laboratory design guideline - ministry of health
TRANSCRIPT
Guideline Laboratory Design NSWHP_PG_018
Page 2 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 6/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
Contents 1. Introduction 3
How were these guidelines developed? 4 What can I expect in this document? 4
2. Definitions 4
3. Principles of Design 5
4. The Process of Hospital and Laboratory Design in NSW 6
4.1. Planning 6 4.2. Design 7 4.3. Delivery and Evaluation 8
5. Laboratory Design 8
5.1. Preferred Layout 8 5.2. Flexible Zones 9 5.3. Core Services 11 5.4. The Core Laboratory 11 5.5. Core and Specialised Services by Type of Hospital and Location 12 5.6. Entry / Reception Area 12 5.7. Pre-Analytical Laboratory (PAL) 12 5.8. Records and Specimen Retention 13 5.9. Laboratory Storage Areas 13 5.10. Education and Research 14 5.11. Pathology Administration and Staff Amenities 14
6. Laboratory Functional Relationships 15
6.1. External Functional Relationships 15 6.2. Internal Functional Relationships 16 6.3. Internal Laboratory Travel Distances 19
7. Other Design Factors 20
7.1. Pneumatic Transportation System (PTS) 20 7.2. Network and Courier Services 20 7.3. Point of Care Testing 20 7.4. Information, Communications and Technology (ICT) 20 7.5. Work Health and Safety 21 7.6. Security 21 7.7. Laboratory Acoustics and Heat 21 7.8. Have you considered? 22
8. Specific Design Factors 23
8.1. Core Laboratory Functional Areas 23 Specialist Laboratory Functional Areas 27
9. Sample Floor Plans 29
9.1. Small Laboratory 29 9.2. Medium Lab 30 9.3. Large Lab 31
10. Detailed Laboratory Design by Clinical Stream 32
10.1. Design Requirements for Anatomical Pathology Departments 32
11. Review 32
12. Risk 32
13. Further Information 32
14. Version History 32
Guideline Laboratory Design NSWHP_PG_018
Page 3 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 6/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
1. Introduction
The once in a generation infrastructure redevelopment of NSW Health facilities and laboratories, is
providing opportunities in new buildings or alternatively, redevelopment/refurbishment of existing sites.
Laboratories in either situation are usually constrained by existing structures or designed within floorplans
worked around the design of acute hospital services. During laboratory refurbishment or redevelopment,
many local staff are part of a local Project User Group (PUG) to ensure that lab design is suitable for local
conditions and services.
NSW Health Pathology (NSWHP) will monitor and endorse pathology redevelopments to ensure alignment
of pathology services and design of infrastructure supports the strategies outlined in the NSWHP Strategic
Plan Towards 2025 and the NSWHP Clinical Services Plan (CSP) and facility planning guidelines and
design notes
The focus of a single, connected and integrated NSWHP is to deliver a high quality innovative diagnostic
and screening service (ie appropriate, timely and accurate set of results) that supports clinical decision-
making for patients and clients irrespective of their geographic distribution, as opposed to focusing on
performing the collection and test on the site where they present.
The key design principle informing all other design guidelines in this document reinforces the focus on
service not tests and onsite laboratories will be designed to support timely service provision rather than
every laboratory containing every piece of testing equipment. Careful planning across LHDs and supra-
regions will determine the onsite testing requirements for each laboratory.
NSWHP will build an integrated statewide pathology service. Laboratories will be interconnected with
other pathology support services, such as specimen collection centres, to provide a single statewide
network of pathology services and expert advice to support high quality outcomes. The role of laboratories
will be reshaped with a primary role to be the advocate of customers and clinicians supporting them to gain
access to clinical and scientific advice and services they need. The key planning guideline in any
laboratory redevelopment and design is to ensure that pathology services are provided in a timely manner
and support the clinical services provided in hospitals. The focus is the service, not the test. All
laboratories may not require all tests if alternative solutions such as clinical couriers or digital technology
can ensure that a service to a hospital
NSWHP has resources to assist this process. We have a Planning Team including senior planners,
change and redesign managers to work beside operational directors, laboratory managers and local staff.
We assist local pathology teams to reimagine their services and work out how to best adapt to new
laboratory design and innovations. This is best commenced before new or redeveloped laboratories are
occupied. In addition to support in the early phase, our team can also support planning the transition into a
new facility and/or adopting new ways of working.
We request that operational directors and laboratory managers contact the Planning Team when any
hospital or laboratory redevelopment is considered/proposed. Planning for redevelopment should start
early so that pathology services are included and optimal laboratories are planned and incorporated into
broader plans and budgets. On occasions this does not happen and we have not maximised our
opportunity to improve functional relationships with acute and emergency services to support time-critical
services. Collective state-wide experiences and post occupancy assessments provide detailed information
on lessons learnt that can be considered in future redevelopments.
Guideline Laboratory Design NSWHP_PG_018
Page 4 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
How were these guidelines developed?
NSWHP planners have consulted the Service Redevelopment Working Group, relevant building codes,
endorsed design guidance notes, and the Australasian Health Facility Guidelines to collate a guideline to
laboratory design. During development of these guidelines, the successes and mistakes of previous
laboratories were reviewed to ensure that we take these learnings forward into new designs. The Planning
Team also provides information to local staff in planning for future potential for innovation such as
specimen tracks or innovative technology.
If you have questions about this guideline, please don’t hesitate to get in touch with:
Deborah Lawson [email protected] or
Geoff Channells [email protected]
What can I expect in this document?
• This document starts with the principles of design and lean management that support efficient
laboratory processing. We then move to process of laboratory design in NSW and how hospitals are
planned and built. The document then goes through laboratory design, functional relationships within
laboratories and other design considerations. Specific design factors, design guidance notes and
sample floorplans are at the end of the document.
2. Definitions
Turnaround time: the time measured from receipt at Central Specimen Reception to delivery of digital
availability of result.
Time to report: aligns with the definition by ACHS measure - “Collect to Validate”. The time measured
from collection of specimen to digital availability of result.
Guideline Laboratory Design NSWHP_PG_018
Page 5 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
3. Principles of Design
Laboratory development and design should:
• Be guided by the key design principle that reinforces the focus on service not tests and onsite
laboratories designed to support timely service provision rather than onsite testing. Careful planning
across LHDs and supra-regions will determine the onsite testing requirements for each laboratory.
• Be guided by LHD and NSWHP clinical services planning. Clinical services planning identifies current
issues and opportunities, and outlines future demand, future models of care and service delivery
change. It uses value based healthcare, and considers data, consultation and future service delivery.
• Meet the Australasian Health Facilities Guidelines, SafeWork NSW and the Building Code of Australia.
• Use Lean Thinking Principles and Tools. Lean thinking identifies what creates value and eliminates
other activities as they are, by definition, ‘waste’. The core areas of laboratories are a linear process
analysing clinical specimens - and research in these types of settings shows that only 5% of activities
add value, 35% are necessary non-value adding activities and many tasks or movements undertaken
by staff add little value.
Ask and answer these key questions until the answer to them all is consistently ‘No!’
1. Is there unnecessary (non-value adding) transportation of specimens, materials, or information
between your processes?
2. Are you testing sooner, faster, or in greater quantities than your customer is demanding?
3. Does your process result in anything that your customers would judge to be unacceptable?
4. Do you have any specimens, work-in-progress (WIP), or finished goods that are not having value
added to them?
5. Do you, and by how much do you, move specimens, people, equipment, and goods e.g. reagents
within any step of your process?
6. Do you perform any extra work beyond the standard required by your customer?
Source: http://leanaust.com/services/lean-thinking
• Human Factors which are managed by designing the work environment to suit human characteristics.
Design considers both the psychological, cognitive and physical factors of human performance. High
priorities in laboratories include manual handling and sustained poor postures. In specimen
processing and product processing products are heavy, bulky and required specific storage that allows
them to be receipted, moved, packed, unpacked and transported within the laboratory. Laboratory
staff spend time examining samples where seating posture and time spent in these postures need to
be designed to reduce potential for injury. • Improve efficiency as much as possible. This will include designing streamlined specimen workflow
and the elimination, or reduction, of unnecessary manual specimen transport between the internal departments within the pathology laboratory. High volume, time critical specimen processing such as biochemistry and haematology specimens, should be located as close as possible to the Pre-Analytical Laboratory (PAL) to facilitate priority specimen processing. The only exception to this would be the use of an automated specimen delivery track system which may negate the need for adjacent location of these high volume, time critical testing areas to the PAL. By creating savings through efficiency, we can reinvest into service and technology that help create better health and justice outcomes for the people we serve. We are all custodians of the public purse, so each saving we make can stretch the health dollar further and makes the state health system more sustainable into the future.
Guideline Laboratory Design NSWHP_PG_018
Page 6 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
4. The Process of Hospital and Laboratory Design in NSW
We aim to provide flexible, efficient, comfortable and safe workplaces within appropriate budgets and
aligned to the Australasian Health Facility Guidelines. Both local knowledge and user experience, along
with our collective statewide experience from laboratory redesign and redevelopments are key to
understanding the requirements for each laboratory function to create a more efficient and contemporary
laboratory.
An important part of Laboratory Design Guidelines includes collaboration between LHD’s, NSW Health
Infrastructure (HI) and NSW Health Pathology (NSWHP) and other organisations requiring pathology
laboratories such as private/public partnership projects. The formal inclusion of NSWHP Planning and
Operations teams ensures that the appropriate information, including experience from other
redevelopments, is provided to HI, LHD’s and others to inform the redevelopment.
NSW Health Infrastructure is the public organisation involved in the planning, design and construction of
health facilities, including hospitals, costing greater than $10million.
NSW Health Infrastructure indicated in 2018 that the cost of a pathology laboratory is around $14,000 to
$16,000 per square metre. Creating efficient space and specimen workflow is a key consideration. It has
been suggested that the cost of running a laboratory is largely staff salaries (70% to 80%), and only a
small proportion is accounted for by building costs. It is sound economics to make laboratories as efficient
and effective as possible.1
Before NSWHP can start planning a new laboratory it’s helpful to understand the Hospital building capital
redevelopment process.
There are three distinct phases in building hospitals:
4.1. Planning
Clinical Services Plan: the LHD produces this plan with a vision of clinical services for at least 10 years
into the future. They compare current and future health data and include population and ageing population
growth.
Master Planning: is creating a map of key clinical connections between different types of infrastructure
and how these interface with existing infrastructure. Master planning also considers relationships between
transport infrastructure and supporting services (for example, roads, hotel services).
Functional Brief: is the key part of the planning phase where user groups are asked to describe their
services and key internal functional relationships within and across departments. This Brief then informs
the first iteration of department floor plans so it is very important that NSW Health Pathology provides the
right level of explanation and detail about our requirements.
Architects refer to the detailed information supplied in the Functional Brief provided by each department,
including the pathology unit, to provide all the descriptive details included in the infrastructure and services
required to support the LHD into the future.
Business Case Development looks at providing value for money for the redevelopment and community.
1 Principles of Laboratory Design, J. Musgrove.
Planning DesignDelivery and evaluation
Guideline Laboratory Design NSWHP_PG_018
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4.2. Design
Concept Design: is a high-level plan site that considers the on-site relationships between all departments
and buildings, including where departments are placed and on which floor level. It is commonly known as
“block and stacking”.
Schematic Design: is where the plan becomes department focused and considers the internal
relationships between different activities as described from the Functional Brief. During this phase Project
User Groups (PUG) are formed to provide user experience to modify and confirm the inter-lab relationships
and consider the locations of key pieces of equipment and supporting infrastructure.
Generally, during Health Infrastructure redevelopments, laboratory staff will not become involved in Project
User Group (PUG) meetings until architects have completed their first iteration of the laboratory design
based on the information supplied to them in the Functional Brief. If the detail supplied by NSWHP in the
Functional Brief is not correct, then the laboratory design may not meet needs or expectations. It is at the
first Schematic Design where laboratory staff contribute to laboratory design
Detailed Design: this is a finer plan that details specifications for the layout of furniture, fittings and
includes details such as placement of services, such as power, data, and plumbing.
It is important to use the Australasian Health Facility Guidelines, particularly during the Functional Brief
and Schematic Design as it helps provide extra detail to support contemporary design and compliance.
NSWHP is committed to ensuring high standards of design and environmental sustainability. The
Australasian Health Facility Guidelines (AHFG) links to NSW Health Policies and guidelines designed to
assist designers to meet these standards and ‘encourage innovation above prescriptive requirements,
where benefits can be proven2”. The current AHFG for Pathology refers to the AHFG standard
components including:
• Part A – Introduction and Instruction for Use;
• Part B – Health Facility Briefing and Planning
• Part C – Design for Access, Mobility, OHS and Security
• Part D – Infection Prevention and Control; and
• Part E – Building Services and Environmental Design
Ergonomics or “Human Engineering” aims to fit the work practices, FF&E and work environment to the
physical and cognitive capabilities of all people”3.
Please note that some rooms and areas are exempt from compliance to Australian Standard 1428.1
outlined in Part C – Design for Access, Mobility, OHS and Security (Building Code Australia Clause D3.4)
above. Accessible access is not required to areas within a hospital where the function of the area would
pose a health or safety risk for people with a disability. In major redevelopments, Health Infrastructure
employ a Disability Advisor to review compliance. Examples include:
• Wet Laboratories
• Store rooms
• Loading docks.
2https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2016_020.pdf 3 https://aushfg-prod-com-au.s3.amazonaws.com/Part%20C%2018%20Sept_4.pdf
Guideline Laboratory Design NSWHP_PG_018
Page 8 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
4.3. Delivery and Evaluation
This phase involves procurement, construction, completion and commissioning, finishing with post
occupancy evaluation.
To support these phases, NSW Health Pathology has developed cascading levels of lab design and
planning to guide Health Infrastructure and Laboratory Managers. These include
1. Principles of design
2. Guidelines
3. Sample floor plans.
Unfortunately, during the redevelopment process with Health Infrastructure there is no set standard
laboratory design as each facility offers different services and test profiles along with each site having
different existing structures and topographies. Consequently, all new laboratory spaces are different in size
and shape, often with site specific limitations due to building structures including stair wells, lifts, structural
support columns and may also have limited laboratory reception frontage which also impacts on site
specific laboratory design.
5. Laboratory Design
This section includes laboratory design guidelines endorsed by NSW Health Pathology, that provides
criteria to ensure that laboratories are as efficient, safe and flexible as possible.
5.1. Preferred Layout
Where possible, the laboratory should be a single level open plan design, with a clear line of sight
across the laboratory, although this may be difficult for larger laboratories. It is desirable the
laboratory has access to controlled natural light for a pleasant work space. Balance between this
desirable content and efficient specimen workflow must be considered. The laboratory will require:
• Access points to power, data and water, ideally accessed from the ceiling with access to waste
plumbing
• Some benches may need to be height adjustable
• Reinforced flooring for large equipment
• Customised trolleys for specialist laboratory equipment may be required
• Rear access to machines for maintenance, cleaning and servicing requirements
• Adequate air conditioning and ventilation to offset the temperatures generated by laboratory analysers,
fridges and freezers
• Sufficient space to accommodate waste management including clean, infectious, chemical and
flammable waste
• Adequate centralised storage for refrigerated and frozen goods, preferably a walk-in cool room, where
appropriate, with clean and dirty storage
• A centralised freezer cool room may also be considered at larger sites if required
• Transfusion labs need efficient, access to driveways for large deliveries 24/7.
Guideline Laboratory Design NSWHP_PG_018
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Open plan flexible design with movable benches is the preferred design principle. The use of fixed or built
benches and walls reduces future laboratory orientations and the inclusion of these is not recommended
where possible except for areas requiring fixed plumbing &/or ventilation requirements. When designing an
open plan laboratory, there should be consideration of noise abatement and specific air conditioning
requirements and airflow impact on specific services.
The most frequent and urgent testing platforms should be readily accessible and aligned with specimen
reception, specimen processing and data entry realms; and there should be consideration for those
services that interface closely with the clinical services e.g. blood storage and cross-matching, blood
culture systems etc.
For example the most frequently used automated testing analysers should be physically located close to
centralised processing and receiving areas - continuous with the Pre-Analytical Laboratory (PAL). As
automation and technology increases, some sites may move to front-end automated track systems
although analysers on “tracks” may negate the need for direct adjacency of analysers to PAL as
specimens would be delivered efficiently to the testing platform via the track system.
All laboratories should have:
• Analytical platforms (some common to core laboratory testing)
• Sample handling, transport and storage
• Scheduling of less time-critical tests to low activity periods
• Hand wash basin/s, eyewash and safety shower station/s
• Wash up / clean up facilities.
Staff amenities, including meal rooms, change rooms, sick bays, and toilets, should be positioned in a
convenient location to support laboratory and non-laboratory staff. Depending on the size of the unit,
multiple smaller toilet facilities may be required. Consideration of a small beverage bay and/or toilet to
support out of hours staff should be considered. Access to administrative areas should not be through
laboratory areas.
5.2. Flexible Zones
All NSWHP laboratories provide services and testing that is time-critical and require fast reporting
timeframes and are mostly undertaken in a central or ‘core’ laboratory.
Laboratories should be organised into three flexible zones:
• Highly flexible
• Semi-flexible and
• Least flexible.
This corresponds to the technological and infrastructure requirements since equipment is central to the
function of the lab. Workflow analysis suggests that organising the laboratory by technology, for example
automated versus manual processing rather than by traditional lab-specific departments is recommended.
Guideline Laboratory Design NSWHP_PG_018
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www.pathology.health.nsw.gov.au
Highly flexible zone
Clinical areas that primarily use automated systems, such as the core lab (which may include
components of chemistry, haematology, transfusion, immunology and serology), along with central
receiving and processing areas should be designed as a highly flexible zone as this area is also the
most susceptible to change. This area processes the majority of testing and accounts for approximately
75% of the testing volume.
Highly flexible zones align with core laboratory testing areas and generally do not include additional
fixed walls within the zone. Highly flexible zones are designed with movable benches which
accommodates changes in analysers and equipment which supports the future proofing and a “highly
flexible” adaptable laboratory. Increases in technology and automation will result in more testing
performed in the highly flexible zone of the laboratory. Regular access to power, data and water, ideally
accessed from the ceiling with access to waste plumbing.
Automated transfusion processing will also fit in the highly flexible zone. In 2019/20 the Australian
Health Facility Guidelines are being reviewed and NSW Health Pathology will advise on changes in
transfusion processing and subsequent design features to support this move. Laboratories with manual
transfusion processing may need an adjacent interface with specimen reception and also require an
external reception to facilitate ease of pickup of blood products with LHD staff.
Semi flexible zone
A semi-flexible zone would include semi-automated testing and manual processing for lower volume and
esoteric tests. The open plan from the highly flexible zone should extend into the semi-flexible zone to
accommodate equipment that spans laboratory areas where this is practical. Zones that require a
degree of enclosure such as microbiology, anatomical pathology and more specialised testing areas are
included in semi-flexible zones. This area should contain reporting and consulting spaces with
appropriate microscopes and connection to internet/intranet and some autonomy to support these tasks.
Some types of testing mandate separate areas.
Least flexible
Combined and shared offices, reporting spaces, meeting rooms and training rooms should be located on
the periphery in a least flexible zone to avoid workflow disruptions, acknowledging that some will need to
be close to, and accessible from, the testing floor to facilitate proper oversight and supervision of the
laboratory. Office spaces should meet the NSW Health policy on office accommodation as well as agile
spaces to accommodate new ways of working. Meetings rooms should also be flexible to provide
alternative sized rooms depending on the meeting group size.
Guideline Laboratory Design NSWHP_PG_018
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5.3. Core Services
All Core Laboratories provide specimen processing and testing and they provide a minimum service that
meets the requirements of the clinical services provided. In general, it includes general biochemistry,
haematology and transfusion (blood bank) specimen processing along with a Pre-Analytical Laboratory for
specimen reception and dispatch.
The services and range of testing provided on-site is scalable according to the role delineation of the
hospital, the location, demand and services provided by the hospital. Some tests considered “core” in say
a Level 6 lab may not be offered in another such as a Level 3 lab.
The NSWHP Clinical Services Plan details the Laboratory Service Models Test Profiles for each range of
different laboratory services and associated tests based on size and location and aligns laboratory
services with the tiers described in the role delineation of a hospital. All the tests listed in the smallest tier
laboratory in the NSWHP Clinical Services Plan, ie the Small lab / Point of Care Testing (L3), include
general biochemistry, haematology and transfusion (blood bank) and would be designed around a core
laboratory concept. Other variations in core laboratories will occur in sub-specialties for example: not all
laboratories will provide microbiology testing as this will vary depending on the location and size of the
facility and distance to other NSWHP laboratories. However, smaller laboratories that do provide limited
microbiology testing may also be included in the core laboratory area.
5.4. The Core Laboratory
A core lab4 includes:
• General chemistry assays
• Full blood counts
• General coagulation
• Serology
• Rapid Nucleic Acid Amplification Test (+/-)
• Blood cultures (+/-)
• Transfusion and blood product management
• Pre-analytical, centrifugation, aliquoting
• Specimen Storage.
A core lab does not include:
• Mass spectrometry
• Dynamic endocrine testing
• Blood film morphology (although it can be performed in the core laboratory)
• Specialised coagulations, platelet studies, haemoglobinopathy testing
• Flow cytometry (characterisation)
• Anatomical pathology/cytology
• Genomics (cancer, rare diseases, pathogen genomics)
• Specialised immunology.
4 Core Laboratory profiles will be further defined in NSWHP’s Clinical Service Plan – Framework of Lab Service Models – due for publication in Sept 2019.
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5.5. Core and Specialised Services by Type of Hospital and Location
Suggested levels of pathology services will align with the size and role delineation level of acute hospitals
and the role of the hospital within a network of hospitals.
NSWHP’s proposed Framework for Lab Service Models outlines these services. Not all services are
available in regional and metropolitan labs. Clinical service planning would determine where specialised
and low volume/long turn-around-time (TAT) services would be located.
Source: Clinical Stream feedback. Key: Dark Blue = Highly Flexible Core Lab, Light Blue = Semi Flexible Zones, PoCT = Point of Care
Testing, NAAT = Nucleic Acid Amplification Testing.
5.6. Entry / Reception Area
• A single auto-locking public entry will be provided to the Pathology Department via a reception area
• A secure environment is required for staff to receive patients and specimens
• A visitor notification system such as a door bell and /or an intercom system is required
• The reception area will include a workstation and will provide general reception and call centre
responsibilities. It may require a PA system
• The entry / reception area will be adjacent and /or co-exist with the PAL
• Waiting chairs and amenities (TV, toilets, family friendly areas etc) may also need to be provided for
visitors.
5.7. Pre-Analytical Laboratory (PAL)
A single large and open-plan PAL is required, divided into a number of zones:
• Specimen reception area
• Flexible workspace for specimens delivered by hand or Pneumatic Tube System (PTS), including
space for canisters to arrive, specimens to be sorted, scanned, labelled and triaged
• Computer workstations for patient data entry/specimen checking and triaging
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• Front end automation, possibly including automated specimen sorting, specimen track systems, to
facilitate specimen delivery to primary core laboratory analysers in Chemical Pathology and
Haematology, along with Microbiology, Serology and Molecular genetics testing
• Bench space and height adjustable benches for centrifuges for preparation of specimens
• For non 24-hour laboratories, a small secure room and fridge will be required to support and preserve
non urgent specimens until the laboratory re-opens. This room may also include access to secure
blood products after-hours to support acute situations. Access to this space, and the blood product
fridge should be via common realm, adjacent to, but outside the laboratory precinct (for use by hospital
staff). Where possible, the transfusion laboratory should have direct access to the afterhours blood
fridge room to maintain transfusion workflow
• In 24-hour labs Freezers and fridges must be located in 24 hour staffed areas to minimise remote
alarming (which fails) and blood product waste
• A Send away / Specimen Referral area:
• on the periphery of PAL
• Space for preparing, packing and transport of samples to other laboratories as well as receipt
specimens arriving by courier
• Space for an incubator, a centrifuge and a large storage space / pigeon hole arrangement for
storing specimen transport containers and blood transport containers ready for transporting
• A fridge and freezer with a workstation with a printer and PC
• In larger labs this space should be adequate to allow automated specimen sampling and
allocation for send aways, including an automated aliquoting machine.
5.8. Records and Specimen Retention
Specimens and reports will be retained in accordance with the requirements of NPAAC and the Health
Insurance Act. Generally, specimens are retained for up to one week; transfusion samples are kept for one
month and positive blood culture isolates are frozen and kept indefinitely. Serology and molecular
microbiology samples and products can be kept for long periods of time due to NPAAC requirements but
also for good lab practice and for validations etc. of new tests.
Anatomical Pathology storage for up to three years of slides and specimens will be required, additional
storage for older blocks and slides is also required, but this can be located offsite. Formalin fixed gross
specimens are required to be stored for a minimum of 1 month in a well-ventilated facility. Consideration
must also be given to the size and weight of glass microscope slides storing specimens. Storage
requirements of slides may change into the future as NPAAC regulations change to address digital and
whole slide imaging.
Records regarding maintenance and Quality Assurance activities will also need to be retained in line with
regulatory policies and NSWHP procedures.
5.9. Laboratory Storage Areas
A range of scalable support spaces will be required including:
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• Cool storage supporting both clean and dirty storage requirements. Cool rooms provide space
efficiencies, in lieu of multiple household fridges and reduce heat generation within the laboratory,
however contingencies must be considered for mechanical breakdowns either via a second cool room
motor or a suitable sized back up refrigerator. Cool room storage should be linked to the LHD Building
Management System (BMS) and connected to emergency power
• For larger sites, a walk-in freezer will improve efficient use of space and reduce the need for multiple
freezer options in the core laboratory and shall be linked to the BMS and emergency power
• A suitably sized centralised dry storage for consumables including compactus, for laboratory reagent
and consumable storage. This should ideally be located adjacent to the Pathology testing laboratories.
A specific pathology loading dock area may increase LHD efficiencies for general consumable receipt.
A separate storage area for other departments such as Anatomical Pathology and Microbiology,
possibly shared depending on size and location, will also be required
• Separate chemical storage area/s for flammable liquids, corrosive liquids
• Centralised area for waste, including recycling and general waste along with equipment clean-up
facilities
• Storage available to conform with department operation and relevant NPAAC guidelines for ‘Retention
of Laboratory Records and Diagnostic Material’.
Limited consumables will be stored in the core laboratory as stock will be decanted, as required, from the
central dry and refrigerated storage area. Space should also be provided to accommodate used and clean
waste bins, including sharps bins. There may be some small fridges required in some areas of the
laboratory to supply frequent access to refrigerated consumables.
5.10. Education and Research
Education spaces will enable collaboration, integrate learning and translational research and future digital
platforms. These spaces should maximise shared use, with easy access from clinical areas and should
include design flexibility to support different sized groups.
5.11. Pathology Administration and Staff Amenities
• The administration zone will include office accommodation for executive, operations, IT and
administrative staff as well as pathologists and registrars as required for the efficient running of the
laboratory
• Pathologists will require a dedicated quiet work facility collated with specific laboratory zones where
they can undertake their work
• Registrars will require a dedicated group work facility adjacent to the pathologists where they can
undertake their work
• Office accommodation will be provided consistent with the Whole of Government policy. This policy
moves towards less individual office spaces and more combined and shared work spaces
• Office accommodation shall incorporate videoconferencing and digital pathology facilities
• Staff not allocated office accommodation will require lockers
• Adequate meeting and training rooms.
Guideline Laboratory Design NSWHP_PG_018
Page 15 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
6. Laboratory Functional Relationships
Functional relationships indicate where spatial, time and work relationships are required. These
relationships are required to support patient, staff and public movements.
6.1. External Functional Relationships
Pathology is a critical clinical service in improving patient outcomes and enabling effective operation of
hospitals. Pathology investigations are an integral part of clinical decision-making with pathologists as
part of the clinical management team. They support high quality patient care by providing information and
expert medical opinion to facilitate decision making about accurate and timely diagnosis and management
of patients.
Site master planning and positioning of laboratories on acute hospital sites needs to consider both the
functional relationships between pathologists and acute and emergency clinicians, as well as the timely
transport of specimens and time to reporting. Infrastructure such as Pneumatic Tube Systems can only
alleviate issues with specimen transport times, however the functional relationship of pathologists to
clinicians is still a high priority in any acute hospital campus layout.
The Pathology Laboratory should have direct access to the high acuity clinical areas of the hospital.
Functional relationships are prioritised as:
Direct Immediately adjacent (two spaces within the department, or two departments that are
adjacent to each other)
Ready Close proximity (one corridor with minimal turns)
Easy The travel time between the two areas is not more than 10 minutes
Positioning of the laboratory away from acute areas of the hospital including the Emergency Department,
will impact ‘time to report’ turnaround times (which includes time measured between collect, deliver,
receipt, process and report on a sample), blood product delivery and Point of Care Testing support. In
addition, it may incur additional infrastructure and equipment costs such as the need for a Pneumatic Tube
System (PTS) and blood fridges if the laboratory is removed away from these acute areas of the hospital.
If laboratories are moved away from acute areas, and a PTS is not installed, an agreement regarding
workflows between the two areas need to be agreed on to ensure that ‘time to report’ meets the needs of
the hospital.
The best solution is to maintain a direct link between high acuity areas by positioning the laboratory close
to these areas. By having a direct link with the high acuity areas of the hospital, including ED, means the
laboratory is more likely to provide patient results in an appropriate turnaround time and ensures that
pathologists and acute clinicians maintain a functional relationship that ensures timely clinical decision
making.
The problem here, is that a lot of other departments also want to be close to the ED. If a direct relationship
is not possible, inclusion of a PTS will prevent delays in urgent specimen transport to the laboratory and
ensures the collection to validation/report times of acute samples into the future. However, it will not
address the functional relationships between clinicians. NSW Health Infrastructure are currently completing
a Design Guidance Note which will help inform when to include PTS in redevelopments across the state.
Guideline Laboratory Design NSWHP_PG_018
Page 16 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
It is important to note, that there is no design guidance note for pneumatic tubes for blood delivery for
massive transfusion events and is to be developed.
Pathology’s functional relationships with hospital units are:
• Direct access to a delivery / drop-off zone for couriers
• Ready access to Intensive Care and Emergency for urgent tests, blood products and support for
Point of Care Testing devices (noting that PTS and blood fridges may reduce this requirement). It
also allows laboratory staff to attend these sites for short notice service obligations, for clinical
liaison or to manage devices or repairs
• Ready access to clinical services particularly short notice clinical liaison
• Ready access to Inpatient Units (IPUs)
• Ready access to loading docks
• Ready access to operating suites for frozen section particularly short notice clinical liaison
• Easy access to the main hospital building.
6.2. Internal Functional Relationships
The Pathology Unit includes distinct functional areas:
• Entry / reception
• Pathology Administration: accessible to visitors without entering the laboratory
• Specimen Collection: collocated with the laboratory and/or in ambulatory care zone
• Laboratory areas incorporating:
• Pre-Analytical Laboratory (PAL) (Highly flexible zone)
• Core labs (Highly flexible zone)
• Transfusion
• Haematology
• Chemical pathology
• Immunopathology (core services)
• Molecular Testing (core services)
• Microbiology (core services)
• Specialist labs (Semi flexible zone)
• Bone Marrow Transplant
• Anatomical Pathology/Cytopathology
• Microbiology (specialist services)
• Morphology
• Immunopathology (specialist services)
• Molecular Genetics (specialist services)
• Laboratory storage areas
• Laboratory cleaning / decontamination areas.
Guideline Laboratory Design NSWHP_PG_018
Page 17 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
Core labs are best organised around basic laboratory functional relationships and testing areas. As the
function of the lab grows, additional areas can be added to achieve optimal efficiency.
Pathology front of house will include a visitor reception and a specimen reception area that includes
appropriate intercom systems to notify staff of visitors. The Transfusion Laboratory must also have an
external reception to facilitate blood product dispatching which may also be located adjacent to visitor.
and/or specimen reception areas. The location of the transfusion external reception and dispatch area can
vary depending on the orientation of the laboratory envelope. Access is required for dispatch and receipt of
large deliveries 24/7 of products often required for immediate use as well as storage.
Where possible, all testing laboratories should have direct access to the Pre-Analytical Laboratory (PAL),
however this is not always possible in large complex laboratories. Priority placement of Chemical
Pathology, Haematology and Transfusion with the PAL is required as these departments generally process
more specimens and perform the majority of the time critical tests.
Transfusion is also responsible for the dispatch of blood products and requires direct access to the PAL
and an external reception area particularly for LHD Staff presenting to transfusion directly to pick up blood
products.
When describing the internal relationships in the Functional Brief, the distance required to manually deliver
specimens within the laboratory for all departments should be minimised to reduce delivery times and
reduce batch delivery of specimens which will improve result turnaround times. Departments and or tests
that have longer turnaround time bench marks such as Anatomical Pathology, are less required to have
direct access to the PAL.
Where possible, Microbiology should have direct access to the PAL but not at the expense of
Biochemistry, Haematology and Transfusion. This direct access is also affected by the size and shape of
the laboratory ie a narrow rectangular design will limit how many departments can have direct access to
the PAL at the front of the laboratory whereas a wider laboratory footprint may improve direct access to
PAL for more laboratory departments including Microbiology. It must be noted that some Microbiology
testing is acute and requires express result times so proximal location of testing to the PAL is preferred. As
technology advances, some Microbiology testing is moving towards core laboratory testing and these will
increasingly become a part of the core laboratory area. Laboratory design should aim to have direct
(proximal) functional relationships between sections of the core laboratory and the similar sub-specialty
areas in semi-flexible zones to enable staff workflows and maximise staff capacity and liaison.
It is important to understand the workload and test profiles for each department lies as this helps prioritise
department and analyser locations to ensure optimum and logical specimen workflow is achieved. It is also
wise to compare existing workflows and specimen distances travelled with the new laboratory plan to
sense check the appropriateness of the laboratory design.
Another useful benchmarking exercise is to identify current space, including bench space requirements, to
compare to the proposed new plan. Laboratories must ensure there is sufficient bench space provided in
the new facility to accommodate appropriate equipment and ensure enough bench space and flexibility is
included to support increase workloads and new technology and equipment into the future. Use of an
updated equipment list will ensure all pieces of laboratory equipment have been accommodated in the new
facility.
Guideline Laboratory Design NSWHP_PG_018
Page 18 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
Below is an example of a large laboratory that has direct access to the PAL for all testing laboratories. It
will be rare to have a favourable, single level space to facilitate optimum laboratory design.
Pre Analytical Laboratory
(Pneumatic Tube System / Triage /
Data Entry)
Lab Reception
/ Lab Admin /
Lab waiting
area
Send
aways and
Clinical
Trials
Courier
Zone
Transfusion Lab
Molecular
Biology /
Genomics Lab
Microbiology Lab
Loading
dock
Staff amenities
Zone (toilets,
meals, lockers)
Pathology
Admin & ICT
Anatomical
Pathology Lab
Work
benches /
Analy
sers
Work
benches /
Analy
sers
Work
benches /
Analy
sers
Work
benches /
Analy
sers
Work
benches /
Analy
sers
Work
benches /
Analy
sers
Bone Marrow
Transplant Lab
Education /
Training /
Meeting Zone
(MDT)
Hatc
h
Work
benches / A
naly
sers
Haematology Lab
Work
benches / A
naly
sers
Work
benches / A
naly
sers
Work
benches / A
naly
sers
Work
benches / A
naly
sers
Chemistry Lab
Work
benches / A
naly
sers
Work
benches / A
naly
sers
Frid
ges /
Fre
ezers
Work
benches / A
naly
sers
Lab Utilities
(gas, water,
clean up, UPS,
servers,
chemical stores) Morphology Immunology /
Serology / Special
Chemistry Lab
Dry Store
Staff amenities
Zone (toilets,
meals, lockers)
Guideline Laboratory Design NSWHP_PG_018
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www.pathology.health.nsw.gov.au
The following diagram show these relationships in further detail:
6.3. Internal Laboratory Travel Distances
On large hospital campuses, the majority of samples will be transferred to the Pathology Laboratory from
clinical units via a PTS to the PAL. Selected specimens, such as tissue samples in formalin and larger
specimens are generally hand delivered to the pathology unit, usually from theatres, to the reception of the
PAL.
To overcome extended specimen delivery times from the PAL, larger laboratories, long narrow laboratories
or laboratories spread over multiple levels may benefit from an internal transport system such as tracks,
conveyer belt systems or even robotic units to prevent delayed specimen delivery times These internal
transport systems may utilise ceiling space.
Guideline Laboratory Design NSWHP_PG_018
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www.pathology.health.nsw.gov.au
7. Other Design Factors
7.1. Pneumatic Transportation System (PTS)
The PTS will link all clinical areas of the hospital to the pathology laboratory and should include canisters
equipped with the Radio Frequency Identification (RFID) to assist in locating canisters with delayed or
missing pathology specimens. RFID also assists in the correct return of canisters to their home department
or ward.
7.2. Network and Courier Services
Courier services require dedicated parking spaces with all-weather access to the entry. After hours,
couriers use a video intercom system. Provision should be made for car washing facilities in the courier
parking bay area. Ideally, a covered access from the parking space/s to the laboratory will help protect
Australian Red Cross Blood deliveries, patient specimens and courier staff.
7.3. Point of Care Testing
Point of Care Testing (PoCT) is defined as pathology testing performed in close proximity to a patient by a
healthcare worker. The testing is performed outside the precinct of a traditional Pathology Laboratory.
Depending on the size and acuity of the service, Blood Gas Analysers are usually located in EDs, ICU,
NICU, Birthing Unit and theatres. There are also PoCT devices in clinics for example diabetes clinics and
sexual health, and Community Health Centres.
PoCT is a supplement to and not a replacement for pathology laboratory services and does not impact on
the overall design of a laboratory. Provision should be made to accommodate more PoCT devices and
equipment in hospital departments around the campus as the range of testing profiles increases into the
future.
All Blood Gas Analysers and PoCT devices should be managed and supervised by the laboratory and are
supported in accordance with NSW Health Managed Point of Care Testing (PoCT) Service Policy Directive
PD2018_028. There are possibly other, multiple, PoCT devices in use in different facilities and/or units that
are not currently under the supervision of the NSWHP.
7.4. Information, Communications and Technology (ICT)
As pathology services are ordered and reported using e-systems, the use of ICT within Pathology is
significant. For example:
• Most instruments used for specimen analysis or to store samples and other products in
fridges/freezers are networked and increasingly up to four data outlets per item is needed
• Access to specialised digital technology for Anatomical Pathology, Haematology and Microbiology will
also be required, including access in conference / meeting rooms and pathologist and registrars’
offices
• There will need to be capacity for:
• Images and data storage
• Interface equipment and backup
• A Laboratory Information Management System
Guideline Laboratory Design NSWHP_PG_018
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www.pathology.health.nsw.gov.au
• Middleware servers that will enable changing technology and machines to be accommodated without a noticeable change by end users
• Each instrument has ICT requirements and these will only increase. Large communications spaces
will be required to support pathology ICT requirements
• Increasingly, laboratory equipment is being remotely monitored by the suppliers as part of a service
contract. Equipment, including cool rooms and freezers, are remotely monitored by the Building
Management System (BMS) and emergency power to ensure the integrity of expensive reagents and
patient samples are not compromised during equipment &/or power failures
• The laboratory shouldhave mobile phone reception and a laboratory Wi-Fi system. A backup phone/s
is required within the laboratory as VOIP (Voice Over the Internet phones) does not always provide
100% reception. A Public Address (PA) system may also be required for larger laboratories
• Transfusion requires wall space for wall monitors for test turnaround times, blood product orders from
wards, and inventory management.
7.5. Work Health and Safety
Considerations will include:
• Provision of emergency showers and eye wash stations meeting the AS4775 and located throughout
the all testing laboratories including the PAL, core laboratory, Microbiology and Anatomical Pathology
• Provision of hand hygiene, both basins and alcohol-based hand rub delivery points
• Ergonomic layout of benches, some may be height adjustable
• Service poles to supply power and data from the ceiling to benches
• Access to plumbing to dispose of analyser liquid waste
• Power point and data outlets used for equipment, particularly blood fridges must be accessible without
having to move large and heavy equipment
• First aid cabinet and supplies.
7.6. Security
Controlled access to the laboratory will ensure the security of staff. Staff security outside the laboratory
shall also be considered particularly when supporting other areas and units on the campus and accessing
different units outside the laboratory building.
7.7. Laboratory Acoustics and Heat
Open plan core laboratories are subject to considerable equipment noise and heat particularly as more
analysers and equipment enter processing areas. Sound dampening strategies and heat extraction
controls must be considered to ensure a pleasant working environment is created and maintained. Fridges
and freezers contribute significantly to laboratory noise and heat generation and strategies must be
deployed and may include cool rooms, centralised fridge and/or freezer areas.
Guideline Laboratory Design NSWHP_PG_018
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7.8. Have you considered?
Laundry services
A laundry bay will be required to accommodate gowns near staff entry to the laboratory. Linen skips will be
provided for disposal of used gowns on the way out. Laundry will be managed and provided by
HealthShare.
Clean-up services
A small clean-up room is required in the core laboratory to wash and drain some equipment including
glassware as well as a dedicated sink to dispose of urine samples. A pipette washer will be needed. Some
departments, such as Anatomical Pathology and Microbiology, may require their own dedicated clean
rooms to support the nature of on-site testing for these departments.
Cleaning services
A cleaner’s room is required within the laboratory for storage of cleaning equipment and consumables.
Supplies
Where possible, consumables should be delivered directly to a specific pathology dock by external
couriers, with direct access to the laboratory dry storage area. This will eliminate hospital ward staff re-
delivering consumables to the laboratory. Any consumable requiring refrigeration should be received and
stored by pathology staff.
Waste services
Waste includes general waste, recycling, clinical waste and flammable liquids. Most waste will be
generated locally and transferred to the disposal room and or hospital waste area. Microbiology generates
a large amount of bulky waste and needs to be supported by autoclaves, commercial dishwashers and
infectious waste disposal. Anatomical Pathology also generates a large amount of bulky waste and require
access to infectious waste disposal.
Firefighting equipment
Hoses, blankets, exits, signage etc.
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8. Specific Design Factors
8.1. Core Laboratory Functional Areas
Please note that activities and tests listed here may not be performed at all sites. Accordingly, these are requirements are scalable relevant to the
local facility needs and is considerate and supported by the NSWHP networked approach.
Lab Design requirements
Pre
-An
aly
tica
l La
bo
rato
ry
The Specimen Reception in the Pre-Analytical Laboratory area is the first contact point of the laboratory and contains arrangements for
drop off and pick up of samples sent through pneumatic tubes, couriers and facility staff. The following is required:
• Large window for drop off and pick up of samples, blood products and send aways. Must be large enough for samples within eskies
and other packaging to be passed through. A bench located just below the reception window will allow for paper records and
processing requirements. Means for closing the window (for security) is also required
• A larger ergonomic workstation (Type from Office accommodation) located near the receiving window for sorting, triaging and
registering of samples with access to the Laboratory Information System (LIS). A corkboard for notifications, etc
• A Pneumatic tube station located close to the workstation used for sorting, triaging and registration of samples
• Internal bench for sorting and registration of samples collected from wards
• Large internal bench for sorting and packing send aways with overhead shelving for container and packing storage. This area
requires access to refrigerated (-4 degrees) and freezer (-20 degrees) space within a short distance from the main Specimen
Reception window.
Specimen Reception should be open to the rest of the laboratory for easy access by out of hours and night shift staff attending to other
essential laboratory testing. The specimen reception area may also serve as a reception area for visitors to the laboratory and/or the
specimen collection area. For these functions, the following are required:
• Access to a PABX system and appropriate software and documentation for visitors
• A security access to the laboratory for staff and visitors
• A duress alarm for staff.
Guideline Laboratory Design NSWHP_PG_018
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Tra
nsfu
sio
n
• Entry for blood product delivery that accommodates large trolley loads of deliveries in large facilities
• A dedicated hatch that hospital staff will access to pick-up blood products which will include a doorbell or intercom notification system
• Open plan area with flexible benches with access to workstation/s and computer/s and a range of analyser/s
• A specimen delivery / drop off area which will allow sorting of specimens and blood product deliveries
• An automated area where analysers perform bulk specimen testing
• Analysers require rear access to complete regular servicing requirement.
• A discrete laboratory work space to complete more complex specimen testing
• A bench top water bath with access to a sink and a free-standing &/or bench top platelet shaker machine as required
• A blood product fridge/freezer (cool room) area containing sufficient room to house the multiple blood bank fridges and freezers. This
area will require appropriate ventilation to accommodate the heat generated from the fridges and freezers
• All Blood fridges and freezer must be connected to the Building Management System (BMS) and connected to emergency power
• Temperature controlled devices are required as air conditioning may not always meet constant regulatory temperatures
• The fridge used to issue blood products to clinical areas will be located closest to the dispense hatch
• Administration areas will include clean work station areas for the senior scientists / staff along with sufficient workstations to complete
clerical and compliance administrative duties
• Power point and data outlets used for equipment such as fridges and analysers must be accessible without having to move large and
heavy equipment to complete mandatory power testing.
Guideline Laboratory Design NSWHP_PG_018
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Ha
em
ato
log
y
• Open plan area with flexible benches with access to workstation/s and computer/s and a range of analyser/s
• An integrated Full Blood Count Analysers system. Depending on the size of the unit, this may include slide maker, stainer and digital
morphology
• Other analysers including coagulation analyser/s, shall be positioned to improve specimen workflow and result turnaround times.
Generally, each analyser will have a dedicated computer supporting analyser activities
• Analysers require rear access to complete regular servicing requirement
• A discrete morphology area towards the periphery of the core laboratory area is required to support morphology activities. The size is
scalable to activity noting some smaller sites may have morphology included within the core laboratory space. Digital morphology
requirements including computer screen requirements, must also be considered. Larger sites, may require a larger separate space for
multi-header microscopes &/or large screen/s for the reporting, teaching and MDT’s
• Fridge and freezer storage including -800 (could be a shared central cool room
• When testing is completed, specimens are transferred manually to a central cold storage room supporting all core laboratory activities
or via automated robotics / track system to an assigned storage position
Ch
em
ica
l P
ath
olo
gy
• Open plan area with flexible benches with access to multiple workstations and computers and a range of analysers
• A flexible specimen triage zone is required for miscellaneous testing
• The main chemical pathology analysers are modular systems, and maybe linked by a track system at larger sites so provision must be
made to accommodate the growth and expansion of these analysers into the future
• Main chemistry analysers require access to a purified water source and appropriate water storage and waste amenities
• Analysers require rear access to complete regular servicing requirement
• Less common, more manual and specialised chemical testing will be processed towards the periphery of the Chemical Pathology area
• When testing is completed, specimens maybe stored automatically into a dirty cool room via a track / automated robotics system in a
central cold storage system or stored manually
• Fridge and freezer storage including -800 (could be a shared central cool room). As technology evolves, personalised pathology such
as proteomics and metabolomics may require dedicated laboratory spaces outside of core chemistry spaces. These new pathology
services will have high pathologist involvement requiring space, bioinformatics and multidisciplinary collaborations
Guideline Laboratory Design NSWHP_PG_018
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www.pathology.health.nsw.gov.au
Imm
un
opa
tho
log
y • Flexible bench space sufficient for analysers
• Fume cupboard access
• Fridge and freezer storage including -800 (could be a shared central cool room )
• Access to facilities for PCR/genetics analysis is likely to be required as personalised medical therapies involving immune modulation
evolve in the future. Similarly assays using live-cells may become more widespread and capability to implement these should be
considered for the future
Sta
t M
icro
• Open area with flexible benches with access to multiple workstations and computers and a range of analysers
• Microbiology reagents and culture media are large and bulky and will require extensive dedicated cold and dry storage areas
• Microbiology samples require prolonged storage at various temperatures and so extensive room temperature, fridge temperature,
freezer temperature and -800 temperature storage will be required
Mo
lecu
lar
ge
ne
tics • Open area with flexible benches with access to multiple workstations and computers and a range of analysers
• When testing is completed, specimens are transferred manually to a central cold storage room supporting all core laboratory activities
or via automated robotics / track system to an assigned storage position.
Guideline Laboratory Design NSWHP_PG_018
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Specialist Laboratory Functional Areas
Lab Design requirements
Mic
robio
log
y
• Microbiology testing will continue to require higher level of microbiological containment, and protection from environmental
contamination and so should be partitioned away from the core laboratory in satellite areas nearby
• Larger sites will require a PC3 containment laboratory to cater to high level pathogen testing such as for Mycobacterium
tuberculosis, and so that new and emerging pathogens can be dealt with in a safe environment for all pathology and clinical staff
• The Microbiology department will require its own walk-in cool room and incubators for culturing purposes
• Specialist areas within microbiology including parasitology, mycology, virology and mycology do not require direct access to the
PAL and would be located towards the back of the department
• Requires access to medical gases and to high pressure oil-free air to run various robotic instruments
• Rooms for decontamination (autoclaving) and disposal of infectious waste and for limited preparation of sterile laboratory
reagents and equipment
An
ato
mic
al P
ath
olo
gy • Anatomical Pathology testing will require a higher level of containment to control exposure to department processing fumes and
needs appropriate ventilation to support tissue processing areas including specimen cut-up work areas
• Fume extraction arrangements that meet Australian Standards for tissue processing are required in a separate and vented
workroom
• Facility to do Fine Needle Aspirates is to be provided within the Department precinct adjacent to Cytology section
• Frozen Section Services will be done within the department, assuming the proximity to theatres remains
• Consideration of solvent recycling facilities should be included to reduce solvent water and its associated costs. This should be
located in the tissue processing room. WHS risks associated with manual handling associated with solvents must be considered
to reduce the risk of injury.
Guideline Laboratory Design NSWHP_PG_018
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Bo
ne
Ma
rrow
Tra
nsp
lan
t (B
MT
) • The BMT lab will be a secured and dedicated laboratory
• The laboratory is required to be segregated into receipt, processing, storage and documentation areas
• The laboratory must be designed to comply the National Pathology Accreditation Advisory Council ‘Requirements for procedures
related to the collection, processing, storage and issue of human haematopietic progenitor cells’ (Fifth Edition 2015)
• It requires a separate Cryo storage room with Oxygen monitor sensors to accommodate two Control Rate Freezers
• Liquid Nitrogen (LN2) resistance floor.
Guideline Laboratory Design NSWHP_PG_018
Page 29 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
9. Sample Floor Plans
Laboratory size will vary between small and larger laboratories.
The following floor plans generally follow design principles and functional relationships.
9.1. Small Laboratory
Includes a patient waiting area, collocated specimen reception room, core laboratory area, cool room and
after-hours blood room.
Nb: this is indicative only, some aspects of this design have changed including a second entry point into the lab area.
Guideline Laboratory Design NSWHP_PG_018
Page 30 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
9.2. Medium Lab
In this floor plan the design has been adjusted to accommodate a central lift and stairwell, see grey area
below.
Guideline Laboratory Design NSWHP_PG_018
Page 31 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
9.3. Large Lab
The sample floor plan adapts to building design, but again follows the functional relationship outlined
above.
Guideline Laboratory Design NSWHP_PG_018
Page 32 of 32 Approver: Transformation Governance Committee, Version Number: V1.0, Publication Date: 4/12/2019 This document is subject to change and a printed copy may not be up to date. The current version is only available online in the NSW Health Pathology Policy Library
www.pathology.health.nsw.gov.au
10. Detailed Laboratory Design by Clinical Stream
10.1. Design Requirements for Anatomical Pathology Departments
For the design requirements for future developments of Anatomical Pathology Departments within
NSW Health Pathology please refer to the NSW Health Pathology Design Requirements for Anatomical
Pathology Departments Guideline NSWHP_PG_019.
11. Review
This policy will be reviewed by 31/12/2021.
12. Risk
Risk Statement
Compliance with this guideline will ensure that NSW Health Pathology
continues to provide high quality services to our customers that meet quality
standards and regulatory and legislative requirements.
Risk Category Clinical Care and Patient Safety
13. Further Information
For further information, please contact:
Policy Contact Officer
Position: Senior Pathology Services Planner
Name: Deborah Lawson
Telephone: 0401 920 500
Email: [email protected]
14. Version History
The approval and amendment history for this document must be listed in the following table.
Version
No
Effective
Date
Approved
By
Approval
Date
Policy Author Risk Rating Sections
Modified
1.0 06/12/2019 Executive Director, Clinical Operations
03/12/2019 Senior Pathology Services Planner
Medium New guideline.