Wolgast Blog

Patient Flow Optimizes the Design of Your Practice Floorplan

Posted by Cory Sursely on Tue, May 21, 2013 @ 04:30 PM

When a patient walks through the door of a doctor’s office, whether it’s a family physician, chiropractor, dentist or veterinarian, he or she needs to easily find the check-in area to make his or her attendance known.  Patients may not know that check-in area starts off a whole path that they will follow while receiving treatment through paying their bill, also known as patient flow.

Architects that are specialized in healthcare design closely analyze a practice’s patient flow to determine the location of rooms and activity areas in a practice.  An office that is inefficiently designed can cause unnecessary delays or bottlenecks in the care of patients, problems complying with HIPAA regulations, miscommunication among staff members, and possibly a frustrated doctor.  An orderly and well thought out patient flow has patients moving in a circular motion, so patients don’t have to back track nor cross paths with other patients.  Doctor and staff are able to easily locate each other to communicate effectively and supply areas are easily accessible by staff members for quick set-up of rooms after each patient visit.

Wolgast Architect and healthcare design expert, Rick Keith, offers two design examples, below, based on the size of your practice needs and the patient flow theories behind each.

New Construction of a Smaller Office Small Office

In smaller offices, a single hallway is typically used.  Although not preferable, it reduces the size of the building and the cost of construction.  The hallway should be wide enough that patients can pass each other in opposite directions, especially patients with wheel chairs or walkers.

A check-out alcove should be created so patients stand or sit out of the hallway.  Often, this alcove area is also where personal information may be gathered, if needed, from patients while they’re checking in.  Staff should be careful to avoid having two patients giving personal information at the same time.

 New Construction of a Larger Office

Large Office 

In a larger office setting it’s desirable to circulate patients one way around a central business/support core.  This circular pattern avoids a bottleneck with personal intake (check-in) and check-out.  It also avoids privacy (HIPAA) issues with patients standing together giving personal information.

At the reception window, it’s preferable for a patient to avoid verbal communication with staff members.  Many offices prefer patients write their name to check-in.  The receptionist then marks through the name to avoid other patients from seeing it.

It’s preferable to have a patient step inside the door separated from the waiting room to give personal information.

 

Our team wants to design and construct comfortable, relevant and efficient spaces for you to provide patient care.  Please share with us any thoughts you may have about improving your practice.

Tags: Medical Office Construction, Design/Build, the Wolgast Way, Dental Office Construction

What Makes a Contractor an Expert in Medical Construction?

Posted by Cory Sursely on Thu, Mar 28, 2013 @ 10:47 AM
surgery center

In light of our staff architect, Rick Keith, LEED AP, attending the Health Facilities Planning Seminar this month, I thought it was timely to discuss what makes a contractor specialized in medical office construction.  To some people, all buildings with walls, floors and a ceiling are the same and the contractor shouldn’t make a difference when constructing it.  While I believe that it always matters who the contractor is and how professional and customer service oriented they are, obviously, most any contractor can build simple buildings (how much hassle you want to deal with is up to you).  However, a medical building is not a simple building.  The healthcare industry is highly regulated and uses a plethora of specialty equipment or med gases each with its own requirements.  Plus whether you’re dealing with a Patient Centered Medical Home or a surgery or endoscopy center, it’ll be easier to successfully achieve your goal

notasimplebuilding

with an architect and contractor that understand what you’re trying to accomplish.  Moreover, HIPAA and ADA regulations alone can get everyone in trouble if the building isn’t built with the appropriate measures. 

Continuing Education

The seminar that Rick just attended was for medical professionals, architects, engineers, and contractors.  While there, he learned the most up-to-date information about healthcare regulations, the future of the industry, sustainability, lean design, infrastructure innovation, and certificate of needs updates.  Rick will now apply that knowledge to his designs and share the information with our dedicated medical construction team.  These aren’t things that your average architect or contractor would know.

Experienced Team

Furthermore, understanding patient flow, communication among staff, storage needs, med gases, certificate of need requirements, surgical/endoscopy/special treatment centers as well as industry trends and HIPAA and all the latest regulatory changes is what makes a contractor an expert in medical construction.  Wolgast has the inside track on all these things with Dr. Michael Shepard on staff.  A former practicing neurosurgeon, Dr. Shepard has years of experience and is connected within the medical field to help our clients flush out their needs and work with Rick Keith to plan the most efficient building layout for their practice and to comfortably treat their patients.

Likewise, Wolgast has a dedicated staff of consultants, architects, project managers and field superintendents who consistently work on healthcare projects and they can help you convert your building into one that is more appealing to patients and efficient for staff.

Call 800-WOLGAST or email mshepard@wolgast.com to discuss your building needs with Dr. Shepard or download one of our healthcare related white papers.

 

You May Be a Medical Construction Expert, If...

 

Tags: Medical Office Construction, Design/Build, Professional General Contractor, the Wolgast Way

Investigating Ancillary Services for Your Practice (a White Paper)

Posted by Cory Anderson on Tue, Mar 19, 2013 @ 09:41 AM

Ancillary ServicesAdding a new, complementary service to your existing business structure can help increase your revenue during your regular business hours.  This is especially helpful for businesses that feel they have reached a maturity or decline stage.

Wolgast has worked with several doctors who’ve implemented ancillary services to remodel or add onto their medical or dental practices.  From physical therapy to cosmetic surgery, there are countless options to help add revenue for a practice.  And the best part, it’s done during regular business hours without additional work on the physician’s or dentist’s part.

With an idea as brilliant as this, why isn’t everyone doing it?  Well, integrating ancillary services isn’t necessarily right for all practices.  A business manager and the doctor must do their due diligence before making changes to their practice or their building.  Things to consider include assessing current staffing capabilities, legal and ethical issues and how the doctor will be able to maintain his or her high level of patient care.  It mostly boils down to your type of practice, the capacity of your staff, and your patient’s needs.  Like with most any other business decision, a feasibility study is the best place to start when investigating the option of an ancillary service.  A CPA that is focused on medical or dental business would be the best choice to start your feasibility study.

In summary, adding ancillary services can be a very profitable option for practices that feel that they have grown as much as they can under their current business structure and are committed to the due diligence process of identifying patient needs, reviewing current practice operations, assessing current staffing capabilities, keeping in mind any legal and ethical issues, and ultimately remaining focused on providing the best patient care available.

 

Michael Shepard, Dr., Ph. has published a white paper “Adding Ancillary Services to Medical/Dental Practices (Making the Correct Decisions)” discussing in more detail the ins and outs of adding ancillary services and the caveats involved.  In the paper you will learn more about ancillary service strategy, cautions, business decisions, and legal considerations.

 

Request Your Copy of White Paper

Tags: Medical Office Construction, Design/Build, Professional General Contractor, Dental Office Construction, Good for Business

You Have Construction Service Options

Posted by Cory Anderson on Wed, Feb 27, 2013 @ 10:24 AM

constructionWhich construction delivery system is best for your project?

There are several unique and distinctive methods for providing construction solutions. As a business owner you have the luxury of selecting the most beneficial and appropriate delivery system for your type of project.

Design/Build

The Owner hires one firm to provide architectural design and construction services in a phased approach.  Oftentimes, the architect is a staff member of the construction company.  The design/builder becomes the single-source that is responsible for designing the building, hiring the subcontractors and coordinating the schedule and invoicing to ensure the project is completed on time and within budget.

It’s the design/builder’s sole responsibility to complete the project to the client’s satisfaction.  The architect and contractor are the same entity, which eliminates misunderstandings as they collaborate throughout the design process.  The design/builder becomes the owner’s advocate, leading them through site planning, permitting, design, value engineering and construction.  The phased approach provides economical/budget information early for the owner to decide if the project is a go or no-go.

Design/build is suitable for busy owners or those who know only a little about construction.  It’s also a fast-track method or a fast construction process for projects with a tight schedule.

Construction Management

A construction manager’s (CM) role as part of the project team is to provide estimating and constructability review during design, and cost, time and quality control during construction.  The client establishes their team of architect, CM and owner’s representative at the onset of the building concept.  The architect is responsible for defining the building through drawings and specifications while the CM regulates and monitors the schedule, budget, materials and performance of the subcontractors.  The owner thoroughly informed by these professionals, can then make educated decisions about his or her project.

The owner must be willing to be involved in the process because by using the CM method each trade contract is signed with the owner.  The CM method is most suitable for those who construction is a recurring activity and/or their project is very large, like schools and retail chains.

General Construction

Considered the design/bid/build method, the owner typically already has plans which were prepared by an outside architect/engineer when they seek a general contractor.  They choose their general contractor by one of three methods, 1) negotiating with one or more contractors of their choice, 2) selecting a group of contractors to bid and then accepting the lowest bid, 3) advertising for a broad variety of bids and accepting the lowest.

For clients who have a simple construction project, general construction is likely the appropriate construction solution.  It’s also the right choice when it’s necessary to bid and then build a project based upon completed plans and specifications.  However, this method leaves little room for correction of design or programmatic errors, if any exist.

Leaseback

The contractor finances, builds and leases a new facility back to a qualified owner, allowing him or her to focus on his or her business.  This is the best option for businesses that are faced with the need to expand their floor-space while at the same time minimize the risk involved with tying up capital in construction costs.

Business owners who qualify and currently have all their working capital in their business without a budget for building their new space are candidates for leaseback.  By choosing leaseback, they can move their business to a prime location and get the space tailored to their design needs.  The owner has the option to purchase at a future date when the business warrants the investment.

Still not sure which one works best for you? Call us to discuss your options.  At Wolgast Corporation, all systems are in place to provide the most appropriate delivery method. 

Click on the Prezi Presentation below for more information about your construction service options.

 

Construction Options on Prezi

Tags: Medical Office Construction, Design/Build, Professional General Contractor, Schools, Construction Management, the Wolgast Way, Restaurant Construction, Leaseback, Dental Office Construction, Manufacturing Construction

Succession Planning & Your Building for Medical or Dental Professions

Posted by Cory Sursely on Wed, Feb 20, 2013 @ 02:06 PM

Succession Planning White Paper Remember the good old days—a decade or so ago—when a doctor could practice for 30 – 40 years and then sell his or her practice to another doctor when they were ready to retire, or better yet, have a son or daughter to take over the practice.  Jump forward to present time and it’s not as easy to find someone to take over a medical or dental practice.  The reality is there are far fewer doctors graduating than there are practices out there and doctors should start succession planning well before they’re ready to retire.

Dr. Michael Shepard, of Wolgast Corporation, has written a white paper “Succession Planning in Medical/Dental Practices in North America; (Are You Prepared?)”, to discuss modern day practices and methods for finding a successor.  Among other advice, he discusses how the design of a medical office and a modern aesthetic can help attract a junior partner.

Being that we’re a contractor who provides Design/Build services, we know firsthand how an outdated and poorly maintained building can detract from business and also cost the owner money in a sale of that building.  An architect that is creative, experienced and well versed in the codes of the medical or dental field, such as Rick Keith (Wolgast’s in-house architect), can make a difference in the aesthetics of your office as well as the efficiency of patient/work flow.  Changes like these will help attract patients as well as a junior partner, so that a doctor may cut back their hours as they approach retirement and, eventually, retire stress free.

One final note, also featured in the white paper, is that the earlier you start your succession planning, like say in your business plan, the easier it will be for you to start your transition seamlessly.  Having a junior partner on board early will help to transfer patient loads as the doctor reduces his or her hours and also keep the established staff employed as the junior partner can work with the senior doctor to set management systems.

Click on the graphic below for your copy of the Succession white paper.

Succession Planning White Paper

Tags: Medical Office Construction, Design/Build, the Wolgast Way, Dental Office Construction

The Value of LEED© Certification for Medical Offices

Posted by Cory Sursely on Mon, Jun 18, 2012 @ 10:07 AM

Determining If the Cost Will Be Offset by the Benefits

The breakdown of advantages vs. disadvantages for LEED© certifying your medical office is easy – it’s energy cost savings, environmental responsibility, plus marketing position (to name a few) vs. cost. 

LEED PointsWhile it’s quite hard to pinpoint what the additional cost truly is over traditional construction, a quick internet search indicates that building owners could pay an additional 0-15% for a sustainable building.  The additional cost depends primarily on the level of certification you’d like to achieve because the higher the level of the United States Green Building Council (USGBC) point rating system the more green materials and equipment you need, which usually have an elevated cost.  There are some points that have no cost, like having a bus stop near your building (6 points), and there are others, like installing a geothermal system (1-7 points) that adds considerable cost.  These are both options on a list of points available to achieve your preferred level of certification whether it’s certified, silver, gold or platinum with platinum requiring the most points. 

The advantages are more concrete to determine.  For instance, there are marketing opportunities and a general buzz associated with having a LEED© certified building and it can attract patients who are interested in green building or sustainability.  Also, since most buildings (medical offices included) carry their highest energy costs from space heating/cooling and lighting, the use of efficient equipment can save significant costs over the life of a building (1-19+ points).  The final benefit that I’ll discuss here is the use of natural light (1 point).  Natural light not only improves mood and general well being of the doctor, staff and patients, but it also improves vision (less eye strain), productivity of staff, and offers health benefits all on its own – definitely an important feature in a medical space.

You may have heard that the USGBC has published a LEED© for Healthcare rating system, specifically for hospitals and other medical facilities to achieve LEED© while addressing stringent healthcare industry regulations.  This new rating system may require more prerequisites than you need to prepare your medical office.  I say this because it’s geared more to a hospital’s 24 hour operation and indoor environmental quality associated with chemicals used on the premises.  It would likely be less expensive for a medical office to use the LEED© for New Building or LEED© for Existing Buildings: Operation & Maintenance.

If you are interested in pursuing it, Wolgast has a team of LEED© Associated Professionals (LEED© APs) on staff and they’ve been trained to help you review the rating systems and develop a list of points that will suit you best as well as design and construct the building.  Contact Dr. Michael Shepard for more information at mshepard@wolgast.com or 989-790-9120.

Sources used: 

www.usgbc.org

http://buildingsdatabook.eren.doe.gov/

Tags: Medical Office Construction, Design/Build, Energy Savings, the Wolgast Way

What Every Business Owner Should Know about Design/Build Construction

Posted by Cory Sursely on Tue, Jan 10, 2012 @ 12:19 PM

Design buildGeneral Construction for a long time was the primary method of delivering construction.  Even Wolgast in the early years was a one-trick pony with General Construction being our only option.  That is, until the 1970’s when we were the first to bring Design/Build to what’s now known as the Great Lakes Bay Region. 

The needs of busy business people who didn’t have much knowledge about construction drove the creation of the Design/Build delivery method.  They were educated people who knew a lot about their line of business, but never had an opportunity to learn about construction practices.  They needed guidance and, really, someone to be their advocate as they went through the process.

What is Design/Build

In a nutshell, The Design/Build method is classified by the architect and contractor being on the same team.  The company that’s responsible for designing the building is also responsible for making sure it’s constructed on time and within budget.  It’s a true collaboration throughout the project between the client, architect and contractor from concept to completion.  Through three phases, the contractor reviews the progress drawings with the architect to ensure that the project is still within budget and can be completed by the deadline.  Potential challenges can be flagged early and discussed to be mitigated.

Two Important Benefits of Design/Build

1 - You get an accurate estimate earlier – when using the General Construction delivery method, you have to wait for plans to be completed by the architect to hand over to the contractor for bidding.  You won’t have a cost estimate until you already have plans for your dream building set.  With the Design/Build method, you get a preliminary budget, roughly, a month or so after meeting with the architect.  You’ll then have enough information to know if financing is needed and, if so, documentation to take to the bank to get your loan approval.  Additionally, you’ll have easily and cost effectively made design adjustments to create a dream building within your budget.

2 – You’re able to find the best price from local bidders – when a general construction project is put out to bid, there’s normally limited time for general contractors to solicit subcontractors for their trade bids by the deadline, which means that you only get a couple of easily solicited bids for each trade.  When a construction project is delivered through the Design/Build method, the Design/Builder has the opportunity to set their own deadline and get bids from all local subcontractors (or any that you may request), which means that there’s no hit or miss with getting all the low numbers.  You’ll have all of the lowest numbers in one bid package.

Contact Michael Shepard to get an early preliminary budget, the best price and exceptional quality for your next building project.  800-965-4278, mshepard@wolgast.com.

To read more about additional benefits to the Design/Build delivery method, you can download our whitepapers on Fast Track The Wolgast Way or Why Some Business Owners Don't Do Design/Build, but Should

Tags: Medical Office Construction, Design/Build, Dental Office Construction, Good for Business, Manufacturing Construction

How to Design an Office for Patient Centered Medical Home

Posted by Cory Anderson on Mon, Nov 14, 2011 @ 11:35 AM

GFPSince the Patient Centered Medical Home (PCMH) is more of a management model or philosophy, you may not have considered the building design changes that may be necessary to make the conversion.  Below we discuss some of the elements that your PCMH office design should consider.

Storage Space

Electronic Medical Records are a key tenet of the PCMH model, however as practices transition into PCMH offices, one could expect to increase file storage requirements due to the added patient education and follow up.  Additionally, you’ll be accumulating the documentation from each visit your patient has with a specialist or key staff member inside or outside your office and therefore your space requirements will need to be addressed in physical space or specially designed spaces, such as climate controlled areas that accommodate computer servers and databases.

Meeting Space

Collaboration is another key of the PCMH model.  Practice doctors and staff members will be having meetings among themselves about their cases as well as consultation meetings with specialists, group meetings held for patients with similar conditions, and patient education sessions.  All of these types of meetings will require private and comfortable space to allow for most optimal conditions for patients, and for easy patient access.

Privacy Measures

With additional files and open areas for communication comes more responsibility for patient privacy and HIPAA compliance.  The design of your building will need to account for the privacy of verbal communication and protection of patient files.

Spare Exam/Treatment Rooms

We have recently completed the construction of a large PCMH office which included in its design additional exam and treatment rooms for visiting specialty doctors, so they can come to the patient rather than having the patient travel to the doctor.  This is a clear benefit to serving your patients with the PCMH model.

Dr. Michael Shepard, M.D., Ph.D., Wolgast Corporation’s medical office development specialist, along with Rick Keith, Wolgast Design Group’s architect experienced in designing for PCMH, can provide insight in the designing of an office remodel or a new building.  Contact Dr. Shepard at 800-965-4278 to discuss the design and construction of your next building.

Tags: Medical Office Construction, Design/Build, Professional General Contractor, the Wolgast Way, Design

Tips for moving into your new Medical/Dental Office

Posted by Cory Sursely on Fri, Aug 19, 2011 @ 11:44 AM

Moving into your new officesSo your new medical/dental office is about ready to be moved into, are you ready? Here are some experienced helpful tips from Wolgast to make the move go easy and not impact you or your employees in a negative way.

First off, remember to get your Medicare and Medicaid paperwork submitted right away so that the government is aware of your change of address and there are no issues that arise with the government. Not getting this information processed on time can lead to a billing gap and we have seen instances where doctors and dentists have lost out on months’ worth of revenue because paperwork was not processed on time.

Next, remember medical record privacy when packing up the patient files. These records need to be packed and moved such that security and only authorized access to them occurs. This may take some special planning but being aware of your HIPAA requirements when transporting and moving records could save you a tangle of paperwork and bureaucratic headaches.  If you are moving electronic files too then you need to treat the computer hardware and backup data with the same respect as you would give moving paper files.

Remember to have your information technology support people out early on the day of the move to ensure that computers can talk to each other, files have been transferred or transported safely, and that electronic medical records (EMRs) and digital imaging equipment (like the new digital xray machines) are connected, networked, and ready to go.  Expect a few glitches that first day and plan ahead by having a service technician there as each system is tried out.

For the general move, start preparing at least two months prior to the move date and make sure everyone knows what they are responsible for packing and unpacking. Your movers can give you an estimate of how much moving materials you will want to purchase. If you start purchasing a few months early you can pace that expense over several months and potentially save money by not over purchasing supplies at the last minute.

Lastly, taking the time to plan ahead and plan early lets everyone finish on time with a minimum amount of rushing. Then sit back and let the movers do the work, discourage employees from moving boxes or equipment themselves as they may injure themselves doing the work. An injured employee won’t be there to help unpack and may actually cause you to have more bills due to their medical treatment for pulls, strains, or sprains. Before you know it you will be moved in and up and running in your new facility.

 

Medical Office Construction Projects

Tags: Medical Office Construction, the Wolgast Way, Scheduling, Safety on Site, Dental Office Construction

Staying Open During Construction

Posted by Cory Anderson on Thu, Jun 09, 2011 @ 02:40 PM

Busy Business Owners Can Build, Too

By: Cory Anderson, Executive Assistant

Open

It’s a classic case:  a thriving company is busting at the seams and needs to remodel or add to their building to make room for future business, but the thought of construction stopping or slowing production stifles the owner from taking the risk of expanding.  So what is a business owner to do?  Instead of putting it off until they lose business because they can’t accommodate any more customers, they should find a contractor that will work with them to keep their operations running.

During the planning stages of a construction project, “not inconveniencing the customer” is an actual thing that is discussed and creatively considered.  Your project manager and project supervisor should discuss with you different ways that will allow your staff to keep functioning during construction.

Getting Creative

Restaurants need to keep serving food to customers.  If any area other than the kitchen is being remodeled or updated, the drive-thru or take-out should be available to keep customer flow happening. 

Other service businesses can benefit from moving equipment and furniture to areas in the building that have been prepped for the temporary workspace.  A Project Supervisor should be able to work with you to plan, schedule and assist during the transition.

Schools prefer to have all construction happen in the summer and in most instances that is the best way to do it.  However, it isn’t possible to finish some projects within the three month time-frame.  Therefore, work schedules can be adjusted so that construction happens during off-peak hours or added safety measures can allow for construction on occupied sites during school hours.

Another means for less disruption is getting through construction quickly, which is Wolgast’s specialty.  For more than 60 years, we have built a reputation for speed and will apply our systemized approach to quickly complete your project, too.

In summary, through necessity and an understanding of business operations, a contractor can creatively find ways to keep businesses open if it is possible.  I have compiled photos and case studies of remodels and additions where the business did not have to close down or slow operations. 
 

Projects Open During Construction

Tags: Medical Office Construction, Schools, the Wolgast Way, Safety on Site, Dental Office Construction, Good for Business