Efficiency and Quality in Pathology Slide Tracking
Erin Grimm MD; University of Washington Medical Center; Phil Nguyen ; University of Washington Medical Center; Rosy Changchien ; University of Washington Medical Center; Rodney A. Schmidt MD; University of Washington Medical Center;
Content:
Workflow in anatomic pathology is driven by movement of microscopic slides. Processes that are particularly sensitive to this include initial diagnostic interpretation and retrieval of slides for conference or send-out purposes. Laboratories traditionally expend significant manual resources tracking workload and slide delivery. One method to improve operational efficiency is to bar-code each slide, then record locations and drive workflow by scanning slides throughout their life cycle. We have developed a system that is tightly integrated to our AP-LIS (PowerPath) and have quantified the resulting benefits.
Technology:
Microscopic slide labels were modified to include 2D Datamatrix bar-codes with a unique identifying number for each slide. Custom software was written in C#.Net to capture scanning events and locations and to interact with PowerPaths SQL database to drive various workflow processes.
Design:
Major design goals were to make the last-scanned location of all slides visible to all PowerPath users, to track shipments of slides between locations, and to improve the efficiency of technical work by automating PowerPath processes. Functional requirements were developed through close interaction with users. Software was written and iteratively tested, then user benefit was assessed via interviews with supervisors and staff, both technical and clerical.
Results:
Modules were written specific to workflow in the histology lab, mailboxes/delivery, and slide storage room. In each, every scanning event is recorded and the location of each individual slide is continuously updated on the Notes tab in PowerPath. Current location information decreased search time for conference slides by at least 0.5 FTE and reduced histology time spent searching for mis-delivered slides by at least 0.5 FTE. The histology module automatically completes all outstanding orders related to each slide when the slide is scanned, thus saving an additional 0.5 FTE. The slide tracking system gives much tighter control over assets and permits us to collect quantitative data about the time slides spend in different locations.
Conclusion:
Precise knowledge of the location of slides greatly improves operational efficiency. Our custom slide-tracking software decreases direct and indirect costs to our department while streamlining workflow and decreasing the potential for error. Additionally, the bar code model can be extended to other elements of the surgical case, such as gross specimens and case related paperwork, allowing potential for even greater improvements in workflow. Traditional workflow can be substantially improved through the use of technology.
