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Remodeling the microbiology lab.

Remodeling the microbiology lab

Extensive renovation turned our microbiology laboratory inside out. Although the upheaval proved stressful at times, the staff and I knew that our spacious, efficient new lab would be worth the temporary inconvenience.

Benches were so close together in the old lab that no one could pass between them when technologists were at work. Halls were cluttered with equipment, and a heavy traffic area like the entranceway became more congested because we performed specimen accessioning just inside the front door. I was stuck in an office near that door, prey to wandering sales representatives and lost outpatients.

Our microbiology laboratory is in the basement of the hospital, while most of the other laboratories are on the sixth and seventh floors. Because of space limitations, we had to hold weekly staff meetings and infectious disease journal sessions six floors up in a pathology department conference room.

The blueprint in Figure I shows what our basement area looked like before remodeling. Here, seven microbiology technologists processed 150 specimens a day for our 410-bed hospital.

Five of the seven technologists plus our secretary were crowded into the main laboratory, which occupied less than 25 per cent of the suite's total floor space. The main lab also had the planting bench, the blood culture bench, and three miscellaneous benches.

Three small isolation rooms off the main lab housed our anaerobe/quality control bench, staffed by a sixth technologist; Touch-Scan instrumentation; and two microscopes. The seventh technologist was assigned to TB/mycology, a separate laboratory in our suite.

The fluorescent microscope had to be used in a storage room. Serology, which I also supervised, was performed by two other technologists in a moderate-size room between the main lab and the kitchen.

The kitchen had two autoclaves, a sink, and an oven. In addition to the day staff, part-time evening lab aides worked there, preparing such things as media and sterile capillary pipets, and keeping track of inventory.

Missing from our laboratory, for lack of space, was parasitology. It was upstairs in urinalysis, under the supervision of a pathologist.

Our four-foot-wide main hallway was narrowed in places by two freezers, a refrigerator, a floor-model centrifuge, and a trash cart (see Figure I). At the entrance hall, the technologist in charge of accessioning was constantly interrupted by routine comings and goings and often had to leave the workstation to make room for deliveries. The planting supply cart, usually parked nearby between the biological cabinet and one of the miscellaneous benches, was another obstruction.

We spent most of 1987 pondering all these problems and working with the hospital's engineering department on a rough set of plans. We gained some space by finding room for serology on the seventh floor. Administration, deciding to go ahead, had an architect incorporate our ideas into a design and obtained bids from construction firms for the remodeling.

Our enthusiasm for remodeling began to wane as we thought of all the problems we would have. How could a microbiology lab continue to function while walls and benches were being torn out and jackhammers made noise and dust? Since there were no temporary quarters for us elsewhere in the hospital, where would we do our work? I had nightmares thinking about the Aspergillus colonies that would grow on all our plates.

As soon as the hospital awarded the contract in the fall of 1987, a representative from the chosen firm met with the architect, a hospital engineer, and me to outline the two months of dismantling and reassembly. Four phases were planned, enabling us to vacate one lab area for remodeling and move into other areas that were awaiting construction or that had already been completed. The transfer of serology out of our basement area opened up enough space to make such a rotation possible.

The specifications required the contractor to put up temporary partitions to confine the construction activity and dust. This translated into transparent, heavy-duty plastic walls taped to the floor and ceiling. Thanks to these walls and careful workmen, the Aspergillus outbreak I dreaded never materialized.

In a further effort to reduce dust problems, the specifications called for existing concrete slabs to be removed by saw-cutting and the masonry walls to be removed piecemeal.

The first phase of remodeling took two weeks in December 1987 and transformed the area previously occupied by serology into my new office (see Figure II). A soundproof wall blocked the noise of the - 70 C freezer and centrifuge just outside; to keep me from feeling isolated, a window looked out into the main lab. A laboratory bench and some cabinets remained in the office.

Phase II, lasting a week, removed a wall from our small lounge, expanding the room to accommodate two tables for meetings, lunch breaks, and student quizzes. We also installed an extra laboratory bench for future use. Although it holds a coffee maker at present, the bench is bound to become a workstation as test volume continues to grow.

This phase of construction also took two functions out of the lab hallway by making my old office a specimen accessioning area, with a receiving window that faces the hospital corridor outside the lab, and a planting laboratory.

In a small lab with a sink at the back of my old office, the upper half of one of the walls was knocked out. That made it possible, after performing Gram stains in the sink, to pass the slides through to technologists working in the main lab at microscopes placed on a new counter. The wall opening also made the suite feel more spacious and less compartmentalized.

The final step in phase II repositioned the front door. Previously, you had to make a sharp right in a narrow space upon entering, to avoid walking into a laboratory wall. The redesign created a foyer, which offered easy access to the main laboratory and reduced traffic congestion.

Phase III, remodeling of the main lab, was a difficult four-week period. Five technologists and the secretary had to move out, and we were hard-pressed to find temporary work space for them. We squeezed two of the three miscellaneous benches, the Touch-Scan, and the biological cabinet into the new planting lab. The Bactec 460 and its two gas tanks fitted nicely into a closet!

The technologist assigned to miscellaneous specimen workups moved to the bench in my new office. The technologist in charge of anaerobes and QC occupied the bench installed in the expanded lounge. The lounge also accomodated our secretary, her desk and CRT, and a table with two microscopes. The kitchen became the repository for all the paraphernalia emptied out of the main lab's cabinets.

This phase removed the walls that separated two of the isolation rooms from each other and from the main lab. One of the double benches was rebuilt as a single bench and moved to increase the space between the benches. In place of the old walls, we installed the secretary's desk and an additional bench. For use of the fluorescent microscope, a blackout curtain was placed across the doorway of the third isolation room. A sink installed near the front door made it easier for technologists to wash their hands on their way out.

Tempers were short during this period. But although technologists had to work almost on top of each other, the quality and timeliness of our reports did not suffer.

Phase IV amounted to a difficult week for both the laboratory staff and the construction crew. The hallway was torn up. Since we couldn't give up our only access to the various laboratory areas, we had to step over, around, and under the workers as they put down a new floor and installed plumbing and electrical lines in the ceiling. At one point, technologists had to make a three-foot broad jump over newly laid floor tiles to get into one of the cold rooms for media.

We survived the construction, and our workflow quickly improved. It is now much more efficient than before.

Sometimes I think a periscope would help me manage serology, which remains on the seventh floor, sharing a room with coagulation. With the addition of virology, its staff has grown from two to four technologists. And with the addition of parasitology to our basement area, we now have a total of eight technologists there, one more than before.

I was fortunate to be allowed a great deal of input on the remodeling, and the staff submitted many good ideas. One of the best suggestions was to move the biological safety cabinet to a low-traffic area where there is less air disturbance. I am also particularly proud of the pass-through windows for specimen drop-off and Gram-stained slides.

Not all of my ideas were winners. For example, I wanted modular partitions and furniture so that we could move walls and adjust bench heights. The flexibility would have been wonderful, but hospital administration balked at the cost.

Cost considerations also prevented us from rearranging the autoclaves, sink, and built-in oven in the kitchen. Elsewhere, I would have liked to get rid of the closet that sits in the middle of the planting lab, but its includes a supporting wall and electrical circuitry and cannot be moved. Similarly unmovable are the chases, which contain the lab's plumbing and conduits.

Overall, the microbiology laboratory looks more roomy and cheerful. We painted the walls a buff color to match the countertops and chose a subdued rose for the cabinets and new lab chairs. Everyone compliments us on our beautiful lab.

We were also fortunate in the hospital's choice of a contractor. He brought the project in on schedule with an extremely careful and considerate crew. One carpenter - plasterer, helped at times by an electrician or plumber, did most of the work. Instead of holding a ribbon-cutting ceremony, we threw him a going-away party when he finished the job.

PHOTO : Figure I Microbiology lab before remodeling

PHOTO : Figure II Microbiology lab after remodeling

At the time the article was written, the author was head of the microbiology section at Pennsyvania Hospital in Philadelphia. She is now retired.
COPYRIGHT 1990 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1990 Gale, Cengage Learning. All rights reserved.

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Author:Dole, Marjorie W.
Publication:Medical Laboratory Observer
Date:May 1, 1990
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