What We Learned for Vet Practice Designs From COVID-19
In 2020, equine businesses have had to adapt quickly to change and challenge, thanks to COVID-19. Fortunately, some of these pandemic-driven adaptations will serve equine veterinarians well in the future. This article will discuss a diversity of fresh concepts to help design and operate equine veterinary hospital facilities better than before. While some of these ideas make us more “pandemic-proof” for times of crisis, many of them are simply better for everyday business.
Let’s look at some of the great design drivers, systems and solutions that have emerged in this year of change.
Benefits of Telemedicine or ‘Virtual Care’
As the lockdown commenced, veterinary practices developed a sudden interest in telemedicine. The AVMA has good resources for practices interested in virtual care models. Practices interested in this evolution will need to understand the legalities of virtual care, the platforms for performing virtual care and the limitations of virtual care.
While the discussion of virtual care can feel forced upon us, virtual care has the potential to revolutionize the equine veterinary business. Because it is laborious to bring a horse to a clinic or to have a veterinarian travel to a client (and has at times this year been impossible), virtual care models can connect a veterinarian and a client more readily and frequently, which allows you to provide a higher quality of care overall.
From an architect’s perspective, virtual care means less brick and mortar for the same revenue. Virtual care is a way of extending your services with no more investment in physical space. Quite simply, if you don’t need more facility, don’t build it.
Benefits of Working from Home
Most of us have struggled with sending staff home. The jury is still out on whether “work from home” is beneficial or detrimental, with some workplace analysists brimming with enthusiasm and others promoting caution.
According to “The Long, Unhappy History of Working from Home” from the June 29, 2020, issue of the New York Times, working from home has some place in the future for many businesses. For veterinarians, these are the most promising long-term adaptations:
Remote call centers. Remote call centers are most effective when they are taking calls for more than one location.
Reducing office space. Human hospital groups are making up for some of the inefficiencies of the pandemic by reducing the use of office space. The same concept applies to equine medicine. Equine ambulatory doctors, for example, do not need much space in a physical hospital other than a temporary “touch-down” station.
Other than supply restocking, ambulatory veterinarians can be remote employees. You can take this further; doctors working in the hospital can have shared office space, with some of them providing virtual care some of the time. The opportunity is for square footage, formerly allocated for non-income generating space such as palatial owners’ offices, to be converted to consultation rooms, laboratory space or other uses that support profit-driven operations.
With the onset of COVID-19, veterinary hospitals of all types initiated curbside appointments and have been forced to utilize outdoor space that had never been used before. Fortunately, equine veterinarians are already used to working in indoor/outdoor environments. The question is, how can we design indoor/outdoor spaces to be more effective for use all of the time?
We want to promote this idea for several reasons, including:
- Indoor/outdoor space can cost less to heat and cool.
- Indoor/outdoor space is more comfortable for horses, as they are less fearful in quasi-open environments compared to fully indoor space.
- Indoor/outdoor spaces are healthier for people. This is a huge advantage now and should we face a pandemic again. Spaces that can be open to the outdoors can naturally ventilate with fresh, outdoor air in an instant.
The following is a description for how to design an indoor/outdoor exam/ treatment space:
- Design your treatment/exam rooms to face the south in cold climates, and to the south or north in hot climates. Avoid east/west exposures.
- The treatment/exam rooms can be outfitted with overhead or rolling barn doors to open to the outside as three-sided enclosures, as weather permits.
- Extend the season by installing overhead fans for summer and radiant heating for winter.
- Install exhaust fans in the space for winter when the doors are closed to allow for proper ventilation.
Beyond exam/treatment, consider indoor/outdoor spaces for these uses:
Covered screen porches with fans for client waiting. When the health crisis is over, you can outfit these spaces with a refrigerator with chilled beverages and/ or a coffee station for your clients.
Covered roofed structure for client consultation. Rather than bringing a client inside, a small outdoor pergola can be a comfortable location for consultation, weather permitting. Ensure the outdoor areas are WIFI enabled to allow for pulling up a radiograph, etc., on a laptop or tablet.
Covered outdoor triage/assessment spaces. This is a fully outdoor space to assess a horse before it enters a facility.
Unconditioned barns. For medically healthy horses (for example, post-surgical patients), a traditional unconditioned barn can be simpler and less costly. You can still boost ventilation in this space simply by exhausting air without expensive HVAC systems.
Ideas for Air Flow and Quality
Hospitals now need to find inexpensive ways to adapt their buildings for new biological threats from humans, when before this time, we focused on animal health. Fortunately, systems that protect human health also protect animals.
Here are some low-cost solutions that can be used now and forever:
Open a window. It might sound elemental, but being able to let your building breathe during a time of biological threat is a big advantage. Most commercial buildings are sealed, but few hospitals are designed rigorously enough to ensure that they’re both sealed and healthy. If you know your hospital is more airtight than it could be, and it is infeasible for you to replace your ventilation systems, look for simple fixes. Installing some operable windows can give you more ventilation options when you are under threat. This old-school idea is now being incorporated into the most sophisticated new office building designs.
Treat the air. One of the technologies you can consider is air treatment. Air treatment can be integrated with an HVAC design, or it can be an add-on to improve the quality of the air within a space. It is important to use a system that has solid research behind it and is appropriate for our industry. An example of a system is the Upper Air Treatment units from PetAirapy. These stand-alone units are attached to the ceiling in a space and utilize ionization as well as UVGI treatment to reduce airborne pathogen loads. These systems are affordable and easy to install.
New Products for Indoor Environments
Once we address the big ideas from COVID-19, there are a plethora of smaller modifications you can make to create a safer indoor environment. Here are a few of the most useful:
- Touchless sinks. As everyone has developed a keen interest in hand hygiene, the product manufacturers have responded. New touchless sinks are less frustrating than their predecessors and can be selected with additional hygienic features, such as a seamless design and sloped bottoms that prevent splashing.
- PPE stations. We are big fans of making PPE easy so it will be used more effectively. Install PPE stations in convenient places in your hospital near areas of animal and human risk. PPE stations are standardized, easy-to-use stations, each with a trash can, a wall-mounted cubby with supplies such as gloves and hand sanitizer, a hand washing sink and clear signage. If you cannot afford to add sinks, set up the PPE stations where sinks exist.
- Mud rooms. Mud rooms will be important in our future. A dedicated space to enter and exit, don or shed gear, wash and sanitize your hands, perform temperature checks, log in, etc., will become part of the hospital design for most of our new facilities.
- Sneeze guard retrofit products. Clear barriers can be retrofitted on front desks or hung from the ceiling to protect reception staff. Clear barriers are good for other spaces such as at the door of your dispensing pharmacy. Ideally, your sneeze guards can be installed and removed as threats change. You can use them during flu season, even if there is no epidemic.
- ‘Officles.’ New offices (office/cubicles) are designed with prefabricated furniture that provide greater enclosure but are still open enough to promote visual connection. Cubicles will come back and will be preferred over closed offices (which take too much space), but cubicle design will improve, using clear panel dividers above desk height to promote a feeling of openness.
I challenge myself and the veterinarians with whom I work to consider the changes to practice in 2020 that might be a benefit to future business. Equine veterinary practice is innovating in ways that reduce the costs of physical facilities and improve the quality of care. That is the opportunity we have been afforded in this year of change.
About the Author: Heather Lewis, AIA, NCARB, is a principal of Animal Arts architecture firm that works globally in the animal industry.