Room size. The smallest space in which to comfortably examine an individual horse is 16 by 16 feet. If you are using stocks in your exam room space, the smallest practical room is 18 by 24 feet, provided that it is designed with flow-through circulation. If you are including stocks and you must turn the horse around in the same space, our clients prefer rooms that are as large as 24 by 30 feet. We have yet to hear a veterinarian complain that his or her exam room is too large!
Level of privacy. Some veterinarians prefer to have individual spaces to examine horses for reasons of privacy among their clients and to reduce distractions. Others prefer to have one open area for physical exams, but divide the space into individual examination areas by creating alcoves with partial- or full-height walls. In that case, remember that the individual exam areas should be no smaller than 16 by 16 feet, so designate an 8-foot-minimum walking aisle adjacent to them for travel from space to space. Recently, we worked with a hospital that preferred one very large open exam area where five horses could be examined simultaneously. While this space is obviously less private, it is wonderful in that it can be used for a variety of functions—such as gatherings and training—when not in use for examinations.
Room height. An exam room ceiling should not be lower than 11 feet. As a large room, even an 11-foot ceiling will seem too low. We would recommend 12 feet as a minimum. If the room connects to induction, it might need be higher than 12 feet, as a surgery hoist beam might dictate the height of a space. We prefer to place hoist beams at 15 feet so that a horse’s head can be lifted off the floor. High spaces provide the opportunity for introducing natural light high on the walls, which is a benefit for the doctors, the staff and the horses.
Connection to the outdoors. Most horses enter a hospital directly into an exam area. For best use of this relationship with the outside, place exam rooms in such a way as to block the arrival of weather. In temperate climates, we like to place exam room doors on the southern or eastern sides of buildings, where they can be pleasant in the morning and shaded from harsh afternoon sun and winter winds. A welldesigned exam room also has large doors that open to the outside. An overhang over these doors will allow you to keep them open and to use the exam area as an indoor/ outdoor space whenever the weather permits. Horses respond pretty well to this type of environment.
A place for clients. Many times, clients are with their horses in the exam area. And yet, clients might need to be slightly separated for everyone’s safety. One favorite design feature is a “client alcove,” which is a seating area located to the side of the exam area well out of traffic flow, so that a client can sfely observe and be available for answering questions while allowing the doctors and technicians to safely do their work on the horse.
Placement of major equipment such as stocks. Some exam rooms might be developed without stocks; others require stocks. The location of stocks within an exam room depends on the configuration of the room, how the horse is being led and how the stocks are designed. Most veterinarians prefer to place the stocks closer to the cabinets for convenient access to supplies, but still far enough away for safety. Placing the stocks on one side of the room allows additional space to treat a horse that does not need to be restrained. In an exam room with stocks, we often provide one-way circulation through the room to a second door, so that the horse does not need to be turned around in the space.
Wall materials. Exam rooms must be durable and easily cleaned. While concrete block masonry is not strictly required, it is the most practical material because it is extremely durable and can be coated to provide a wall surface that can be hosed down. We also like concrete block masonry because it is easy to create a quiet space with more massive walls. Block walls have a thermal advantage, as well. For example, interior concrete block spaces will stay cooler on a summer morning for a longer period of time. We recommend grouting the walls solid in any space where a horse might bounce off of the walls. For example, induction rooms are always grouted. Other concrete block walls can be grouted per code, then insulated with a foam insulation in the non-grouted cells.
Floor materials. While flooring is a topic in and of itself, the options for equine exam are limited. Poured rubber and some polyurethane floor materials are the best, but most expensive, choices. They can be coved up the wall a few inches for a sanitary transition. Source this type of flooring extremely carefully, as not every product that is labeled for use for horses actually performs well in the short or long term. For a lower cost option, rubber mats can also be used individually or as a floor covering. Rubber mat flooring should be installed by gluing the mats to the substrate and sealing all the seams. The least expensive option is an exposed concrete slab. The slab must be carefully finished for a safe texture and sealed to reduce porosity.
Ceiling surfaces. If you prefer a smooth drywall ceiling, then budget for some sound absorption panels to be placed at the perimeter of the room, at the tops of the walls. This is less important if you use rubberized flooring, which will dampen some noise in the space. We also like to use ceiling fans in exam areas to help circulate air.
Location of drains. It is important to be able to clean an exam room thoroughly. Place drains close to the area where mess is generated—for example, near the stocks. We prefer not to place a drain directly under the stocks because drains can be scary for horses. For this reason, we would place them to the side of an open examination area, as well. A small piece of rubber can be cut and loose-laid on the drain so that the horse does not see the drain, but it is still accessible when necessary for cleaning. Drains in exam rooms should be equipped with sand interceptors to filter out debris before it enters and clogs plumbing lines.
Cabinetry. Plastic, metal or stainless steel modular cabinets are our preference for base cabinets because they hold up to abuse. They are very expensive, so another alternative is to provide a stainless steel counter under which you can park mobile equipment carts. Upper cabinets can be plastic laminate for cost savings.
Lighting. Exam rooms should be lit more brightly than office spaces. Light fixtures should be placed parallel to work areas so that they cross-illuminate the patient. In today’s market, LED lighting is the best alternative because it can produce a lot of lumens for the wattage used. LED lighting fixtures can be dimmed easily if desired. LED fixtures in equine exam rooms should be dust-protected and gasketed if the room is open to a humid outdoor environment.
Janitorial. Locate hose equipment out of the way to protect the horses’ safety. We prefer to place janitorial items such as mop sinks and buckets in an alcove or a closet off the exam space, so that the room itself remains uncluttered.
Clock. A clock mounted high on the wall helps keep doctors and staff on track during the day.
Storage. Your equipment is expensive, and it is a hazard to horses and staff if it is loose within an exam room. Provide a storage closet for ultrasound and X-ray machines, carts, etc., to keep equipment out of the way when not in use. The best exam rooms are uncluttered and easy to move around in.
Take-Home Message While all of these basics are important to get right, don’t forget that in the end, you will be spending hours in the exam area. The exam area is also your clients’ introduction to your hospital. Create a space you enjoy and a space that represents your practice and its philosophy. This might involve including more natural light from high windows or skylights. It also might include an aesthetic touch such as a wood ceiling. The thought and effort you put into your exam rooms will pay off for years to come.