Programming Your New Office & Assessing Your Needs
by Don Leighton-Burwell, AIA/Tenth Times November 1996

Let’s assume that you have located a site or secured a lease space, have considered your budget and obtained commitments for financing, and have chosen a design professional to assist you in creating your new office -- so what’s next? Within the architectural profession, we call this phase “programming”. This is considered a Pre-Design service and is the building block for creating a design that will accurately address your needs. The program will address human, physical and external factors through data collection, analysis, organization, communication, and evaluation. The end result will dictate many factors of your design and set priorities for decision-making.

I begin the Programming Phase with a multi-page document (to be filled out by my client) that addresses a range of issues. We will consider the new space including available area, views, access, solar orientation, presentation to the street, aesthetic preferences, and other pertinent items. In addition, I request a list of projected staff positions to plan for future employees. Reviewing financial information is advisable, and I also like to discuss projected occupancy dates relative to current leases, etc. One of the most important elements is having the doctor define his/her project goals. This may be only a few short sentences, but can be invaluable in describing characteristics that are not easily quantifiable (like mission statements) but help to define your practice. Last, but not least, I recommend a complete tour of the existing dental office to ascertain what works and what doesn’t, and experience your practice “style” first-hand.

The heart and soul of the Programming Phase is the inventory of spaces and space requirements. For organizational reasons, I have broken this into three areas: Clinical, Public and Private. These are the three principal “zones” within the office, and all have interrelationships that need consideration to address issues of use, adjacency, communication and circulation. Within each “zone” or area, there is a subset of relationships with their own hierarchy of requirements.

For example, in the Clinical Area the primary consideration is the Operatories or Treatment Rooms. After all, this is the area that sustains the financial well-being of your practice and most directly affects your daily perception of your office. You will want to consider the number, configuration and size of these rooms (usually 9.5'x10’), delivery systems, cabinets, lighting, x-rays, small equipment and computer integration. The Sterilization Area (or Tray Prep) should be your second consideration (in this area) with it’s relationship to the Treatment chairs of critical importance. Current sterilization methodology supports the “clean vs. dirty” separation of work areas within this space. As a rule of thumb, entry to this space should be no more than 20’ from the farthest treatment room. A Dark Room/X-Ray Processing Area should be convenient to the Treatment Rooms while providing support for any Central X-Ray Area. The position of the Lab is not as critical, but should (in most cases) be positioned nearer the Treatment Rooms used by the doctor.

I describe the Public Areas as those spaces that your patient will experience that are not clinical. For the greatest continuity and workability of your environment, these spaces should be considered with equal weight to the Clinic Areas. These are often the patient’s first impression of your practice and are the support spaces that help to maximize your production in the clinic. If you “skimp” here, you will likely regret it later. The Public Areas include: Reception Room, Front Desk, Business Office, Patient Toilet (Handicap Accessible) and Consultation Room (optional). I strongly recommend separating the Front Desk and Business Office functions. The Front Desk is a greeting, payment and re-scheduling area, and should only be used as such. The Business Office, while ideally adjacent to the Front Desk Area, should be private enough to carry on the “behind the scenes” business and not invite public scrutiny. If the “front office” is inadequate, not only will you see a higher turn-over in employees, but you will also limit their ability to adequately process patients thereby hurting your overall production.

Private Areas, some of which you may omit based on available space, include: Doctor’s Office, Staff Room, Staff/Doctor’s Toilet(s), Storage, Medical Gas Tanks, Dental Equipment Room and other support spaces. Most doctors do not need large private offices and Staff Rooms can be a great morale booster if space is available. Generally speaking, these areas can fit in the spaces left after solving the Clinical and Public requirements.

Look closely at your needs and practice style. Ultimately, your program should accurately reflect the inventory of space requirements to be accommodated within your new office. When you are done with this phase, your architect can take this list of spaces and interrelationships, and distill them into schematic design options for your facility.