Inside Job

When employees at cancer-testing firm NeoGenomics tracked a specimen through their laboratory last year, they were shocked to discover it traveled one-third of a mile from start to finish.

It's a familiar story for fast-growing companies that continuously add people and equipment. The circuitous route the specimen took through the 26,000-square-foot NeoGenomics lab in Fort Myers wasn't by design. Over time, NeoGenomics has successfully grown its cancer-testing operations to the point that people and equipment were located wherever there was room to put them, without too much regard for workflow.

But NeoGenomics executives decided last year they couldn't wait to reorganize the lab because they knew it couldn't handle the additional work that was coming in the future. “We were operating at full capacity,” says Helen Edenfield, director of project management for NeoGenomics.

What's more, it would have cost the company at least three times more to move into a new building. “Then you start messing with people's commutes,” says Steven Brodie, director of molecular genetics and cytogenetics.

So the Fort Myers-based company launched an ambitious project to completely redesign the lab even as it was performing cancer tests for physicians and their patients. The hugely complex process cost $1.2 million and months of extra staff time. “If we're going to do this, let's do it right,” recalls Michael Zombory, manager of Florida laboratory operations for NeoGenomics.

Executives say the project was successful because front-line employees were involved from the start. The new lab's design wasn't forced on them by a small group of supervisors and they didn't hire an outside design firm to develop it for them.

Because of the redesign of the Fort Myers lab, the specimen that traveled one-third of a mile now just moves 100 feet within the facility. Executives estimate the redesign will allow the lab to handle at least double the volume that it did before without adding many more people to the lab's current staff of 130.

This is important because health care companies have to find ways of being more productive in the face of government and insurance cutbacks. Automation and workflow design are critical, executives say. For example, in the first quarter, NeoGenomics says the number of cancer tests per employee rose 12% while the cost per test fell 7%.

Kaizen meetings
Zombory says he's worked at other companies where teams of supervisors meeting in secret decided how to reorganize the workplace. Predictably, those efforts failed and workers resented the new setups.

By contrast, at NeoGenomics, the company created meetings of representatives from all employees, from front-line technicians to supervisors. Based on the Japanese continuous-improvement process called “kaizen,” the meetings included about a dozen people from each section of the lab. Participants left their titles at the door. “Everyone is equal in the room,” says Douglas VanOort, the chairman and CEO of the company.

For three to four consecutive days last year, each of the half-dozen kaizen teams isolated themselves in a room for 12 to 14 hours a day to evaluate every step in the lab procedures. Lunch was catered. “They even took tape measures and measured the steps,” says Chief Financial Officer George Cardoza.

The company granted those employees in the kaizen exercises the time to focus on redesigning the lab instead of performing their usual jobs. “It caused us to focus on what we were doing,” says Felix De La Cruz, supervisor of the wet lab.

In one exercise, the kaizen teams drew lines on white boards with black markers to track how a specimen traveled through the lab and to show where the bottlenecks were. They discovered that all specimens traveled through one door in the lab that became a notorious bottleneck, eventually leading to a new design without inside doors except for some offices and conference rooms.

A new floor plan
NeoGenomics didn't let an outside architect design the floor plan for it, preferring instead for employees to design the space they needed. “We came up with the floor plan concept,” says Zombory.

Working with McGarvey Development's in-house architects, NeoGenomics employees asked the construction crews to tear down all the inside walls and replace them with columns that would contain the wiring necessary to power the equipment. Zombory recalls the construction managers' surprise: “McGarvey said: Where are you going to put the walls?” Zombory chuckled.

The only fixed equipment were the sinks because the plumbing lines are built into the concrete floor. Refrigerators that once lined the walls are now in the middle of the lab so employees don't have to walk so far to reach them. “If it's put against the wall, it adds another 30 steps,” Zombory explains.

Except for the sinks, every piece of equipment and furniture has wheels so it can be moved easily. Even the cabinets are attached to tables on wheels. Movable glass walls separate the noisy wet lab from technicians who need quiet to analyze specimens on the computer.

What's more, there's room for growth. When a new, more-productive machine is available, it can easily be wheeled into place. Zombory says each lab has planned for additional equipment by leaving some spaces empty on purpose.

Computers are positioned all over the labs so that employees don't have to take too many steps to enter the data as a specimen passes through the facility. A giant flat screen in each lab shows the specimen cue and its progress through the lab at a glance.

Instead of traveling through the facility, a specimen now comes through a door in the middle of the lab and a group of employees direct the specimens into various labs organized in a fan shape around the receiving department. “Before, we never had a space for deliveries,” says Zombory. “They sort of got plopped in the middle of the lab.”

The big move
Before construction renovations began, the administrative staff of about 70 people moved out of the lab and into an adjoining building. Edenfield says one of the keys to a successful renovation was communicating the construction schedule to all the staff via email, though looking back she says she would have started the daily messages before the construction even started.

Communication was key because the construction workers were sometimes noisy and giant tarps had to be hung to contain the dust. “We tried to schedule things at night and on weekends,” says Edenfield, who had the power to halt construction on some occasions because of the noise. “They were very understanding,” she says.

Employees endured the seven-month construction period because they were involved in creating a vision of what the lab would look like. One bonus everyone appreciated: The single-use bathrooms got a makeover by making them bigger. “There would be lines outside the bathroom,” says Zombory.

A long hallway was built from one end of the building to the other so employees don't have to walk through the lab to get around. Natural light was allowed to flow into the building when the walls came down, creating a more pleasant environment.

In addition, NeoGenomics built a collaboration room where employees can gather in comfortable chairs in teams. The chairs and white boards are also on wheels and a room divider can provide some privacy. In the past, teams of employees would meet inside the lab.

VanOort noted the lab's redesign in conference calls with analysts and investors. He says the company can continue to push productivity gains of as much as 8% to 10% a year. “We were looking at this as a smart investment,” he says.