Pros and Cons of the Transfusion Service Laboratory being located in an open area of the Core Laboratory

A colleague in South Carolina reports that their core laboratory is in the process of doing "LEAN" renovations. Plans include moving the Blood Bank/Transfusion Service Laboratory to the back of the new Core Laboratory, which will be in an open area with the Core Laboratory. They presently (and always have been) in a "closed" area in the Lab, due to noise levels, distractions, etc. They are a 500-bed facility that services trauma, OB, NICU, open hearts, and reference workups from smaller surrounding hospitals. Of special interest is the fact that their blood bank staff have not been involved as part of the LEAN process. The inquiring South Carolinian would appreciate comments or opinions about the Blood Bank being in an "opened" area.

The following comments have been received.

ADDENDA February 12, 2009

1. A colleague in Kansas reports that his blood bank laboratory was moved into a back corner of their main lab about five years ago with all the usual dire predictions of distractions, including fear of overheating and excessive noise due to the proximity to the refrigerator compressors, etc, etc. To the contrary, in the opinion of the respondent, the redesign has worked out reasonably well, and has made cross-training on '2nd shift' and on '3rd shift' possible with accompanying FTE reductions. Several years ago this same institution moved enough of its Micro staff into the same main lab to do Gram stains and cultures on 2nd shift and 3rd shift. Now staff can see when someone in another department is drowning in work and can move over to help as needed, then go back to their initial assignment when the crisis is over. All ten of the staff on 2nd shift, and all five of the staff on 3rd shift are in the one large room, permitting better overall coverage.
   
   
2. A Blood Bank Supervisor in Arkansas reports that her 300 bed hospital blood bank moved from an enclosed blood bank to a new hospital and open area lab. After a year of being in the open and too small a space, they were able to design a new lab and move into a newly built tower with an enclosed blood bank. They did not have any known major errors while working in the open space, but in the supervisor's opinion, work was less than efficient; they had to take extra time to focus on their work, and clerical errors were evident due to increased interruptions. They have been in their current enclosed blood bank lab space for the past five years. In that time they implemented a new computer system, a blood bank instrument, new refrigerators and increased workloads. In her opinion, this would not be a safe situation if they had stayed in the open space.
   
   
3. A colleague in the Pacific Northwest reports that she previously worked in a busy 500-bed hospital transfusion service that redesigned its laboratory so that the transfusion service was entirely open within the larger main lab. The blood bank lab had previously been in its own room, but with the redesign the new blood bank lab was open to the rest of the lab. In the redesign, it was requested that the blood bank lab be on the perimeter of the larger lab. As it turned out the blood bank lab had three walls enclosing it, with the fourth wall open to the rest of the lab. They designed the blood bank lab in such a way that they placed a desk barrier for accessioning/specimen processing and triage between the blood bank and the rest of the lab. The area was open to the noises generated by chemistry, hematology, specimen processing and the phlebotomy dispatch area. It took some work and cooperation, but they were able to make it function. The respondent cautions, however, that distractions are a definite consideration.

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