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Taking a 40 year old lab, bursting at the seams with equipment, and redesigning it with no additional space proves challenging at best. Although it is a tedious process, with a little ingenuity and input from coworkers, we are finding that we can come up with several creative options.
The lab at Broadlawns Medical Center was built before the computer age. It was back in the era of manual testing varying from glucoses with an antifreeze bath, mouth pipetting, manual bilirubins and enzymes on a spectrophotometer. The lab was designed with numerous workbenches for techs to perform manual testing using test tubes and pipettes. Most testing was performed in-house, as the lab test menu was not all that extensive.
Now, as times have changed, so have our needs. Trying to squeeze new instruments in and around the workbenches provided was getting more difficult. Then we started adding in more refrigerators to keep up with the ever-increasing number of reagents needed to run the instruments.
At first, we didn't think about the heat that these instruments and refrigerators were giving off. The air handling system couldn't keep up. We added an occasional air conditioning unit. It still wasn't enough. We added a few more.
Meanwhile, Our lab menu was expanding as well as the tests we are sending out. We needed more space dedicated to send outs as well as another refrigerator and freezer for those specimens. We couldn't forget the addition of all the computers and the cords and more heat. There's nothing worse than an overheated tech trying to keep up with increasing test volumes. Any of this sound familiar?
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| Before Phase 1 Remodel. ADVANCE thanks Broadlawns Medical Center |
A New Approach
The decision was made to try and update the lab. The hospital is currently going through a remodel, and during the process, there weren't enough funds allotted to the lab for updated remodeling. The lab director decided to redo the lab but over a 5-year time period with the blessing of the hospital administration.
The first thing we did was ask for the input from the techs and the phlebotomists who work on the bench, resulting in some good ideas. With a lot of brainstorming there was a general consensus on where to start. A couple of us gathered the information and presented it to the lab director. He told us what the budget was for the first phase of the remodel and we went to work.
First, some of the counters had to come out so we could move equipment around to streamline the workflow. Wire racks were purchased for temporary storage units. There is asbestos sealed in the countertops so asbestos abatement had to be included in the budget. When we finally had some extra space to move, it was decided to move the central processing area to the front of the lab. This would cut down on the traffic through the lab from the rest of the hospital while dropping off specimens. Before we moved anything, a tube system was installed that connected us to the emergency department and some of our clinics.
While we were narrowing down our options, we had a few vendors come in and give us some quotes. One vendor in particular stood out because he gave us a fair price and also showed us a cheaper and better way to design our new cabinets.
"The hardest part would be picking out a color scheme," said Biff, from Innovative Laboratory Systems. We laughed at first. How could that be so hard? Well he was right. We had several samples and everyone had a different input and after various opinions, the decision was narrowed down to three combinations, which the lab then voted on and we finally came up with a color scheme.
Biff came out a few times measuring and giving us different ideas. Finally, the first phase of cabinets was ordered. This was very exciting to us as well as a learning experience. Thank goodness we have a patient Plan Ops department because we called them numerous times to add outlets, phone jacks and ports for computers when our new counters arrived.
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| After Phase 1 Remodel. ADVANCE thanks Broadlawns Medical Center |
Phase 2
From this first phase, we have learned what we like and what we would like to change a bit for the next phase. We have measurements taken now for the next group of cabinets but this will entail moving departments around and rearranging storage areas.
One of our goals is to make the lab more Lean while gaining space as we go. Just by opening up the lab, by taking out several workbenches and shelves, we have improved the airflow significantly.
While still not perfect, it is more tolerable until we get a new air handling system, which should be within the next couple of phases.
Getting input from all the staff has proved invaluable. While our process may be slower than others, we have come up with some really great ideas that have already decreased turnaround time and streamlined our work flow even more.
It's always fun getting something new but when it also provides better patient care as a result, it's a win-win situation for everyone.
Karen Nichols is lead technologist in Microbiology at Broadlawns Medical Center, Des Moines, IA.
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