Automation in the lab: A necessary growth pillar when emerging from COVID-19

The COVID-19 pandemic drastically changed the laboratory industry. Preexisting challenges related to staffing, workflows, and logistics were magnified by an unpredictable tsunami of testing volumes and the critical need to deliver important insights to vital frontline staff and patients. Though many put routine medical care on hold in the early months of 2020 and 2021, some were not able to pause care and treatment, and labs had to adapt to the new normal the pandemic brought with it — including finding ways to combine existing work with climbing COVID-19 testing volumes.

Fortunately, flexibility has always been key in the lab. For years, labs have been evolving to suit the growing needs of the populations they serve. The COVID-19 pandemic only accelerated this process.

Automation is one such way labs can increase flexibility and remain nimble within their existing staff resources. Namely, automation can save lab employees critical time in their day-to-day operations, optimizing workflow and freeing time for more meaningful tasks.

By reducing the need for what was once hours of manual work, employees in the lab can have their work focused by what is akin to an automated personal assistant — something that enhances the value of the human being working to deliver important results to patients.

A case study on the importance of automation in Clifton, New Jersey

Prior to the COVID-19 pandemic, we at Quest Diagnostics had begun the process of moving lab operations in our Northeast region to a new, state-of-the-art facility in Clifton, New Jersey. In January 2021, we started processing samples (both COVID-19 related and others) in the new facility — one of the largest medical laboratories globally.

Clifton’s extensive automation capabilities helped us tremendously throughout the pandemic. The lab was purpose-built in that every aspect was created to enhance our commitment to high-volume diagnostic testing services. Specifically, the lab needed to be able to suit the needs of many hospital customers scattered throughout the vast New York metropolitan area. But more than that, the Clifton laboratory offers superior medical quality with increased productivity, while considering our capacity to meet current and future regional demands. 

The laboratory features two distinct automated lines for clinical testing and a multi-bridge design that enhances efficiency. Automation has several uses in the lab, primarily serving to enhance the employees’ workflow. First, the facility utilizes barcode tracing solutions to track and store specimens, making it easier for providers to request follow-up tests or further analysis in real-time. Most impressively, our automation will allow us to use very little blood volume to perform numerous tests. This is beneficial to patients, particularly those who are older or have conditions that may require sensitive care, including geriatric, pediatric, and oncology patients. It also enables physicians to run additional tests without further phlebotomy.

While the automation in the lab is exciting, people, not technology, drive innovation. For that reason, it was vital to make the facility’s design a team effort, aimed at fostering a culture of innovation through inclusion and collaboration. Employees were involved in every step of the lab design process; before a shovel hit the ground, we convened hundreds of employees to design their spaces, using everything from cardboard cutouts to butcher paper to capture their ideas.

At a time when companies are battling for talent, involving our employees in the design process was key to conveying our commitment to our workforce. The pandemic put our staff to the test and many employees in our labs worked around-the-clock throughout the surges of COVID-19, all to provide critical testing information to patients. The technology in our lab is just one piece of a much larger puzzle, which our workforce supports every single day.

Focusing on microbiology to add value

One department in Clifton provided a specific opportunity for enhancement with automation technology. Our microbiology team had several pillars of improvement we hoped automation could support.

Before embarking on introducing further automation in our microbiology department, we took time to assess the true needs of our staff, as implementing automation for automation’s sake will result in failure. This provided an opportunity for us to set clear expectations on how our automation could enhance the operation in meaningful ways, including incubation and culture reading. As an example, our new automation in microbiology enables touchless processing from specimen receipt to results reporting on a significant portion of cultures for the first time ever, ultimately leading to an important result: saving time for our staff to report results to physicians, in order for them to diagnose and provide the right treatment plans.

The foundation of all automation implemented was to make improvements that would significantly improve the patient experience. Each decision on automation was seen through this lens of our patient experience, from the eyes of the senior leadership team to our medical technologists.

By increasing automation in the microbiology department at the Clifton facility, we reduced the length of incubation for several culture types by anywhere between 25 to 60 percent, depending on the test. We’ve also been able to streamline tasks like specimen loading, barcode labeling, and storage, allowing for the reallocation of some remaining responsibilities to different employees throughout the lab. Automation has decreased the time we are spending on negative cultures, allowing for our technologists to focus on making the most accurate, efficient reading of positive cultures.

Digitization has also made recalling and sharing information much easier. If an infectious disease doctor wants to fully understand a patient’s results, we now have the capability to retrieve images from the entire specimen process, rather than reading comments in the system, empowering the physicians we work with and delivering better patient outcomes.

Considerations when implementing automation

Increased demand for testing and staff turnover means many labs are stretched thin and may be desperate for ways to take pressure off their operations. While automation can be a great tool to address challenges and revolutionize the way the lab works, there are some things that must be considered when implementing an automation strategy:

1. Make sure to leave room for expansion

The COVID-19 pandemic proved there is no predicting the future in diagnostics and that a lab’s best offense is to be prepared for anything. We took that lesson to heart, ensuring that in our Clifton, NJ, lab, we have the footprint and flexible design needed to add another automation line on our main floor as testing demands increase. 

2. Communicate with frontline staff

Open and transparent communication with frontline staff is crucial to a lab’s operations. We have found that when employees are involved in the process of change at the lab, they are more engaged. Keeping an open line of communication can also assuage worries of job security that talks of automation may naturally bring. Fundamentally, automation brings cultural change as, across the board, staff members are asked to adapt to lab improvements. One thing that makes this process smoother is engaging employees at each step of the journey, from inception to implementation.

Additionally, lab employees can provide vital input on the design and functionality of shifting areas of the lab, increasing efficiency and morale. During the process of our lab transition, we involved employees in every stage of the move, something that increased employee participation and teamwork.

3. Clearly define the goals of automating

Each lab has different inputs, outputs, and needs, and while automation can solve a variety of problems, it is not a one-size-fits-all solution. For some labs, it may make sense to fully automate. For others, there are only certain parts of the workflow that require this solution.

Some should consider partnering with an expert in automation before taking on this challenge themselves. Before beginning the automation process, consider exactly what needs to be achieved, and the main purpose of the automation. This will ensure staff engagement and a successful program, from increased scalability to better quality results.


It is impossible to predict if we will see the high testing volumes brought on by the COVID-19 pandemic again. This is why flexibility and elasticity in testing is so important. Diagnostic labs have a responsibility to patients to deliver accurate results, and tools like automation make it possible for lab employees to focus on what’s most important: providing those needed insights.

By increasing productivity and efficiency (and reducing minimal human error), automation can add value to the dedicated workforce that makes the lab what it is. The people behind the automation are the heart of the lab; the results that are delivered simply could not happen without them. We are adding value to our patients and clients by providing accurate, timely, and cost-efficient test results. With tools like automation enhancing their work, it can be expected that many labs will continue to follow suit in implementing enhanced automated features, helping hardworking frontline staff have more high-quality time back in their day.