Leveraging preprocessor scanning to improve safety, quality, and lean workflow in the anatomic pathology lab.

Authors: Lilly Guevara, Kristie Wolfe-Steele, Brian Johnson

While procedures exist in AP laboratories to protect patient samples and prevent loss through specimen tracking, misplaced cassettes between grossing and tissue processing are still problematic. Significant time may be spent locating a misplaced cassette in this part of the workflow. Pathologists Bio-Medical (PBM) Pathgroup implemented a new system to address this need for preprocessing sample tracking in their AP workflow. PBM worked to create their own solution for tracking AP samples. This included the use of barcodes, scanners, and high-resolution cameras to track samples throughout the lab. It was a time consuming and costly effort pursued over the course of years. However, visibility in the pre-processing workflow was still problematic. In some instances, cassettes scanned at grossing were not used at all, or a cassette was inadvertently returned to the specimen container. In order to truly advance patient safety, improve quality, and optimize lean workflow, this needed to be addressed. In March 2023, PBM implemented a system that automated data capture for cassettes at preprocessing. This resulted in a reduction in time associated with reconciling misplaced/missing cassettes from grossing to embedding: from as long as a few days to as short as a couple hours. Another benefit of the new system was tracking cassettes by processor retort. This is especially important for laboratories that have multiple dual retort processors supporting various tissue types. In the past, lab staff spent significant time solving processing quality issues and identifying which cassettes were loaded on which processor(s). The new system software enables full reporting of this information. This system has provided a quick method to investigate processing errors with various specimen types. These changes created a more efficient laboratory, reduced stress for staff, and enhanced turnaround times.