Clinical Laboratory Facility Planning
There are four major steps involved in getting the facility development process off and running, and they all require concentrated effort and involvement of laboratory staff.
Program Concept Validation
The very first thing (and one that is often ignored) is to reexamine the goals and objectives outlined in your strategic plan (you do have one, right?) to make sure that the logic which got you to this point is sound, that the plan is consistent with the hospitals' missions, that you have evaluated the new venture from a solid business perspective, and that you have carefully considered what activities need to be carried out in this new facility, not only in the short term but in the long term. Too many labs get so involved in planning a new facility that they never step back and take one more look at their situation from a strategic point of view. I'll never forget the beautiful (designer perfect) lab of one hospital. The pathologists and lab staff had designed their dream facility, and it ended up being twice the size it needed to be. There was aisle after aisle of empty counters and casework. Administration was furious! I think you get the picture -- make sure you need an off-site facility and that you know what will need to be done there long-term. Could the core lab be located at one of the hospital labs instead? It's cheaper to operate three labs rather than four, even if hospital space is expensive. There are many advantages to an off-site location, both politically and operationally, but just make sure they justify the additional cost.
Functional Space Program
This is the document which determines the required square footage for the laboratory; it should be developed early enough to use the information as the basis for the search for an appropriate building or site. It is a document which takes every activity that will occur in the new facility and defines the space necessary to carry out that activity, including room circulation space (standing room in front of counters, walkways, counter depth) and building circulation space (hallways, doors, etc.). The space program should be separated into the primary operational areas, such as specimen processing, automated lab, cytology, transcription, mechanical support, etc. In worksheet format, it identifies every piece of equipment and work space, providing linear feet of counter space and space for floor based equipment (if applicable) for each workstation, and how many of each workstation are needed. It also defines any special requirements for each area, such as negative pressure, reinforced floors, air handling, etc. Beware of architects or builders who want to use a factor, such as tests per sq. ft. or sq. ft. per FTE to determine overall space -- laboratory space is NEVER determined this way! It must be based on the required equipment and the support activities to be performed. Who develops the space program? You do, with help from a laboratory consultant or architect who understands your program concept and has a thorough knowledge of lab operations and facility implications.
Are you going to buy land and build a lab, or are you going to lease an existing building? Leasing involves less capital investment at the beginning, but many institutions don't want to put the cost of renovation into a building they don't own. Renovation of an existing building can also be a faster process, allowing you to get up and running earlier. The decision to buy or lease should be made up front. Use a real estate broker specializing in industrial properties to identify potential sites. You will need to provide the broker with guideline criteria for the site -- location is a primary one, but there are others. How many parking places will you need? If you are looking in an industrial park, many of these sites do not have adequate parking for a laboratory operation. Do you need a loading dock? An area for courier car maintenance, loading, and unloading? The broker will identify potential sites for your inspection, define the conditions of the site and buildings, and develop a financial analysis for those which appear to be most promising. If you are leasing space, your architects should do "test fits" using the space program to ensure that the laboratory will fit in the building under consideration. You are then ready to make a final site selection and negotiate lease or purchase.
The architect will review the functional space program, meet with laboratory staff to gain a more thorough understanding, and then lay out a preliminary plan. The lab staff should work closely with the architects to refine the layout, particularly in the areas of work flow, adjacencies, and workstation design. The placement of telecommunications equipment and computer terminals will need to be defined. As the architects move from preliminary layouts to blueprints, the laboratory should have several opportunities for review and revision. Keep in mind that revisions made after construction has begun are extremely costly!
These are the initial steps in facility development; all require laboratory staff involvement and direction. The next steps are construction documentation, construction, furnishing, and occupancy. You should have a project manager to oversee these steps; the ideal project manager has an engineering and facilities management background with good laboratory construction and project management experience. While the facility is being constructed, the laboratories will need to be developing a detailed transition and move-in plan, including licensing of the new facility, an equipment move-in and setup schedule, as well as addressing many other issues.