Article Submission Guidelines for Practice Management, EHR, Glaucoma, and Managed Care

Exclusive Date: March 19, 2014

Office Design Tips

 Sponsor: Alcon® - DAILIES TOTAL1®

I frequently work with optometrists, architects and frame display firms that are involved with optometric office design. I’ve also designed several different offices for my own practice over the years and lived with the results; some of it good and some not so much. Here is a summary of some of the key factors that I think make a good floor plan.

Frequent design mistakes
  • The optical is not large enough. I believe the optical dispensary is often overlooked by ODs who place a much higher value on clinical and administrative spaces. Surprisingly to me, even frame display companies that design offices tend to make the opticals too small for my preference. If we consider how much revenue the optical produces and the importance of optical to the general public, it should be large! I want it to look impressive at first sight and I want the patient to think right away that he will be getting his glasses here. We need a large number of frames on display and we need room for several patients at once and multiple dispensing tables. My rule of thumb is that the optical should be about one third of the total floor space. If the office is rather small overall, that may not leave a lot of square footage for the exam areas. But I would not skimp on the optical.
  • The front desk is not large enough. I’d like to see space for at least three staff members without being crammed too close to each other. We need room for three computers, a multifunction printer, two or more telephones, credit card machine, files and just some desk space. We also need enough floor space that people can walk around each other when seated.
  • The patient waiting area is too close to the front desk; not enough floor space. Sometimes offices just need empty space. You can’t have furniture or displays everywhere. The front desk is a high traffic area where people walk and stand. There may be patients checking in with family members and other patients may be checking out. The staff at the front desk makes many phone calls and talks to patients about private matters, so you don’t want other patients seated very close.
  • More space for staff to work or hang out. Consider where staff will go when they are not with patients. Where will they work on charts, place orders for supplies, open mail and deliveries, call patients, and much more? Your staff does not all need a private office, but they need a lab or tech work station that is large enough to give them a place to go.
  • More pretest and special test rooms. Consider all the special instruments you have now or will have in the near future and where will they go. I like to have some very small rooms that are sized for just one instrument, such as a retinal camera or visual fields. This keeps the room available when you need it because it is not being tied up with people doing other testing. A good size for this special purpose room is 6 X 10 feet. It is very useful for procedures you do often or that take a bit longer to run. But if you have too many single function rooms, you have to move the patient too much. So I like one pretest room with an arc table that holds three or four devices. You want to delegate more as your practice grows so plan for the space.
  • Multiple exam rooms for the future. You gain maximum efficiency when you have at least two exam rooms per working doctor. If you think you could grow to having two doctors at the same time in this location, you need four exam rooms. You don’t have to equip them all at the beginning. Exam rooms are a great investment and make a huge difference in patient flow.
  • Contact lens training rooms are a waste of space. I think these dedicated rooms are outdated. Contact lens care has become extremely easy and we treat it as no big deal in my practice. We have no problem using an optical dispensing table to teach the procedure or an exam room. The vast majority of contact lens patients fit today have already worn them before anyway.
Nice things to have
The following items may be considered a luxury, depending on how much space you have.
  • Some separation between the waiting area and the frame displays is nice, but the areas are still connected. If space is really tight, you could have very few chairs for waiting and just have a larger frame display area with chairs here and there.
  • A refreshment center in the waiting area. I think Keurig coffeemakers are great and patients help themselves with minimal mess. They take very little space. Plan for a small sink if you can.
  • A private office for the office manager. Working with staff members is one of the biggest jobs a manager has and it is very helpful to be able to have some talks in private. Consider insulating this room for sound and using a solid core door.
  • A private back entrance for staff and doctors. This is extremely handy if anyone is arriving late, leaving early and at lunchtime.
  • A lab big enough for an edger and several staff to work at once. Even without an edger, staff need a place to store active jobs in trays, call suppliers and patients, order jobs online, check in and verify eyeglass prescriptions and adjust patient frames. This is a real work center. It is handy to have it adjacent to the optical area and a window in the adjoining wall works well so staff can see patients.
  • Exam rooms big enough for a scribe. Working with chairside assistants is proving to be a great time saver for doctors, so plan ahead for it. A 9 X 12 foot room is about the smallest that will work well. An 8 X 10 room is probably best for just the doctor and patient. Watch the door swing so it will not hit the scribe when seated.
  • I consider a staff break room (which doubles as a conference room) and a small private office for the doctor as high on my list of needs.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week