Factors That Impact Turn around Time of Surgical Pathology Specimens in an Academic Institution
S Patel, JB Smith, J Guarner. Emory University, Atlanta, GA
Background: Turnaround time (TAT) of laboratory results is an important factor in customer satisfaction. Monitoring of TAT for routine specimens is mandatory. However, there is no standard definition of routine specimen; thus each institution creates its own definition. The objective of this study was to analyze which factors impact TAT of surgical pathology specimens.
Design: We calculated the TAT for all surgical specimens (excluding biopsies) from receipt to verification of results adjusting for weekends and holidays. Twenty days were studied, ten in June and 10 in July 2009. Factors recorded for each specimen included tissue type, number of slides per case, decalcification, immunohistochemistry (IHC), consultations with other pathologists, and diagnosis. Fisher exact test was used for statistical comparisons and p<0.05 were considered statistically significant.
Results: A total of 713 specimens were analyzed, of which 551 (77%) were verified within 2 days and 162 (23%) in 3 days or more (97 in 3 days, 37 in 4, 15 in 5, and 13 in 6 to 14). The overall average TAT was of 2.07 days (SD 1.18); however, the mean TAT was >2.07 days for genitourinary (GU), lung, breast, skin, head and neck, and gastrointestinal (GI) samples. A diagnosis of cancer was made in 47% of cases verified in 3 days or more and in 14% of those verified within 2 days (p=0.0001). TAT was also significantly impacted if the case had more than 10 slides, IHC studies, or consultations with other pathologists. Decalcification did not impact significantly the TAT. Study of the variables per tissue type showed that a diagnosis of cancer impacted TAT significantly for GI tissues, head and neck, soft tissues, skin, breast, gynecologic (GYN), as well as various other specimens but did not impact TAT of lymph nodes, lung and GU tissues. IHC studies impacted significantly the TAT of GI, skin, GYN, GU, and various tissues. Having more than 10 slides impacted significantly the TAT of head and neck, skin, breast, and various tissues. Consultations with other pathologists impacted significantly the TAT of soft tissue, skin, breast, and various tissues.
Conclusions: TAT for surgical specimens is impacted by all variables studied except decalcification. Central to significantly prolonging the TAT for surgical pathology specimens is the diagnosis of cancer (7 out of the 11 tissue types) suggesting that institutions serving cancer centers will tend to have longer TAT than those that do not serve cancer centers. The interrelationship between the variables and TAT should be studied further.
Category: Quality Assurance
Monday, March 22, 2010 1:00 PM
Poster Session II # 205, Monday Afternoon