The profits behind door number three!

As health-care, office-design specialists, we frequently are hired to evaluate the efficacy of a space for its use as a health-care facility prior to its development.

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Garrett Ludwig

As health-care, office-design specialists, we frequently are hired to evaluate the efficacy of a space for its use as a health-care facility prior to its development. That assessment starts at the perimeter of the site and is influenced by parking, convenience, ambiance and accessibility. Besides the obvious code concerns, this assessment includes means of ingress and egress and their respective impact on function and flow within the facility. It is essential that we take a global perspective of the facility's potential and entertain all options of development; regardless of cost and complexity. Such was the case when I was contracted by orthodontists Dave Reen, DMD, and Tom Reen, DMD, to assess — and ultimately develop — a space for their third office.

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The 3,000 square-foot suite is located on the ground floor of an upscale, 20,000-square-foot professional office building, which is anchored prominently amidst a large, bustling retail and entertainment complex. The rectangular structure, which measures roughly 55 feet by 130 feet, features parking around its entire perimeter. Front and rear entrances are positioned at the center of the longest dimension and provide access to the stairs, elevators, public lavatories and ground-floor suites. Intrinsically, these doors presented the most likely of the three optional primary entrances to the suite. However, the process of elimination began with the client's preference for a less obvious alternative.

Option 1

Parking provisions aside, my clients were enchanted by the fact that their proposed suite featured a private entrance which shared the same characteristics as the primary building entrances. The entrance also featured double, smoked-glass entry doors and side lights. My objective was to develop a plan that would utilize these doors as the primary entry. Since the building is located in western Massachusetts, it was imperative that climate-related issues be addressed first. That meant the inclusion of a vestibule or weather-buffer. The enclosure bisected the available space; encroaching on seating in the waiting area, as well as obscuring visibility of the waiting area from the reception desk.

Those impositions not withstanding, the concern for demands on heating and cooling were equally daunting. The combined effect of the southern exposure on a highly glazed exterior, magnified by the anticipated high occupancy of the waiting area, created the likelihood we would need a third heating and cooling zone.The combined cost to construct the vestibule and upgrade the HVAC was $5,000 to $6,000.

Last, but certainly not least, that section of the suite was determined to be the least hindered by physical obstruction. It offered the most favorable location for the six-chair treatment bay. Consequently, we abandoned the idea of using the private entrance as the main entrance, and took the next, most logical course of action by looking at the more conspicuous entrance from the public corridor.

Option 2

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Dr. Tom and Dr David Reen's office before renovations
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Although nicely appointed, the lobby and passageway offered a conventional tenant directory and limited signage on the solid-core doors through which all of the ground-floor suites were accessed. Beyond the lackluster entrance to the object suite were other encumbrances. The area immediately inside the suite was constrained by the building's elevator hoistway. That condition was exacerbated by the existence of a structural support column that was positioned seven feet inward from the entry door. The appeal of utilizing that entrance was further compromised by the lack of natural light.

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The Reen's office after renovation.
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We could have replaced the existing, solid-core door with a glazed entry, the cost of a fire-rated, single-light door was estimated to range between $1,000 and $3,000, depending on the type of glass and frame used. Lastly, close parking was determined to be extremely limited. That was clearly due to the fact that most patrons logically parked as close as possible to central entrances as a matter of convenience. Although there was substantial parking available at the far ends of the building, the compulsory traverse was equally undesirable. Collectively, these factors inspired my clients to have me seek yet another alternate means of ingress.

Option 3

Surprisingly, the east entrance offered a variety of inherent benefits:

1) An abundance of parking was located directly opposite and bilateral to the entrance, the result of the parking usage referenced above.

2) The east entrance offered a greater potential to accommodate waiting and reception services and to create optimal traffic flow within the suite.

3) An overhead door was a real eyesore on the highly exposed eastern elevation. We felt that chances were good that the building owners would be receptive to a facelift that would include visible signage.

All were exceptional advantages; however, the latent potential for free marketing was by far the most engaging. That was inspired by the fact that the enormous mercantile complex which surrounded the structure was bifurcated by a heavily traveled, two-lane access road, from which the east end of the building was highly visible in each direction. The greater majority of patrons of the various amusement and retail establishments were channeled past the site. That qualification was distinctly enhanced by the image that the end of the building could be perceived as a separate and exclusive address.

The existing conditions, on the other hand, presented some fiscal, as well as physical, challenges. The former tenant — an insurance agency and claims-processing center — had installed the overhead door and hinged utility/egress door on that end of the building to accommodate a drive-in, claims-adjusting service for their clients. Also, as a result of the topography on the site, the 600 square-foot drive-in facility was positioned approximately one-and-one-half feet below the primary grade, with which the main floor of the suite aligned. The two levels were connected internally by poured-in-place concrete stairs.

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To take advantage of the benefits, it was imperative that the following be addressed:

• Removal of the 10-foot overhead door and the three-foot, steel-hinged door

• Partial enclosure of the remaining openings with matching brick

• Installation of a new window in the opening formerly occupied by the overhead door

• Breaking through the waill to create the new glazed entry

• Installation of the new entry

• Construction of a handicapped ramp and ambulatory access stair to meet the existing level

• Pour a concrete floor in line with the main portion of the suite

• Installation of awnings, signage, and exterior lighting.

Despite the $18,000 price tag, the concept was warmly accepted by the building owner and my clients.

The bottom line

The amortization of the renovation to the eastern elevation of the building over the term of the lease was clearly fractional: one new patient per month would more than cover that expense. More importantly, the cost/benefit analysis between the actual expense and its marketing value alone was profound. A full-page, weekly ad in the local newspaper or annual Yellow Pages directory could not compare with the subtle, broad-based impact of the signage.

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Similarly, the availability of convenient parking directly outside the private entrance to the practice was particularly appealing. The added benefit of smooth and efficient traffic flow can't be overlooked either — a happy staff stays with a practice and an efficient staff generates revenue. The exuberant feedback from patients and staff has been extremely positive and my clients anticipate unprecedented growth.

Economic perspective

Our projects have ranged from a very modest $30,000 in cost to over $1,700,000. Regardless of the size and scope of each project, our focus has always been dedicated to function, efficiency and, above all, a calculated return on investment.

The most successful projects have been created in concert with clients who have a propitious understanding of the difference between cost and investment and a willingness to endorse their belief in themselves. The Reen brothers are a good example of commitment to that mindset. Not only did they recognize the value of the investment in the east entrance, they further endorsed the expenditure by including amenities like a vibrant floral display at the building's threshold and a soothing, wall-hung fountain in the expansive waiting area. The open, flowing reception desk and the abundantly spacious treatment bay were also requested features that they perceived would augment their clinical and administrative services. In the few short months since the opening of their new facility, those perceptions have borne fruit.

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