease. Circulation paths must be cleanly laid out and well organized.
Zoning in large equine hospitals is more complex than for small hospitals. Large equine practices are often comprised of several veterinary specialties. To minimize conflict, confusion and unnecessary circulation, it makes sense to design a plan that groups similar functions into distinct departments. These departments might even occupy separate buildings.
For example, an imaging department might have its own self-contained human, medical and patient zones.
For a large facility to operate smoothly, it must have a clear circulation pattern. An internal racetrack pattern that runs between departments or buildings minimizes complex cross-circulation and reduces the overall number of steps needed to travel from place to place.
This “racetrack” pattern might even run between buildings if departments are located in separate structures.
Case Study 2
The case study above demonstrates how a large hospital might be organized into smaller departments, and how the circulation could be organized.
Combination Large and Small Animal Hospitals
Some equine practices combine forces with small animal practices to provide more services to their clients, draw from a larger market and share the risks and rewards of business. Floor plans that combine a small animal hospital and a large animal or equine hospital have their own unique challenges. However, combining practices is a great way to share resources and save on overall square footage when building a facility.
The following are examples of functions that can be shared between both sides of the hospital:
• Waiting and Reception
• Pharmacy and Laboratory
• Doctors’ Stations
• Pack/Prep and Scrub
• Administrative and File Areas
• Storage, Loading and Central Supply
• Laundry, Utility and Food Prep
Case Study 3
In the floor plan above, a central circulation spine organizes the shared functions between the small animal and large animal sides of the hospital.
Well-organized designs unify the hospital and the site plans into an overall design that promotes efficiency, safety and bio-security. It might not be easy to initially anticipate what will work for your site and your plan, but it is often easy to see mistakes before they occur. As your design team develops your preliminary floor and site plans, ask these two questions:
1. Can you clearly define the human, medical and patient zones on the site and within the plan?
2. What is the circulation of humans and horses between these zones?
If you see crossing circulation paths, stop and rethink what you are doing. It is worth spending time in the preliminary stages to develop a great plan, as the right design lays the groundwork for a useful and efficient hospital.