A New Resident QA System, an Interesting Self Study Activity in Pathology Residency Training.
Madhu P Menon, Michelle Hure, Bruce A Woda, Patricia Miron, Lou Savas, Zhong Jiang. University of Massachusetts Medical School, Worcester
Background: Our residency program instituted a quarterly resident quality assurance (QA) system to evaluate residents' performance in their daily pathology practice. Each quarter, senior residents evaluate several aspects of resident performance. The purpose of our resident QA program is to identify systemic problems and individual resident mistakes at any point in the course of processing surgical pathology specimens.
Design: Data was collected by senior residents, laboratory directors, managers, LIS specialists and traditional log books in a quarterly fashion from May 2009 to April 2010. The specific items addressed include each resident's total number of errors when processing specimens, the accuracy of labeling specimens with the correct accession numbers and patient initials, any delays in the processing or reprocessing of specimens and any inadequacies in processing, such as thick tissue sections. Each quarter, a senior resident summarizes the data and presents the findings during a resident meeting, which is also attended by the Program Director and the Associate Director. The Director of Anatomic Pathology also reviews the QA data as one of the important parts of our departmental QA program. The residents, Program Director, and Associate Director analyze the data and compare the current data to the previous quarters' QA data to track performance.
Results: Analysis of the data showed several interesting observations. There was no significant difference in the total error rate across different post-graduate levels. However, as expected, specific errors like processing errors were represented more in the junior residents. Also, the average error rate per resident/quarter (number of errors per resident/quarter) was observed to be lower as compared to the error rate of Pathology Assistants (3.9 vs. 7.6). In addition, since the inception of this program, specific pre-analytical errors that could seriously impact patient care such as wrong surgical numbers, wrong cassette codes and wrong patient initials were dramatically reduced. Specifically, the number of cases with wrong surgical numbers dropped from 22/quarter (May2008-May2009) to 7/quarter (January to April 2010).
Conclusions: The UMass resident QA process has created a good opportunity for residents to identify their errors when grossing and processing specimens. As a result, the number of both minor and egregious mistakes, e.g. not detecting mislabeled specimens, has been significantly reduced. Resident QA is an excellent learning and self improving activity for our residency training program.
Category: Quality Assurance
Tuesday, March 1, 2011 11:15 AM
Platform Session: Section H 2, Tuesday Morning