Flexible and functional: a case study in efficient laboratory design; Several key design issues must be addressed when planning new or renovated laboratory space for the most positive impact on operational efficiency - Column

Medical Laboratory Observer, Nov, 2001 by Ron W. Garikes, Suellen Maxwell

Flexible. Open. Adaptable. Expandable. Functional. Safe. Efficient. These are the critical design issues that must be addressed when planning new or renovated laboratory space. The ultimate objective is to provide efficient lab space that enhances operations and ultimately profitability. By thoroughly analyzing operational issues such as specimen, staff, supply, and waste flow; workstations; FTEs; and test volumes, effective design solutions can he created that will have a positive impact on operational efficiency.

Trends in laboratory design

The operational issues that influence lab design have completely changed over the last five to seven years. "Lab design today is predicated on new issues and criteria that did not even exist 10 to 15 years ago. In the past, the size of the lab was determined by evaluating the hospital bed count, FTEs, and test volumes," says Linda Wilson, executive vice president of the Karlsberger Companies' Birmingham, AL office (formerly Garikes Wilson Karlsberger), a national planning and architectural firm specializing in laboratory and healthcare design.

"Automated instrumentation, outreach programs and the emergence of central core labs serving multiple hospitals and healthcare systems have completely changed our approach to lab planning. In today's environment, design is based on projected workstations (by type and function), instrumentation, and the degree of automation currently in place and projected," she explains.

With rapid advances in automated instrumentation and testing procedures, the lab must be able to readily adapt to progress and the changing needs of each department. Flexibility and adaptability are critical issues that must be incorporated into the laboratory design. The ability to expand and modify the functional relationships and flow within the lab can be achieved by utilizing an open lab plan. A large, open lab area with limited partitions allows for enhanced flexibility of staff assignments, the ability to share equipment, and the consolidation of workstations and equipment.

The use of flexible lab casework can also provide a convenient method for modifying and reconfiguring the workstations. Work surfaces can be raised, lowered, added, or deleted. Base and wall cabinets can also be similarly changed. All of this can be accomplished with minimum inconvenience and down time to the surrounding workstations.

The planning process

The development of a comprehensive facilities program, which describes the laboratory's strategic and operational objectives, is the first step in the lab planning process (see Table 1).

"Major factors which determine a project's success are established by the time the programming phase is completed," Wilson says. "The accommodation of function, technology, environment, organization, comfort, amenity, safety, interaction, and efficiency form each design decision. The programming and planning process should be a balanced, integrated and simultaneous resolution of all project objectives."

Intensive interaction with the lab leadership and user groups is the best way to develop a comprehensive lab facilities program.

"Our challenge is to test early assumptions and existing systems by applying an objective process of data gathering and analysis with active lab administration and staff participation followed by the generation of creative alternatives and solutions," Wilson says. "Only through this participatory and objective planning process can an accurate road map be created for future growth and development."

Utilizing this interactive and participatory approach, a functional, flexible, and efficient laboratory design was created at the regional reference and core lab for DSI Laboratories, a NCH Healthcare System affiliate, in Fort Myers, FL.

DSI Laboratories

DSI Laboratories is located in the rapidly growing area of southwest Florida. DSI Laboratories was established in 1984 at the Naples Community Hospital with a mission to provide the quality and range of testing equal to that found in large academic medical centers. To initiate this process, several board certified Ph.D.s were hired to provide the technical expertise to develop esoteric testing in the areas of toxicology, special chemistry, and infectious disease.

Over the next decade, the laboratory services expanded as a second hospital was added in 1990, and the volume of outpatient testing increased. Offsite outpatient service centers were added and the courier routes extended to a growing number of physician offices, physician's office labs (POL), assisted living facilities, and extended care facilities. As space on the main hospital campus was limited, the NCH Healthcare System acquired a shopping center a few blocks off campus. DSI Laboratories established its administrative services including marketing, payroll, human resources, accounting, billing, and purchasing at that site.

The molecular medicine lab was also developed at this location. In addition, testing sections moved from the hospital to this site over a several year period starting with virology, then immunology and followed by microbiology in 1994. This, in effect, created the infectious disease department.