Inside the fishbowl

There's no such thing as "my case" or "your case" at California Veterinary Specialists in Carlsbad, Calif. Every doctor shares cases, information, and expertise to make sure that every patient and client receives top-notch care. So it stands to reason that when the five co-owners were designing their third facility together since 2003, they wanted a building that would reflect their no-barriers business approach.

Reception and waiting area: Storefront windows grace the waiting area, and a large bronze sculpture separates the reception and discharge areas. Recessed fixtures provide even lighting. The front desk gives receptionists visual control of the entry, exit, discharge, waiting, retail, exam, and treatment areas.

With a little time and a lot of thought, the doctors converted an existing structure into the practice's third facility, using an open space designed to foster a shared sense of community. The Veterinary Economics Hospital Design Competition judges found favor with the facility, granting the practice a 2008 Merit Award. The judges praised the doctors' use of glass throughout, great floor plan, and attention to detail.

"The fishbowl": Large windows provide visual contact between the treatment area and doctors' workstations to better integrate patient care. This airy, open room serves as the hub of the hospital.

Putting philosophy into practice

Co-owner Dr. Tim Concannon says the practice's philosophy is to be integrated across the board. "We wanted a design that would put us all in the same room at the same time so we could share cases and communicate easily," he says. "Floor plan and flow is definitely part of it, but it's also the mindset that we work under."

Floor Plan: California Veterinary Specialists

To achieve an integrated design to support the practice style, Dr. Concannon and his co-owners chose to include a feature they call "the fishbowl," a glass enclosure in the center of the practice housing the doctors' workstation within the treatment area.

Exterior: The aging painted aluminum mullion and glass entry was removed from the existing building and replaced with a new storefront, allowing more natural light into the waiting area. An outdoor patio area was also enclosed to create a larger, more striking reception area.

"This is my favorite feature," says Dr. Concannon. "I love being able to see everything going on around me. Even now, as I sit here, I can see our oncologist examining a patient and signaling a surgeon and a radiologist to get their opinions on what to do. Our design now supports our collaborative approach to medicine. It essentially puts us all in the same room at the same time."

CT scan: The CT room, which features full lead shielding, was strategically placed in a corner of the hospital near the radiation therapy and nuclear medicine areas to allow for smoother traffic flow and to minimize congestion.

With the new facility came a smoother flow from surgery to recovery and from surgery to radiology. "Each time we've built we've kept a lot of our old ideas but scaled them up significantly," says Dr. Concannon. "Here, we brought surgery, recovery, and radiology closer to one another to save steps and work more efficiently." These changes not only make practice more efficient, they foster teamwork and allow for a better flow of information, he says.

A look at the numbers

Challenging convention—and City Hall

While the final product flows well, the building process wasn't a breeze, Dr. Concannon says. For one thing, the original building wasn't designed for commercial use. Located in the heart of a research and development park and close to many pharmaceutical companies, the site was just what the practice owners wanted. But it took a lot of persuasion to convince local officials to allow California Veterinary Specialists to convert the facility to an animal hospital. The doctors, however, persisted—and for good reason.

Administrative office: Doctors have plenty of space to take care of administrative tasks in this office conveniently located near both inpatient and outpatient hospital functions.

"We do a lot of oncology research, as well as a lot of collaborative projects with pharmaceutical and medical device companies," Dr. Concannon says. "We always have multiple studies going with these nearby companies. So we went to the city to argue our case; the sheer number of our collaborative efforts with these groups swayed them to think it was reasonable for our business to be here."

Surgery and prep: This area features a clear view into surgery for ease of communication and visual monitoring of recovering patients. Transparency is key to success in this hospital.

The original site also lacked many disabled-access requirements. Specifically, the doctors had to figure out how to fit disabled parking spaces and paths to the building in the available space. And the existing shell needed retrofitting to accommodate sufficient HVAC equipment, more floor space, and structural load requirements.

Ward: The dog runs feature storefront windows to admit natural light and to make it easier to monitor patients.

Installing the linear accelerator also presented a challenge, as it does for most practices, Dr. Concannon says. "Seeing workers pour 30 truckloads of concrete to house the accelerator left me in awe," he says. "That was the moment that it struck me how big a process we had undertaken."

Chemotherapy: Clients bringing patients for chemotherapy wait in a separate area and use the two oncology exam rooms just off the main reception area. Demand for oncology services was a primary factor in the owners' decision to build a larger facility, Dr. Concannon says.

It took a lot of work to make the conversion happen, but the doctors are happy with the result. "Our architect tells us we tried to fit 20 pounds of laundry into a 10-pound basket," Dr. Concannon says. "But it really worked out well for us."

Sarah Moser is a freelance writer and editor in Lenexa, Kan. Please send questions or comments to ve@advanstar.com.