Hanging with Hafen: It's easy being green—and lean

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Nov 01, 2010

[Editor’s note: This is the second in a series of monthly columns from veterinary architect Mark Hafen, AIA, co-owner of Animal Arts in Boulder, Colo.]

My hero isn’t Gandhi, Einstein, or even Al Gore—it’s Kermit the Frog. I think he’s uniquely relevant in this day and age. Specifically, he’s green and lean, and these days, that counts for a lot.

Kermit sings, “It’s not easy being green.” I think he’s right, but maybe not in the specific way he was thinking. Respecting and valuing the environment—or being “green”—can be hard, but it does make sense. For example, in a veterinary clinic, you can:

> Use linoleum instead of sheet vinyl PVC flooring (linoleum is made from renewable materials).
> Incorporate a heat recovery system as part of your HVAC system. This allows you to precondition the air you’re taking in with the air you’re exhausting.
> Use low volatile organic compound (VOC) paint that doesn’t emit noxious chemicals.
> Design the facility to harvest sunlight in the winter and use passive connective cooling in the summer.
> Install on-demand water heaters at each sink in lieu of an oversized, constantly running central water heater.

But I think “green” is even more important when you couple it with “lean.” With the up-and-down performance of the economy, it’s going to be increasingly important that veterinarians develop strategies to sustain and grow their businesses even during tough times.

The answer is being lean. Human healthcare recently discovered leanness, as evidenced by Toyota’s production system for eliminating waste. In human healthcare, “lean” means “the analysis of operations to reduce wasteful non-standard procedures, eliminate non-value activities and in the process, reduce defects.” But I think it’s important to define “lean” not as a reactive stance but as a proactive strategy: How can you use your available resources more effectively, including personnel, space, materials, and even technology. Here are a few ways you can do just that:

Personnel:
> Cross-train team members to do more than one job well.
> Have receptionists wear wireless headsets so they can answer the phone from anywhere in the practice.
> Group exam rooms and other work areas into pods that reinforce work teams.
> Eliminate the reception desk and use a tablet PC so that team members go to the client, not the other way around.

Design:
> Design your exam rooms to be multipurpose so when they’re not being used as exam rooms, they can become procedure rooms, consultation rooms, or office space.
> Design spaces to be more generic—incorporate rolling mobile carts and tables for storage as well as work surfaces that can move where you need them.
> If you have an oversized facility, place a small outpatient treatment and charting area near the exam rooms so you don’t have to travel far.
> Consider incorporating a two-table surgery room so you can finish up one procedure as you begin another.
> Standardize the layout of your exam rooms so that you always know where things are.
> Place storage and receiving areas as well as the pharmacy in a central location to minimize the handling of food, drugs, and supplies.
> Find the most convenient spots for supplies and materials in your practice, and consider where you’ll place trash and recycling receptacles.

Technology:
> Build two dental stations that bracket your dental radiography machine to get the most use out of the equipment.
> Switch to digital radiography.
> Become a paperless practice.
> Use video monitoring and wireless telemetry to monitor patients.

All of these lean money-saving strategies are also green, because when you design a more effective facility—or, for that matter, when you use an existing facility more effectively—you save on construction costs, materials, and utility costs. Ultimately, I think Kermit would way that in the new business environment we’re living in, you’ve got to be lean and green.

Ribbit.

Veterinary architect Mark Hafen, AIA, is a Veterinary Economics Editorial Advisory Board member and co-owner of Animal Arts in Boulder, Colo.