[2031] Institution of 24 Hour Histology Processing and the Impact on Turn-around-Time

Luke T Wiehagen, Rachel D Wall, Susan M Kelly, Samuel A Yousem, Anthony L Piccoli, Anthony A Green, Anil V Parwani, Liron Pantanowitz, Sarah Navina. UPMC Presbyterian Shadyside, Pittsburgh, PA

Background: Expeditious processing of pathologic specimens, to make slides available in a timely manner for pathologist review, enables the pathologist to render diagnosis in a timely manner for patient care. This dramatically decreases the time it takes for clinicians to begin treatment of patients. This project describes the effects of moving to a 24 hour work cycle in our institute's Histology Laboratory. It compares similar time periods pre and post implementation to gauge effectiveness.
Design: Prior to implementation, the Histology Laboratory operated on a daylight shift and serviced two hospital campuses. Specimens were processed on two runs set up during the day and ran automatically during the night when no staff was on site. During the day, histology staff embedded blocks, made slides and performed stains on the specimens processed the night before. After months of planning, a 24 hour work cycle was implemented and a new workflow was designed. This included two additional work shifts - an evening and night shift. This change allowed continuous specimen processing, embedding, cutting and staining.
Results: The project measured the turnaround time by each bench from accession to sign-out prior to implementation and post implementation as illustrated in Table 1. TAT was significantly reduced in most benches.

Table 1.
Center of Excellence (COE)Pre 24Hr (days)24Hr Process (days)% ChangeAvg. Minutes Saved Per Case
ENT2.912.37-18.52%266.67
GU2.372.7515.76%-226.92
GI - BIGS2.772.64-4.95%71.31
GI - Quicks1.401.38-1.42%20.38
Neuropath2.532.47-2.34%33.63
PUH Cyto1.781.40-21.18%304.99
SHY Cyto1.631.57-3.39%48.82
BST2.242.14-4.59%66.16
Thoracic1.671.46-12.98%186.89
Transplant1.481.35-9.13%131.47
Overall2.031.87-7.93%114.25



Conclusions: There are a litany of variables that can affect TAT within a pathology department that include both professional and technical components. Acknowledging other variables, a 24 hour processing can significantly decrease the TAT of Histology processing, affecting total specimen sign-out TAT Moving to the new processing schedule also allowed for additional capacity within the lab. Since the lab services two campuses, the greater impact was seen on the specimens that remained on the campus which houses the Histology lab.
Category: Quality Assurance

Tuesday, March 5, 2013 9:30 AM

Poster Session III # 254, Tuesday Morning

 

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