[2029] Turnaround Time for Large or Complex Specimens in Surgical Pathology: A Q-Probes Study of 56 Institutions

Keith E Volmar, Michael O Idowu, Donald S Karcher, Raouf E Nakhleh. Rex Pathology Associates, Raleigh, NC; Virginia Commonwealth University, Richmond, VA; George Washington University Medical Center, Washington, DC; Mayo Clinic, Jacksonville, FL

Background: Turnaround time (TAT) for large or complex surgical pathology specimens is an indicator of efficiency in anatomic pathology and may affect coordination of patient care. This study aimed to develop benchmarks for TAT of these cases and to identify practice characteristics that may influence TAT.
Design: Participants in a 2012 Q-Probes quality improvement program of the College of American Pathologists were asked to retrospectively review all surgical pathology cases over the prior six months to identify up to 50 cases coded as CPT code 88307 (excluding biopsies) and/or 88309. Participants reported the times and dates of accessioning and final report sign out.
Results: 56 institutions reported on 2,763 large or complex cases. The case mix was 70% CPT code 88307 and 30% CPT code 88309. Cases requiring special handling comprised 51.5%, while 48.5% were characterized as routine. Actual TAT (not working days) was calculated from reported dates and times of accessioning and final sign out. For all cases the median turnaround time was 3.02 days. TATs by institutions and by case type are included in the table below.

Turnaround Time for Large or Complex Surgical Pathology Cases (in actual days)
 10th percentile50th percentile90th percentile
Institutional TAT6.232.721.22
Routine handling cases5.991.940.98
Special handling cases9.114.131.33

Significantly longer TAT occurred in governmental institutions (median 6.06 vs 2.13, P<.001) and in institutions that mandate overnight fixation for some specimen types (median 3.83 vs 2.07, P=.03). Case characteristics associated with significantly longer TAT were as follows: CPT code 88309 vs 88307 (median 3.99 vs 2.82, P<.001), special handling (median 4.13 vs 1.94, P<.001), cases with frozen section (median 3.38 vs 2.92, P<.001), radical cancer resection vs other resection types (P<.001), and malignant vs non-malignant cases (P<.001). The most common forms of special handling were extended fixation (27.7%) and use of immunohistochemistry (27.6%). TAT was not significantly affected by either training programs or routine weekend sign out.
Conclusions: This study provides benchmark data for TAT in large or complex surgical pathology specimens. Turnaround time was good overall but the range among participating institutions was wide.
Category: Quality Assurance

Tuesday, March 5, 2013 9:30 AM

Poster Session III # 251, Tuesday Morning


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