'Dot the Form' – An Easy Way To Improve Inpatient Biopsy Turnaround Time
Xueli Hao, Mary Abbuhl, Joseph E Willis. University Hospitals Case Medical Center, Cleveland, OH; Case Western Reserve University, Cleveland, OH
Background: Inpatients have higher acuity illnesses for which rapid diagnoses are often imperative. Surgical pathology biopsies are often integral to this process in either the initiation or continuation [or withdrawal] of therapies. Efficient turnaround times (TAT) of biopsies is particularly important for meeting the needs of these patients in a timely manner. This study investigated whether a simple change to specimen processing would improve inpatient biopsy TATs in a busy academic medical center.
Design: All inpatient biopsies were identified at accessioning and the requisition annotated with a simple decal. In the histology lab, all requisitions with decals were identified and a second decal was placed on the specimen working draft. This allowed for the ready identification of inpatient biopsies by residents and staff. These cases received first priority for sign out throughout the day. This laboratory had previously implemented continuous flow specimen processing. TATs from date of accession to date of sign-out for all inpatient biopsies for two six month periods were calculated. 676 inpatient GI biopsy specimens from January to June of 2012 were prioritized using the above method. TAT time was compared to that of 792 inpatient GI biopsy specimens from January to June of 2010 signed out without prioritization. Data were analyzed using one sided T test.
Results: Average TAT improved for all routine and complex GI inpatient biopsies by 13% from an average of 3.4 days in 2010 to 3 days in 2012 (p= 0.02). For all routine inpatient GI biopsies, average TAT improved by 14% from 2.2 days in 2010 to 1.9 days in 2012 (p= 0.01). There was no statistical difference of TAT between 2010 and 2012 for complex inpatient biopsies (2.8 days versus 3 days, p=0.13).
Conclusions: A simple prioritization technique significantly improved all inpatient biopsy TATs allowing for early reporting of patient results. Given the complex variables involved, it is difficult to quantify the effects of improved inpatient biopsy TAT on overall patient stay. However since daily inpatient hospital stay costs in the US range from approx. $2700 to $4500 any process that improves inpatient biopsy TAT is likely to have significant cost savings. Institution of a simple triage and prioritization process for inpatient biopsies could potentially impact large numbers of patients and save significant healthcare resources without imposing any increased burden to Pathology Departments.
Category: Quality Assurance
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 253, Tuesday Morning