I have the opportunity to assist many eye care practitioners with the design of their office floor plans and I've designed six offices for my own use over the years, so I've seen lots of innovative concepts as well as plenty of design mistakes. Office space is always limited to some extent, so it is necessary for the practice owner to prioritize the various options. It can be challenging to decide what to leave out due to lack of space, but that's much preferable than omitting a design element or room function because it wasn't thought of.

Frequent omissions

Consider these rooms and functions that are often omitted due to space limitations or because the designer didn't think of it. Some of these are big mistakes while others are merely luxury features that one can live without. Which is which is often in the eye of the beholder.

• Multiple pretest areas. I see many offices designed with one pretest room, but when you consider the goal of maximum delegation along with the new advancements in clinical instrumentation, it won't take long until the limited pretest office space stifles practice growth. In addition to the usual pretest instruments (like autorefractor/keratometer, visual field screener, non-contact tonometer and lensometer) plan ahead for the threshold field unit, retinal camera, corneal topographer and nerve fiber analyzer. Larger practices need at least two of the basic pretest instruments to avoid a bottleneck. One should also consider the dilemma of choosing to put multiple instruments in one larger room or using several smaller rooms with each one having only one instrument. The latter has the advantages of faster room turnover while offering complete privacy for only one patient at a time, but it has the disadvantage of moving the patient among more rooms. I use both and I've found that a room size as small as 6 X 10 feet works well for one procedure.
• Multiple exam rooms. Plan to have at least two exam rooms per working doctor. I think the ideal size for the exam room is 10 X 14 feet but 9 X 12 is still comfortable. Smaller rooms will certainly work but I would try to avoid it if possible.
• Technician workstations. Where do we expect technicians to work when they aren't with patients? Ideally, they will have many other duties, such as placing orders, talking to patients on the phone, verifying contact lenses, updating office records on paper and computer. This area can also serve to store diagnostic contact lenses, lens care kits and pharmaceutical samples.
• Staff lounge. This serves as a lunchroom, conference room for staff meetings and special project room. Plan for a sink, microwave, refrigerator and TV. It is a very important room to staff.
• Private executive office for the doctor. This would be high on my priority list even if it is a small space. Successful doctors do much more than examine eyes, they also run a business.
• Private administrative office. In addition to the front business office that is seen by patients, this is a workspace for an office manager, insurance coordinator, and others who work on projects behind the scenes, such as monthly mailings, bulk photocopying, bank deposits, accounts payable and more. Even paperless offices have a need for some space for filing cabinets.
• Large optical. The optical dispensaries in so many optometric offices today seem to be planned as minor entities right from the start. Some serious square footage is needed to make it impressive.

Other innovative ideas

• A private washroom for the doctors. The benefit is self-explanatory. A shower is a handy luxury. Try to place the patient washroom near the reception area. A restroom just for staff is a much appreciated perk.
• A vestibule or lobby to buffer the reception room from extreme cold or heat.
• A coffee bar with a small sink in the reception area.
• Granite countertops at the coffee bar and front desk.
• A flat panel TV, wall-mounted in the reception area.
• All rooms wired for computer data jacks.
• Some rooms can serve double duty. Contact lens patient training, for example, can be conducted in a variety of spaces and a dedicated room for this is often underutilized.
• Plan for some empty space. Don't place patient waiting chairs too close to the front desk. Maintain plenty of room around each dispensing table in optical. People like space and some degree of privacy.
• Lockers built into a hallway wall so each employee has a place for a coat, purse and personal items.

Only you can decide what the priorities are for your office facility, but it helps to enter the process with lots of ideas.