Improving patient flow and the patient experience doesn't necessarily require a complete practice renovation. In the course “Optimizing Patient Flow and Staff Efficiency Through Facility Design”at the American Academy of Ophthalmology (AAO) 2026 meeting, an architect discussed how ophthalmology practices can make meaningful improvements to existing facilities through relatively simple, cost-conscious design changes.

This transcript has been edited for clarity.

Hi, my name is John Morasco, and I am an architect at Morasco & Associates. We are an architecture firm that specializes in outpatient health care facilities all across the country, and ophthalmology is the number one specialty that we work with. I was asked to give a quick recap of the presentation that I gave at this year's AAO meeting, and one of the questions was: What relatively simple design changes can an existing practice make to improve patient flow without undertaking a complete renovation?

Well, unfortunately, that's a really difficult question to answer because every existing situation has different opportunities, and every existing situation for a remodel needs to have an initial domino that can fall—meaning if you're already full and you want to make more space, there's no space to make. So you have to be willing to give up something. There has to be space that you can manage. But once those dominoes start falling, you can actually affect quite a bit of your existing layout by doing a little piece here, a little piece there, a little piece here. It’s definitely something that can be done, but remodels are really difficult.

A few really low-cost things to look at if you're just trying to improve the existing situation in your office: I always have my clients take a look at that front desk and waiting area. Those are 2 areas that tend to be done poorly by many of our clients, and this is your first opportunity to make a first impression. Really thinking about what that impression is and how it feels to your patients is really important. When I ask my doctors, "Well, have you ever gone out and just during the day go sit in your waiting room and see how it feels to you?" The answer is always “no.”

That typical scenario of entering a suite, coming to a reception desk that has papers taped up everywhere of “don't do this” and “don't do that” and “this is happening” and “this is happening,” it's just very us-vs-you kind of behavior. And you really want to have much more of a concierge feel and look to that. This isn't something that you have to change walls for, that you have to do any sort of major remodel to achieve, but consider everything from the aesthetic of that environment to the furniture of that environment.

Many of our facilities that we go into, their waiting rooms are very bus-depot based—chair, chair, chair, turn, chair, chair, chair, turn—and they're very much a mill of the patients and families coming through there. When we design facilities, we like to be inspired by Starbucks and have little pockets of areas because that's how human beings exist. They don't want to sit next to some stranger 3 inches away. If you have the ability to take a look at even your furnishing—again, we're not even changing any sort of structure in the facility, but you can really make a difference to your patients by providing them a very nice, quiet, friendly concierge-type of environment at that front desk. The waiting room is going to be by far the longest place that they wait in your facility, and so you want it to be the nicest possible. Once they get back into the practice, your patients really aren't expecting anything other than a clinic. It wants to be a clinic, it wants to have that feel, but that waiting room is one place that you can really make a difference—to have those patients feel special being there. So that's one thing I would look at.

Another way to help with that reception, and I'm sure you've seen these at industry meetings, but these reception kiosks where patients can check themselves in, put all the information in, but they don't have to interact with the receptionist. Now, this isn't for everybody. Certainly in ophthalmology, where the clientele tends to be older, you're going to probably run into some situations where it's a bit tough for people. But for those who are technologically savvy enough to do it, it's a great way to streamline your system and get things in and out quickly. And the square footage this takes to put in somewhere around your front desk or around the corner in your waiting room is 10 square feet. So it's very, very small, doesn't really have an impact, but can go a long way to how you use that space.