Start with the test menu and volume
Define which tests you will offer and the realistic daily volume for each. This determines analyser throughput, staffing and whether a given section is viable at all.
Tests you will refer out do not require equipment. Over-equipping a low-volume section is the most common capital waste in new laboratories.
Pre-analytical
Phlebotomy furniture and supplies; sample transport containers; centrifuges sized to throughput; refrigerated storage for samples; and a labelling and identification system.
Most laboratory errors originate pre-analytically. Equipment choices here have outsized impact on result quality.
Haematology and coagulation
A haematology analyser matched to daily volume with an appropriate parameter set; a coagulation analyser or point-of-care coagulation testing where volumes are low; microscopes for film review; and an ESR method.
For low-volume or near-patient coagulation monitoring, point-of-care PT/INR systems can be more practical than a benchtop analyser.
Clinical chemistry and immunoassay
A chemistry analyser matched to throughput and test menu; immunoassay capability where the menu requires it; an electrolyte analyser; and calibration and quality-control materials.
Reagent cost per test over the expected volume matters far more than analyser purchase price. Model it before deciding.
Microbiology
Incubators; biological safety cabinet appropriate to the work; autoclave for media preparation and waste decontamination; refrigeration for media and reagents; and identification and susceptibility testing capability.
Biosafety requirements must be established before the room is designed, not after equipment arrives.
Supporting infrastructure
Deionised or purified water to the grade your analysers require; uninterrupted and stabilised power; appropriate air conditioning and heat management; a laboratory information system; waste management including sharps and biohazard handling; and calibrated reference thermometers.
Water quality and power stability cause more analyser downtime in practice than analyser defects.
Quality and accreditation
Internal quality control materials and procedures; external quality assessment enrolment; documented standard operating procedures; equipment calibration and maintenance records; and staff competency records.
Building these from the outset is far cheaper than retrofitting them for accreditation later.
Frequently asked questions
What is the biggest capital mistake?
Over-equipping low-volume sections instead of referring those tests out.
What causes most analyser downtime?
Water quality and power instability, rather than the analysers themselves.