Reduction of Anatomical Pathology Slide Mislabel Rate Due to Implementation of Barcoding at Two Tertiary Care Hospitals.
Gaurav Sharma, Anthony Piccoli, Susan M Kelly, Luke T Wiehagen, Liron Pantanowitz, Anil V Parwani. University of Pittsburgh Medical Center, PA
Background: Manual entry of case numbers in the pathology laboratory information system to generate labels can lead to mislabeling of pathology specimens and their derivatives (blocks, slides etc.). Two dimensional (2D) bar coding technology has emerged as a viable technology for use in anatomical pathology laboratories. Benefits include accurate data entry when bar codes are scanned, asset tracking with routing, and a streamlined workflow. The aim of this study was to determine the effect of barcoding at different hospitals in reducing the slide mis-label rate.
Design: Barcoding was implemented in the histology laboratories at Hospital A (400+ beds, around 25,000 surgical pathology cases accessioned annually) followed by Hospital B (900+ beds, around 50,000 surgical pathology cases accessioned annually). A 2D Datamatrix barcode standard was integrated with the anatomical pathology laboratory information system (CoPath version 3.2; Cerner DHT, Kansas City, MO). Bar code printers (Shandon Microwriter; Thermo Scientific, Waltham, MA and GDKV2-C; General Data Corporation, Cincinnati, OH) for cassettes were installed at grossing stations and barcode printers for slide labels (Cognitive Cxi; CognitiveTPG, Lincolnshire, IL) using chemical resistant adhesive labels (StainerShield XT, General Data Corporation, Cincinnati, OH) were installed in the histology laboratory. Bar code scanners (Symbol DS 6607 and 6707; Motorola Corporation, Schaumburg, IL) were placed in the accessioning area, gross room, histology laboratory and at pathologists' workstations. The mislabeled slide rate before and after bar code implementation was compared.
Results: Implementation at Hospital A spanned 12 months (March 2008 to March 2009) where the rate of mislabeled slides decreased from 2.5 slides/month (pre-barcoding) to 0.58 slides/month (post barcoding).Implementation at Hospital B spanned 7 months (January 2009 to July 2009), where the rate of mislabeled slides decreased from 4.25 slides/month (pre-barcoding) to 2.74 slides/month (post-barcoding implementation).
Conclusions: Successful implementation of barcoding in anatomic pathology practice is best accomplished in a phased manner. Experience gained with initial implementation at a smaller laboratory decreases the implementation time at a larger laboratory. Our data show that 2D barcoding of slides can help significantly reduce mislabeling errors, even in complex anatomical pathology laboratories, and thereby improve patient safety.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 181, Tuesday Afternoon