cost effective office design - desergo.com · while increasing the sense of spaciousness and...

Cost Effective Office Design:

David J. Ahearn, DDS • Pacific Dental Conference, 2019 • Vancouver, BC

You can create a beautiful, comfortable and highly productive practice on a budget that works for YOU. Save space, reduce cost and streamline workflows through smarter design strategies – all while increasing the sense of spaciousness and improving the patient experience.

You will leave knowing how to refine the vision of your future practice, layout the steps needed to bring it to life, and how to affordably create an office that will exceed both your goals and your patients’ expectations.

In this course, we will discuss the following topics and provide solutions:

• Create a clear outline of objectives for your new or improved practice design.• Learn the 17 principles of an attractive, comfortable and highly productive office.• Markedly reduce the costs to create a great new practice while providing better patient

care.• Create the capacity to grow to unexpected heights.• Gain new and exciting insights into what today’s most successful practices are doing

right now.

Dr. David Ahearn is first and foremost a full time practicing dentist. Although located in a rural town, his office ranks among the nation’s most productive practices. Trained in prosthetics at the University of Michigan, Dr. Ahearn, like many of us, struggled to reconcile his desire for the highest quality possible with the requirements for practice success. His discovery of the principles found in the Toyota Production System in the early 90’s – and his subsequent application of them to dentistry – began a quality and productivity revolution that is at the heart of his design work.

He is the founder of Design/Ergonomics, the nation’s largest independent dental office design firm, as well as Ergonomic-Products, a manufacturer of high-productivity, ergonomically sound dental equipment. Both companies work with doctors across North America to design and equip comfortable, productive and highly cost effective practices.

Dr. Ahearn has held faculty positions at both the University of Michigan and NYU’s College of Dentistry, and was a founding member of the ADA’s Ergonomics Subcommittee. He is a frequent lecturer and contributor to numerous dental publications, including multiple chapters in the current edition of the ADA’s Practical Guide to Dental Office Design.

Thank you for joining us in Vancouver! www.desergo.com www.ergonomic-products.com www.dental-reboot.com

CEOD Handout 3_1_19

Cost Effective Office Design

© 2019 Dr. David J. Ahearn, Design Ergonomics | www.desergo.com | 800.275.2547

Introduction

Why We Do This• World Mission Partners (and other worthy charitable efforts)

• And How to Make Giving Affordable

World Mission Partnershttp://www.worldmissionpartners.org/

Dentistry From The Hearthttp://www.dentistryfromtheheart.org/

INTRODUCTION

22

Construction Cost 2250 sq/ft build out @ cost of $150 per sq/ftr

Traditional Design Concept

@ 450 sq/ft per treatment room - 5 rooms

Cost per treatment room = $67,500



High Flow Concept

*Yielding 30% Additional Patient Capacity

INTRODUCTION

23

Equipping Cost 2250 sq/ft build outr

*Savings of 37% Per Treatment Room And A Savings of 16% With 2 Additional Rooms



Room Centric Equipping

Total = $223,500

OfÞce Centric Equipping



Total = $197,400INTRODUCTION

24

Performance 2250 sq/ft build outr

Increased Productivity of 96%

$25,000 per treatment room x 5 rooms

Traditional OfÞce Production

Total = $125,000

Design/Ergonomics OfÞce Production

$35,000 per treatment room x 7 rooms

Total = $245,000


The 5 Components of CEOD


Psychology of Spaciousness

We’re hard-wired to “read” a space in an instant

Resources:

Psychology of Spaciousness 38



1

• Your patients need to be reassured that they are in a safe, non-threatening environment.




Architecture

17 Elements of an Attractive, Comfortable & Highly Productive Office

2

1. Clearly identifiable patient entrance

2. Staff entrance screened from view

3. Immediate visual and physical access to the front desk upon office entry

4. Waiting room seating removed from primary traffic flow

5. Patient bath visible to, but removed from, waiting room seating

6. The major proportion of the open front desk does not face the waiting room seating

7. Conference room accessible by the doctor without passing into waiting room or front desk space

8. Conference room location minimally exposes patient to treatment room noise

9. Treatment rooms isolated from the front desk

10. Treatment room alignment does not channel noises from room to room

11. Treatment area is compact, minimizing segregation of doctor and hygiene staff

12. Doctor’s office near treatment rooms for easy management

13. Space for mobilization of technology

14. Sterilization, lab and resupply areas in close physical proximity to treatment rooms

15. Radiology areas do not block traffic flow when in use

16. Staff lounge isolated from clinical and business areas

17. Expansion easily accommodated with minimal practice disruption

Attracting & Impressing Patients

MakingPatientsComfortable

MakingSystemsFlow




Interior Design The Four Commandments of Interior Design

1. Create a Sense of Space

2. Keep Things Consistent

3. Control Patient’s Focus

4. Guide Patient Traffic

3Interior Design: 131The Four Commandments

Create a Sense of Space

Interior Design: 132The Four Commandments

Create a Sense of Space




Interior Design - continued

Pros & Cons of Different Design Providers

3 Interior Design

142

Do it Yourself DesignrConsProsl

l

Less Expensive

Build Personal Knowledge of Interior Finishes, Installation Techniques, & Furnishings

Lack of Experience & Knowledge of Residential verse Commercial Finishes

No Discounts / Special Rates on Products & Finishes

Great Demand on Time

Complete Control

Interior Design

143

Hire a Local Interior Decorator or Designerr

ConsProsll

Face to Face Communication

Access to Trade Showrooms, Products, & Discounts

Few in Healthcare Niche

Samples Shipped rather than Hand Delivered

Some Design Fees

On Site Coordination & Installation Assistance

Interior Design

144

Hire a Dental OfÞce Interior Designerr

ConsProsl

l

Saves the Practice Time, Money, & Headaches through Comprehensive SpeciÞcations

Little to No Face to Face Communication

Samples Shipped rather than Hand Delivered

Some Design Fees

Current with the Demands of a Dental OfÞce Environment

Devoted to & Passionate about Dental Interiors

Do it Yourself Design

Hiring a Local Interior Decorator or Designer

Hiring a Dental Office Interior Designer





Materials:

High, Middle & Low range materials are available throughout your practice,Flooring and Office Cabinetry often have the greatest financial impact.

How the material is use and where, will often dictate the most effective choice.

3

Interior Design: 161Materials - Flooring



Natural Stone - Expensive

• Extremely luxurious appearance• Extremely high cost

FLOORING

Sheet Vinyl - Cheap

• Low cost• Great utility in less visible clinical/staff areas• Durable

Carpet/Tile/Vinyl Plank - Reasonable

• Great visual appeal• Broad range of materials can create very custom look• Decent longevity (material/ traffic dependent)

Use these mid-grade materials where Patients will see them.





Materials:

3

Interior Design: 170Materials - OfÞce CabinetryInterior Design: 170Materials - OfÞce Cabinetry

Interior Design: 170Materials - OfÞce Cabinetry

Solid Wood - Expensive

• Investment quality• Presents an old-school professional stability

OFFICE CABINETRY

Painted Fiberboard - Cheap

• Low Cost• Good for staff areas• Readily available

Carpet/Tile/Vinyl Plank - Reasonable

• Attractive• Cost Effective• Low maintenance• Use in areas visible to the Patient





Return On InvestmentWhen making Material Selections, consider ROI as a function ofCost, Durability and Impact.

3 Interior Design

Return on InvestmentMost Color & Immediate Design Impact:

• Paint• Decorative Items

$Low Expense

}3 - 5 Years of Wear

175

Interior Design

Return on InvestmentIntroduction of Style & Color:

• Plastic Laminate Work Surface• Lighting• Furniture

$Moderate Expense

}}8 - 12 Years of Wear

176

$

Interior Design

Return on InvestmentMost Neutral, Timeless, Design & Color Palette:

• Flooring• Cabinetry• Dental Equipment• Architectural Details• Specialty Materials

(Corian, Quartz, Stone, Metal Etc)

$High Expense

}15 - 20+ Years of Wear

177

$$

} }

So be conservative with the durable items. Be fashion forward with lighting fixtures and furniture. Feel free to be trendy with paint.




Treatment Room Design

The Problems with the Operatory of Today1. It’s Too Big2. Things are out of reach - yet there’s not enough space.3. It’s too expensive.

Room Centric vs Office CentricOne of the greatest areas of confusion in designing, outfitting and using a dental office revolves around the concepts of how a practice plans to deploy and resupply equipment and materials.

Room Centric - all rooms are stocked identically with all inventory and equipment. This is sus-tainable (if not ideal) with 3 or fewer rooms. Beyond that, the system breaks down, materials are difficult to locate, and inventory/reordering becomes problematic and error-prone.

Office Centric - Office Centric thinking, planning, design and practice is based upon LEAN Pro-duction techniques and builds on the knowledge and experience of many manufacturing sectors well beyond healthcare.

Supplies are kept in a central Sterilization/Inventory/Resupply area. Restocking is accomplished by modular bins and tubs holding 1+ week’s worth of operatory materials, placed in the treatment room, as close to the zone of production as possible. These materials are determined by your most common procedures (your “90% Profile”). Less common procedures are supplied as need-ed via specialty tubs and/or mobile deployment carts.

4

FIRST FLOOR PLAN5338 SQ. FT.334 SQ. FT. PER TX. RM

PROJECT NUMBER: KEELAN - FP 2015DATE: 1/5/15DRAWN BY: JBCHECKED BY: GP

A 1.0

DR

. PA

UL

KEE

LAN

BU

TLER

, PA

198 Airport RdFall River, MA 02720

DNOffice Centric floor plans representingdifferent capacity needs.

Central Sterilization & Resupply are highlighted.




Treatment Room Design - continued

Two Ergonomically Sound Solutions for Staging Supplies for Delivery

Operatory Lighting1. What Your Patients Need Lighting has a significant impact on the

way we perceive a space.

2. What YOU Need a. Great Intraoral Lighting b. Great Task Lighting

- That is not spread all around the room!

4 Treatment Room Design

Two Productive Ways To Equip A Treatment Room

205

Treatment Room Design206


Two Productive Ways To Equip A Treatment Room

205

“Over the Patient” “Over the Head”


Clinical & Threatening

Open & Inviting

New technologies employ oriented LED strips and custom lenses to channel light output up, where it is reflected off the ceiling and walls. This results in full-room lighting that is brighter, creates a greater sense of spaciousness and reduces eye-strain.

Traditional fixtures direct light straight down, which creates very uneven illumination, and makes the room feel smaller. The resulting hot-spots and glare cause discomfort for your patients, who are forced to look directly at the light source.

Traditional Tube Lights Reflected Light FixturesTraditional Tube Fixtures Reßected Light Fixtures



Traditional Tube Lights Reflected Light Fixtures

Clinical & Threatening Cozy & Inviting


Clinical & Threatening

Open & Inviting



Traditional Tube Lights Reflected Light FixturesTraditional Tube Fixtures Reßected Light Fixtures



Traditional Tube Lights Reflected Light Fixtures




Construction Considerations

Case Study - Two different builds of a 6 Operatory Practice

5Construction Considerations: A Case Study

Project Introductions 4

• 2880 sq ft.• 480 sq ft./op Yield• @ $275/sq ft.• = $792,000 construction cost

• 1920 sq ft.• 320 sq ft./op Yield• @ $225/sq ft.• = $432,000 construction cost

Construction Considerations

OfÞce A - 6 Ops

OfÞce B - 6 Ops

Construction Considerations: A Case Study

• Stone: $60.00 x 290 s/f = $17,400.00• Wood Base: $1.36 x 68 l/f = $93.00• Painted Drywall & Wood Trim: $3.50 x 612

s/f ($4.20 x 68 l/f) = $2,697.00• Painted Ceiling & SofÞt: $2.50 x 300 s/f +

($2.60 x 36 s/f) = $844.00• Custom Stone Cabinetry: $367.50 x 3

($73.50 x 36 s/f) = $3,749.00

Reception 4 OfÞce A

• Carpet: $4.75 x 290 s/f = $1,378.00• Wood Base: $1.37 x 68 l/f = $93.00• Paint Drywall: $3.75 x 612 s/f = $2,295.00• Painted Ceiling & SofÞt: $2.25 x 300 s/f +

($2.50 x 36 s/f) = $765.00• Custom Wood & Stone Cabinetry: $52.50

x 54 + ($73.50 x 36 s/f) = $5,481.00

OfÞce BReception Total = $24,783.00

Reception Total = $10,012.00




Construction Considerations - continued



• Stone: $75.00 x 266 s/f = $19,950.00• Wood Base: $1.36 x 66 l/f = $90.00• Painted Drywall & Wood Trim: $3.67 x

594 s/f + ($4.20 x 132 s/f) = $2,734.00• Painted Ceiling & SofÞt: $2.50 x 266 s/f

+ ($2.60 x 132 s/f)= $1008.00• Waiting Room Total = $23,782.00

Waiting Room 4

• Carpet: $4.75 x 266 s/f = $1,264.00• Wood Base: $1.36 x 66 l/f = $90.00• Paint Drywall: $3.75 x 594 s/f =

$2,228.00 • Paint Ceiling & SofÞt: $2.50 x 266 s/f

+ ($2.60 x 132 s/f) = $1008.00• Waiting Room Total = $4,590.00Capacity for 15

Capacity for … not many

OfÞce A

OfÞce B


• Flooring: $60.00 x 99 s/f = $5,940.00• Wood Base: $1.36 x 40 l/f = $54.00• Painted Drywall: ($3.67/2) x 81 s/f = $149.00• Divider Cabinets: ($1,024.00/2) x 22 l/f = $11,264.00• Painted Ceiling: $3.50 x 99 s/f = $347.00

Operatory Build 4

• Flooring: $5.00 x 99 s/f = $495.00• Rubber Base: $2.10 x 40 l/f = $84.00• Painted Drywall: ($3.67/2) x 360 s/f = $660.00• Acoustical Ceiling: $3.75 x 99 s/f = $371.00

OfÞce A

OfÞce B

• Operatory Subtotal = $17,754.00• $17,754.00 x 6 Rooms =$106,524.00

• Operatory Subtotal = $1,610.00 • $1,610.00 x 6 Rooms = $9,660.00







• Stone: $60.00 x 120 s/f = $7,200.00• Wood Base: $1.36 x 44 l/f = $60.00• Painted Drywall: $3.67 x 396 s/f = $1,453.00• Painted Ceiling: $3.50 x 120 s/f = $420.00• Cabinetry - Dental Manufacturer: $1624.35 x 22 l/f

= $35,736.00

Sterilization / Lab 4

• Linoleum: $4.72 x 120 s/f = $566.00• Rubber Base: $2.10 x 44 l/f = $92.00• Painted Drywall: $3.67 x 396 s/f =$1,453.00• Painted Ceiling: $3.00 x 120 s/f = $360.00• Resupply Pulldowns: $1,200 x 5 = $6,000.00• Cabinetry - Home Depot & Plastic Laminate: ($50.40

+ $42.00) x 22 l/f + ($3.15 x 44 s/f) = $2171.00

OfÞce A

OfÞce B

• Sterilization/ Lab Total = $44,869.00

• Sterilization/ Lab Total = $10,642.00Construction Considerations: A Case Study

Equipment 4

• Equipment Subtotal = $44,700• $44,700 x 6 Rooms = $268,200

• Equipment Subtotal = $28,200• $28,200 x 6 Rooms = $169,200

OfÞce A

OfÞce B







Same for both ofÞcesÉ NOT included

• Panorex = $18,000• Intraoral X-Ray =$3,500 each

OfÞce A

OfÞce B• Panorex = $18,000• Intraoral X-Ray =$3,500 each

Radiology 4


Cost Difference: $624,054.00

• Construction: $792,000.00• Reception: $24,783.00• Waiting Room: $23,782.00• 6 Op Build: $106,524.00• Sterilization: $44,869.00• Equipment: $268,200.00

Complete Cost Summary 4

• Construction: $432,000.00• Reception: $10,012.00 • Waiting Room: $4,590.00 • 6 Op Build: $9,660.00• Sterilization: $10,642.00• Equipment: $169,200.00Total: $636,104.00

Total: $1,260,158.00

2880sq2

1920sq2

OfÞce A

OfÞce B



Summary

10 Elements for SUCCESS...

1. The principle of performance equipping is immutable... You Can’t Use What You Can’t Reach!

2. You have significant control over construction costs

3. It’s pretty easy to blow a lot of money

4. The best time for most businesses to grow is in the middle of a downturn. With all of the challenges that we have in dentistry, the simple fact is that you don’t have to outrun (have a better value proposition than) the entire profession… You simply need to outrun your neighborhood.

5. Interior design matters. Understand buyer psychology!

6. There are (at least!) 17 principles that determine a great architectural design. Just get these right.

7. Office resupply strategy is a critical decision

8. There is a new and even more significant math for larger offices... and it looks very attractive.

9. Whoever you get to design & build your next office - make sure they understand there’s a system to it… and if they don’t nail all the elements, you’ll pay too much and it won’t produce enough.

10. YOU CAN DO THIS!!

cost effective office design - desergo.com · while increasing the sense of spaciousness and...

Documents