Küster Dental Blog

Posts Tagged ‘dental office ergonomics’

Design for Accessibility

Posted on: May 19th, 2014 by James Kuester No Comments
Mom & Dad

Mom & Dad

I recently traveled with my aging parents to my sister’s wedding on Chesapeake Bay. It was a lovely weekend and everyone had a great time, yet while I see my parents every week, living and traveling with them for four days reinforced to me just how much care we, as designers, need to take in designing for accessibility.

My parents are both in their mid-80’s and I think they get around pretty well. They are both in good health, yet do suffer from typical effects of aging such as diminished hearing, vision, balance, and mobility. Consequently, traveling to unfamiliar places poses a challenge. They don’t hear instructions by TSA agents, hotel clerks, and restaurant servers well when there is a lot of background noise. They get tripped up when floors and transitions are not smooth or stairs are of an uneven height. They don’t immediately identify signs and wayfinding clues. Watching my parents navigating unfamiliar terrain made me realize just how much work we have cut out for us in creating designs for our clients that work to diminish these challenges.

The elderly are not the only ones that need good accessibility design. Anyone who has ever broken a leg or ankle or for whatever reason was restricted to crutches or a wheelchair can tell you just how challenging getting around can be. Entrance ramps that are supposed to provide accessibility are often at the wrong angle and require tremendous effort to mount. Restrooms that do not follow ADA accessibility guidelines are next to impossible to navigate alone. Most operatories are designed for the efficiency of the staff and do not take the ability of the patient at all. Good signage in dental offices is almost non-existent. Patients of all ages can benefit from better accessibility design. Our job as dental office designers it to make sure our clients’ practices excel in providing it.

Attention to Details

Posted on: February 7th, 2014 by James Kuester No Comments
The wrong color stands out

The wrong color stands out

We’re working on a dental office design project right now and are struggling to find just the right color match between the floor tiles, countertop, and backsplash tile.  Since the client really loves the floor tile, it is the backsplash tile that is being problematic.  I’m sure, as a dentist you can relate.  When working to build a new crown for a patient getting the enamel color just right so it matches the teeth around it is critical.  If it is a shade or two off the tooth will stand out like a sore thumb and everyone will notice.  The same is true in design.  If something isn’t just right, the overall effect will be marred, and consequently, the impact from the design will be diminished.

There are multiple goals when creating a new design for a dental office:

  • What is the branding message the practice is trying to send?
  • What is the patient experience that the practice wants to be remembered for?
  • How can the practice become more productive and efficient through better space planning and design?
  • How can repetitive use injuries be reduced or avoided through better ergonomic design?
  • How can the practice use energy and water more effectively and efficiency through green design?
  • How can the practice make more productive use of its space through the application of technology?

These are just of a few of the questions that we ask our clients and ourselves on each project we work on. Hitting a homerun on all or most of these requires careful attention to details – just like getting the color right on a patient’s tooth.

Making Your Dental Office More Inclusive

Posted on: November 6th, 2013 by James Kuester No Comments
ADA Compliant Smile Branded Dental Restroom Sign

ADA Compliant Smile Branded Dental Restroom Sign

I just saw the coolest thing while in line at Starbucks.  Starbucks now offers a version of the Starbucks Card in Braille for the visually impaired.  The visually impaired have so many challenges and pulling the right card out of their wallet to buy their coffee should not be one of them.  Nor should navigating their dental office.

Proper interior signage in dental office is often an afterthought during the design process.  So many dentists and staff think that because the office isn’t large and they know where everything is that signage isn’t necessary.  They so often forget about their patients, or future patients, that may be visually impaired.  Even though there are codes on the proper placement of interior signage, they are often not followed, I think more out of ignorance than anything else.  Sadly, the Braille on off-the-shelf signage is often incorrect.  Many large manufacturers don’t have anyone that is visually impaired on their staff to check the signs before they are sent out.

We strongly encourage everyone to make sure the design of their dental office is an inclusive as possible by checking the placement of interior signage and the Braille to make sure everything is correct.

Sound Design in Dental Office Operatories

Posted on: September 11th, 2013 by James Kuester No Comments
As quiet as a forest

As quiet as a forest

One of the areas that is a constant struggle in dental office design is to create enough sound masking between operatories so that the office is in compliance with HIPAA without breaking the office into a series of individual, tiny rooms.  Traditionally, dental offices are comprised primarily of drywall walls and ceilings.  Drywall is one of the most reflective surfaces making sound transfer between operatories an issue when one is trying to prevent it.  Drop panel ceilings can help with this by offering more sound absorption, but they do not offer the same level of sanitation and cleanability that drywall offers.  We have utilized acoustical panels mounted on walls and in cabinets in many of our designs to assist with sound absorption with fairly good results.  But, we’ve always felt that there has to be a better way.

I’m at the Greening the Heartland Conference in Chicago this week and one of the sessions dealt with sound design.  One of the key takeaways from the session was that the more varied the surfaces of a room are, the more the sound is muffled and the less transfer between spaces one will get.  Think forest as compared with a drywall room.  As a result of this session I am excited to explore new operatory designs that make use of higher ceilings with multiple surfaces to help the sound go up and away rather than reflecting back to be heard by others. I think these concepts can afford some very exciting dental office designs that will help our clients get even better HIPAA compliance without resorting to individual rooms or bothersome noise masking technologies.  Stay tuned for more as we explore the possibilities.

Getting More Done with Less

Posted on: June 24th, 2013 by James Kuester No Comments

I was at a conference a couple of weeks ago and one of the speakers presented the following predictions:


  • 7 Billion people on Earth
  • 49% live in urban areas


  • 9 billion people on Earth
  • 70% live in urban areas

In order to feed 9 billion people agricultural production on existing land is going to have to increase 70%.  Think about that, the productivity of existing agriculture is going to have to increase by 70% in the span of 37 years in order to meet the demands of the world’s population.

In your dental office would you be able to increase the productivity by 70% in the same amount of space?   Well, yes, you probably could if you put a second shift on and hired a second doctor.  A crop tends to take up all of the space in a feed for the entire time it is in the ground and is a 24 hour operation already.

What if adding more work hours in the day was not an option and one had to create more efficient ways to work?  My guess is that we’re going to have to do this in dental office design.  As we add 2 billion more people to the Earth and crowd them into urban areas, the amount of available space is going to become more constrained.  Dental offices will need to find more productive and efficient ways to get things done within the same, or less space.  Going digital is definitely one great space saver.  We’ve already helped clients make more efficient use of the space they have by reusing space previously taken up by storing paper and putting it to use as added operatories, staff lounges, on-site labs, and such.  What new techniques will be developed over the next 30+ years that will help us get more done in less space?  As designers we can hardly wait to be a part of this exciting and creative future!

Bring Your A Game

Posted on: May 13th, 2013 by James Kuester No Comments

Yesterday I took my mom out for Mother’s Day.  To start our day we went to brunch at the little local breakfast place that I frequent virtually every Sunday when I’m in Indianapolis.  I know almost the entire staff and often feel more like family than a customer while I’m there.  They have amazingly good food and great customer service.  It doesn’t hurt that I’m also very fond of their clean, contemporary décor.  My mom had never been there so I was really looking forward to sharing one of my favorite places with her.

As yesterday was Mother’s Day, I expected the restaurant to be busy.  Well, it is always busy on Sunday mornings, but busier than normal.  What I didn’t expect was for none of the regular staff to be working.  Chris, the manager, is a really nice guy, but there have incidents in the past that made me question his decision-making skills.  While I can appreciate wanting to reward some of one’s best people with a holiday off with their mom’s, I question the wisdom of having the entire, regular Sunday crew absent.  After all, Mother’s Day is a really big deal in the restaurant biz, and often times the only opportunity a restaurant has to make a good impression.

Now, I’m not saying the replacements did a poor job.  They didn’t.  Actually, if I hadn’t known better I would have said they did a good job.  Unfortunately, I know how spectacular of job the regular crew can do and the replacements haven’t had years of working together to generate that seamless flow that propels one’s performance to World-Class status.  Not their fault, but I was disappointed in the experience Mom received yesterday.  She didn’t get this establishment’s A Game.

In a dental office what is the equivalent of a really high-profile, Mother’s Day holiday event?  Off hand, I can’t think of anything.  The closest is when a new patient comes into your practice for the first time.  Undoubtedly, you and your team want to make a good impression so this new patient will tell all his family and friends about his amazing new dentist and will not find an excuse to cancel his next appointment.  To me a dental office team needs to bring their A Game each and every day.  This is hard.  It is a difficult thing to always be “up” and firing smoothly on all cylinders, but that doesn’t reduce its importance.  So, what do you do, as the team leader to help the staff always put their best game face on?  One thing is to provide a work environment in the form of the dental office design that is conducive to a positive work experience.  Make sure the front office is efficiently laid-out and ergonomically designed to reduce work-place fatigue, frustrations, and bottle-necks.  Make sure there is a clean and comfortable place for staff to escape from the rigors of the day occasionally and vent frustrations away from where patients can see or hear.  There will always be challenging patients and giving staff a place to regroup build camaraderie is critical.  Lastly, make sure the operatories themselves are efficiently and ergonomically designed.  Again, this will reduce fatigue, frustrations, and the likelihood of work-place injuries.

One’s dental office design cannot ensure that one’s dental team always brings their A Game to their job each and every day, leadership and coaching play a big role in that, too. However, having a great place to work certainly helps.  If you question this, just think about the demand for newer and better stadiums and arenas at all levels across the country.

A Better Bath Design

Posted on: January 28th, 2013 by James Kuester No Comments

Exposed pipes

I have written several times about poor designs in bathrooms, but the other day I actually came across a dual-sink bathroom counter that almost passed mustard with me.  Each sink had its own hands-free soap dispenser and the waste receptacle cutout in the counter top was placed in the center between the two sinks.  Each sink also had its own paper towel dispenser so no one had to drip across the counter to grab a towel, dry their hands, and throw away the towel.  These are things I find to be problems in so many dual and multi-sink baths.  I also liked the visual appearance the glass vessel sinks.  They really added a nice pop to the bath giving it style and character.

So, what is my issue with this particular bathroom?  The drain pipes under the sinks were not covered by a modesty panel or insulation wrapped to prevent contact with someone in a wheelchair’s legs or knees.  This is a basic requirement to be in compliance with the Americans with Disabilities Act (ADA).  I did like that the installer used chrome pipes rather than ugly PVC like so many are prone to do, but while this garners some style points compliance inspectors really aren’t interested in those.

One other small thing that bothers me in the execution of this particular dental office bathroom design is that the water doesn’t drain 100% from the vessel sinks.  This strikes me as unsanitary and just a bit gross.

A Dental Office Design Flooring Alternative

Posted on: November 5th, 2012 by James Kuester No Comments

Always in search of flooring options for operatories we’ve recently come across a new options that offers some interesting design options for your next dental office design project.  Gerflor has a very high density (VHD) design option that offer some really fun patterns.  This product, since it is a foam, offers sound insulation up to 18 dB, which significantly reduces impact sound and walking resonance.  The foam also offers greater comfort which sanding for long periods of time, yet recovers rapidly from impact marks.  The surface treatment has a 100% PVC wearlayer that can withstand most commonly used chemicals, is non-absorbant, impermeable, and non-porous which all inhibit the growth of harmful micro-organisms.

Another reason we like this product is that it can be rolled up the walls to form a seamless cove base for surgery suits.

Additionally, the product is 100% recyclable, which along with its low VOC’s makes it a great green design option.

We can hardly wait to use this in our next design project!

The Elements of an Interior Brand

Posted on: July 18th, 2012 by James Kuester No Comments

We speak frequently about the importance of the dental experience and knowing and defining this experience.  One of the best ways to figure out what your patients are truly experiencing is to have your dental office mystery shopped.  During a mystery shop experienced shoppers visit your website, they call your office, they book an appointment, and they even have a simple cleaning or consultation performed.  All the while they are making notes about what they are experiencing during this process.  A body of shoppers – usually three to six – make a good shop and their notes are compiled into a single report that you can use to help guide improvements to your dental experience.

As Michael Gerber writes about in, “The E-Myth Revisited” all businesses are really in the business of selling an experience and this true for dental office, too.  We go on to believe that the sum total of the dental experience defines your dental office’s brand and is the reason that patients tell their family and friends about you, book return appointments, and don’t cancel their appointments when they have a chance.  There are five elements that go into creating a strong Interior Brand.  They are:

Color, Light, and Texture

Human Interaction

Application of Technology


“Defining Touch”

These five elements work together to create an emotional reaction in the minds of your patients and define your dental practice for them.

Sharing the Sidewalk

Posted on: June 11th, 2012 by James Kuester No Comments

Dental Office Reception Counter with area for Wheelchair Accomodation

Last night I’m walking along on my way to meet friends for dinner when I’m approached by a man in a motorized wheelchair coming up the sidewalk toward me.  While I tend to walk to the right side of the sidewalk anyway as a general rule – just like I was driving a car – as the man came closer rather than hugging the opposite side of the sidewalk he actually steered directly at me until I had to step into the street to keep from being hit.  We were the only two people on the sidewalk and it is a wide walk, so there was no obvious reason why he felt the need to run me off the sidewalk.

At the grocery where I normally shop there is a woman that I see often that is confined to a motorized wheelchair.  She has a bike horn attached to her chair and if you are standing looking at something on a shelf and she wants past she starts blowing her bike horn at you.  I’ve been the object of her horn blowing before and I’ve witnessed this several times.  Most of the times there is plenty of room for her to go around the person that is shopping but she doesn’t.  She wants them to get out of her way.

When I was in high school there was a fellow student that was confined to a motorized wheelchair.  He, too, had a bike horn attached to his chair; however, he rarely used it.  Instead, he’d just run into other students that were in his way going down the hall.  He also tended to run his chair at full speed through the crowded halls.

So, why does there seem to be a general rudeness amongst individuals confined to motorized wheelchairs?

I believe that this stems from a frustration with just how difficult it is to maneuver in a world designed for the walking.  While the Americans with Disabilities Act set standards for how spaces are to be designed to accommodate those with disabilities these are only minimum thresholds.  To be truly accommodating one needs to strive to live like someone confined to a wheelchair and incorporate as many features as possible into a space so as to make it as easy to work, live, and play in as it is for those with no disabilities – to truly make a space universal in its design rather than just accommodating.

Test out your dental office and see how accommodating it is.  Borrow or rent a wheelchair sometime and try to maneuver through the office like you were a patient.  Start from the parking lot and go through the entire process of checking in, getting from the chair into an exam chair, back out of the operatory to the restroom, and back to check out.  Have each member of your staff do this, too.  Compare notes at the end and see the experience from the eyes of a disabled patient.  Now, what if a member of the staff was confined to a wheelchair?  Would that person be able to do his or her job?  The entire exercise can be very eye opening as to just how unfriendly our work spaces are to those that cannot walk.

Perhaps if the world was just a little more compassionate and accommodating to those with disabilities I’d stop being run off the sidewalk on my way to dinner.