by Jeff Carter, DDS, and Pat Carter, IIDA
The most challenging dental facility project type is the remodel and expansion of an existing practice facility.
Five expansion challenges:
- The practice must remain open and productive during construction.
- The impetus for adding square footage should be the need for added clinical function to fulfill increased demand for dental services. The addition of operatories to an existing facility will alter sizing and location of many support spaces that were previously optimal.
- MEP (Mechanical, Electrical, and Plumbing) systems will be impacted by adding significant functional capacity to the facility and prove inadequate without upgrade.
- Newly constructed remodeled/expansion spaces will contrast "untouched" spaces, which will be perceived as "tired and dated." A successful remodel should appear seamless, improving the patient experience and updating the practice's image.
- Projecting costs for a remodel expansion is much more difficult than new construction. As a result, projected costs for remodel expansions are often inadequate and layered with multiple contingencies that make financial planning difficult.
Overcoming these challenges:
"Phasing" will ensure that your facility remains open and productive during construction. Phasing is a process in which construction is staged to work around an active practice, minimizing disruption. A phased project will have two or more phases of "staged" construction vs. new construction, which is typically completed in one continuous effort.
Successful phasing may dictate temporary spaces that provide interim functional solutions.
Consider the following "per operatory guidelines" for optimizing supporting spaces and avoiding an "unbalanced" facility outcome.
- 1.5 waiting room seating options added per operatory
- 2.0 parking spaces added per operatory
- 0.5 front desk/business area work spaces added per operatory
- 0.25 restrooms added per operatory
- 0.5 staff area lockers and staff table seating options added
- 0.33 doctor private office/doctor workspace added per
- 10% increase in size and functional capacity of sterilization, lab, and storage per operatory added up to 10 operatories. Larger facilities will reduce the percentage proportionately as they increase in size.
When adding more than 1,000 square feet and/or three or more operatories, plan and budget for a new electrical panel ($10,000 to $15,000) and one new HVAC air handling unit ($3,000 to $5,000). If your facility is in a lease space, the landlord will typically incur these costs and pass those along to you either in amortized rent or debiting of the negotiated finish-out allowance. Adding three operatories or more will also require an assessment of dental mechanical units (dental vacuum and compressed air) and med gas systems. Your dental equipment dealer can counsel you on the upgraded capacity needs and how to budget for new units and components.
Refurbishing the existing facility that remains intact is necessary to ensure that your newly constructed spaces and "untouched" spaces are esthetically complimentary. Refurbishing is limited to removing and replacing surfaces without moving walls or reconfiguring cabinetry and utilities. A refurbish may include replacement of floor coverings, wall coverings, fabrics/upholstery on furniture, ceiling tiles, and fresh paint on painted surfaces. You should budget up to $25 per SF for refurbished areas.
Phasing will add up to 20% to the construction cost per square foot due to the phasing process. This 20% does not include increased cost for upgrading electrical panels, HVAC units, and dental mechanical systems.
The successful design integration of an existing space with a newly constructed space is more complicated than perceived initially. However, when your existing location is enviable and your remodel plan proves viable, the opportunity to improve your practice experience is exponentially worthy of the inherent challenges.
Search for "Expansion remodeling" on www.dentistryiq.com to view work-in-progress images.
Jeff Carter, DDS, and Pat Carter, IIDA, are owners of PDG - Practice Design Group. Located in Buda, Texas, PDG offers a full range of design and consulting services to dentists nationwide. For information, call (800) 511-7110 or visit www.practicedesigngroup.com.
Past DE Issues