Empathy and Innovation in Veterinary Hospital Design

 

Author
Sarah Cantine & Brian Hoeft

 

Veterinarians engage in empathy more than many professions as part of their work. Their patients can’t verbally express what their difficulties are, and veterinarians can’t explain the concept of medical care back. To transcend the communication barrier, veterinarians creatively use their professional experience, active observation, and patience to establish a connection and trust with the animals they treat. Communicating this empathy is important for the animal’s well-being and receptiveness to treatment, and often for the veterinarian’s own safety. The architecture of the veterinary hospital should be an extension of veterinary care and requires the same level of professional experience, active observation, and patience in its design, plus a certain level of questioning the status quo to push these spaces forward and meet identified needs. Empathy and innovation are integral to the design process and ensure that the architectural solutions not only support but advance the important work within.

With The New Road Ahead project, the Oregon Humane Society (OHS) embarked on an ambitious plan to create a campus dedicated to the wide range of pet animal needs. OHS already had very successful adoption and spay and neuter programs, food banks, training classes, a residency program for Oregon State University veterinary students in their Shelter Hospital, rescue services, and the Humane Law Enforcement department. Despite the successes of these programs, the needs of our community and the capabilities of our existing facilities were not aligned. From this understanding came a plan to build facilities for emergency animal housing, long-term retraining, specialized housing spaces where animals can heal physically and socially, an expanded forensics facility, and the Community Veterinary Hospital that would support all campus programs, offer lower-cost medical care to the public to keep pets with the families that loved them, and a facility designed to teach the next generation of veterinarians. In this piece, we will specifically examine the approach to the Community Veterinary Hospital.

Scott Edwards Architecture has extensive experience in veterinary clinics and hospitals as well as working with over 90 non-profit organizations. OHS has over 150 years of experience in animal welfare and holds a position of leadership and training within their industry. The organization aimed to reexamine everything they thought they knew about animal care facilities in order to be open to innovation and remain flexible for any unknown challenges the future may bring. They looked to SEA to guide this exploration process, engaging their many stakeholders, from volunteers to doctors to donors, to develop a thoughtful and comprehensive approach.

The new Community Veterinary Hospital reception area is open, inviting, and accessible.

We started the design process by embedding ourselves into OHS—with their programs, learning their mission, and understanding their culture. As a teaching institution well versed in training (and relying upon) volunteers, they easily brought us into their activities, showing us what worked and what didn’t, what materials held up to their cleaning protocols, and where architectural interventions could make their jobs easier and animal comfort improved. To design, we first had to listen to and understand their needs and those of the animals in their care.

We observed multiple rescue intakes, kitten season, dog training, kennel cleanings, and feeding times and met many memorable animals along the way. We attended donor events, lectures on Fear-Free design and others, inventoried OHS buildings, and held volunteer and staff working charrettes. The design team traveled together to learn from esteemed forensic pathologists for guidance on planning the necropsy suite, the Oregon Zoo for medical suite and transfer door studies, and other animal adoption, behavior rehabilitation specialists, and veterinary facilities in Oregon and multiple other states. With each group we interacted with, they generously gave of their experience knowing that it would support animals and advance their industry. This kind of exposure not only gave us insights into practical architectural issues but also showed us people with a true devotion to animals and relieving their suffering. Through these animal advocates, we grew to see animals in a new way, with greater empathy for their experience of the buildings we as architects design. This understanding impacted each and every design solution we developed.

We grew to see animals in a new way, with greater empathy for their experience of the buildings we as architects design. This understanding impacted each and every design solution we developed.  

When asked what surprised her during the design of the Community Veterinary Hospital, Oregon Humane Society Project Manager Ashley Evans shared that “In the years we spent planning and designing the hospital we visited many different veterinary hospitals, ranging from corporately owned chain hospitals to private non-profit hospitals. Every clinic had different opinions on best practices and design preferences, so much so that it was hard to discern what would work best for us. However, after visiting all these hospitals we started to notice that there were many areas that proved to be common “problem areas” for hospitals. Exam rooms and lobbies tended to look the most worn down, especially when it came to casework and countertops. Animal sightlines were a common issue that led to increased stress on patients. Employee areas always looked to be an afterthought and natural light was almost non-existent. We took all these observations and addressed them in our building design and are very happy with the results.”

Aerial image shows the plaza of the Community Veterinary Hospital building, including benches, soon-to-be matured plantings, and strategically placed ‘pee posts.’

So how does one plan the experience of a pet visiting a hospital? It starts by empathizing with the pet’s first experience in the parking lot where they may be excited to be on an outing or traumatized to be in a carrier in a strange place. We planned generous parking stalls to create safer and easier spaces to exit vehicles with fewer carrier bumps. Concrete pathways to the building reflect the sun and remain cooler than asphalt to keep paws comfortable on hot days. Plantings (although young now) will grow to provide shade and support wildlife, with plants considered specifically for their place, function, and safety with animals. Plants near paths were chosen to be non-toxic and withstand pet traffic with specific basalt columns strategically placed to give dogs places to relieve themselves prior to entering the hospital—and also to get an idea of who else might be in the waiting room. These ‘pee posts’ as they’ve been affectionately dubbed are a hit with the animals, and being set in a gravel base to contain urine so it doesn’t migrate to the walking surface, they are also a hit with pedestrians and the OHS maintenance crew.

Years of walking shelter dogs informed the overall approach to creating a landscape of mounds that minimize animal interaction on pathways and create buffers to adjacent roads. The front ‘plaza’ mound is tall enough that dogs can’t see over it but does allow their humans to see other people/animals and adjust their movements as needed. Outdoor amenities such as benches, dog bag dispensers, receptacles, and ‘pee posts’ support outdoor waiting areas for animals that may find the waiting room stressful, and the entire area is surrounded with fencing so that their owners have less worry about their pet fleeing the site should they get loose.

The building entrance is clear and unobstructed and designed so that the sequence is as incremental as possible; first under a canopy, then a glazed vestibule for sound and safety, and into the waiting area to acclimatize animals into this new space gently. Sensory changes are minimized in continuing the concrete floor surface indoors which is awash in natural light and plants (installed after photos) to feel more like the outside the animal has just come from. Windows with bird-safe glazing extend from the ceiling to the top of the perimeter seating benches so animals that are walking, in carriers, or in arms can see nature outside and sense expansion. The durable perimeter benches allow freedom of movement and choice in how to sit and where to look and be seen (or not). Moveable furniture in the interior allows additional flexibility for staff to adjust furnishings based on experience or to support specific medical events.

From left to right, images show the dog side of the lobby and the cat and small animal side of the lobby.

The waiting area also separates dogs from cats (and other small or fearful animals), and there are carrier cubbies for those animals who are more comfortable not seeing those around them at all. Dr. Steve Kochis, Chief Medical Officer at Oregon Humane Society, expressed that the “consideration of how patients would flow through the spaces and the separation of species not just in the lobby, but exam rooms, and housing of cats and dogs are on opposite sides of the building, are examples of the design acting as an extension of the care we provide.” The design goal was for every animal, person, or family to find their own comfort spot.

Hard, flat surfaces are important to avoid dander and hair accumulation and to be easily cleaned. But with so many, noise could easily be a stress-provoking element. To mitigate this in the design, we selected a specially engineered wood acoustic ceiling to trap sound and add a natural material to the interior. It has proven very effective and keeps the space from feeling antiseptic. Dr. Kochis shared that “there was a lot of thought given to acoustics and sound and after practicing in the space, that has definitely proven itself valuable.” Bench tops and the front desk are covered with seamless solid surface material which is warmer to the touch than quartz and can be easily repaired and cleaned. Due to the low porosity of the material, it is quite hygienic, resisting moisture, stains such as urine, bacteria, and fungal growth. Clean touchable surfaces protect animals against contamination, minimize triggering scents left by other animals, and establish confidence in animal owners that the care will be sterile and professional. The animal and their owner are a unit and minimizing the stress on both is essential. Care was taken to make the interiors as relaxing and joyful as possible with a neutral and natural palette and discrete ‘pops’ of color.

One of the benefits of running a high-volume animal shelter is that you quickly learn what materials work well and which ones don’t. This worked in our favor when designing the hospital. We always joke that our most asked question was, “What happens if this gets peed on?” But asking these questions and taking a close look at what each material would be exposed to definitely helped us to make good decisions regarding materials.
— Ashley Evans, Project Manager, Oregon Humane Society

Dr. Kochis examining Helo in one of the Community Veterinary Hospital’s new exam rooms.

The exam rooms are species-specific and located off each waiting room area to avoid stressors of cross-species scent and sound. They carry over similar materials as the lobby with a pop of cheerful color chosen by staff—paint is a cost-effective way to personalize space that is easily changed over time, offering flexibility and opportunities to customize work areas for OHS. The rooms are simple with plenty of open space and a fold-down table so animals can take in the entire room to feel more comfortable. Tall gypsum ceilings keep climbers from attempting escapes, and the rooms are soundproofed from others for added comfort and privacy.

The 1st-floor layout of the hospital, above, illustrates how the design considers important adjacencies, access to natural light, and patient and staff experience moving from space to space.

Exam rooms ring the internal treatment room, minimizing the distance patients and staff need to travel as most patients will not need to go further into the building than this area. Natural daylight is vital to human and animal well-being and our design concertedly incorporates it whenever possible. In the treatment room, we use skylights to bring daylight into the space. For safety, the floor is a more slip-resistant medical-grade surface, and ergonomics are thoughtfully supported by ensuring that equipment is properly located and clearance around treatment tables is right-sized. Light-filled outpatient housing is situated just off the treatment room forming a loop to the hallway where the animal first entered to be easily reunited with their families when they are done. 

One of the things we really focused on was quality of care for the animals visiting our clinic and for the people caring for them. Supporting the people caring for pets is just as important as the care we provide to our patients. When making design choices we thought about the entire experience from start to finish. Walking through the activities performed in the space and applying design principles to build a space that was both durable and efficient was paramount to the success of our programs.
— Ashley Evans, Project Manager, Oregon Humane Society

The surgery suite pictured above is filled with natural light and overlooks the “Doctor’s Garden.” 

Patients requiring surgery are brought to the back of the hospital to light-filled surgery suites where doctors doing the most critical care get the full benefit of natural daylighting. The preparation and recovery area is central to both the surgery suites and inpatient care so that animals need only be moved a short distance from sedation into surgery, from surgery to recovery, and from recovery to inpatient treatment where their recovery progress is monitored in kennels that benefit from interior den-like environments. This can all be done within a single sealed sterile corridor to prevent infection and minimize stress on the animals.

The back-of-house support space provides a valuable secure connection to all other programs within the campus. Hospital services are shared with the Animal Crimes Forensics Center program located on the second floor, and animals from OHS’s new Behavior Rehabilitation and Rescue Center, also part of this project, can receive high-level medical care and assessment just next door. The hospital staff in return shares the campus breakroom and lockers on the second floor, fostering a sense of shared mission and the opportunity for cross-program conversation, collaboration, and innovation.

Lots of natural light and brightness of the workspaces benefit the staff, and each area of the building seems very welcoming. I love the use of color and various textures throughout, too.
— Dr. Steve Kochis, Chief Medical Officer, Oregon Humane Society

A pet patient and his humans seated in the new Community Veterinary Hospital’s lobby. 

OHS’s willingness to question and test typical choices facilitated intentional design decisions—this approach allowed SEA to apply what has been working elsewhere knowing that it stood up to scrutiny, and push for innovative options when it didn’t. The deliberate space planning, materiality, architectural features, and sequence of all these elements together are highly considered and we hope to offer a prototype for similar veterinary hospitals moving forward. We’ll also suggest that the added layer of empathy in our architecture and the importance of understanding what a vital role it plays in veterinary care produced a stronger design that would likely have been impossible to develop in its absence. Empathy in design is innovative in its own right, and we are grateful to the Oregon Humane Society and the project partners for their collaborative and giving spirit throughout this process.

 
DesignRandi Haugland