We have just started tracking from order to sign out for frozen sections. (In addition, frozens are tracked from receipt in pathology to sign out using the CAP guidelines).
The trouble with the electronic order (in our institution) is that the OR may place the pathology order in hospital computer system early in the surgery so that the order time that prints on the requisition is substantially different than the actual collect time. We have resolved this by having the OR staff write the actual collect time on the requisition and initial it. This collect time is also noted in the OR documentation notes for the surgery. When OR forgets to note collect time manually on the requisition (and they do), I call back and have them look up and verify the collect time. This was started with the cooperation and support of the OR administration. For the pathology accession staff, this means they can not use the order time that crosses the interface to the LIS (lab computer system) but must enter the handwritten time as noted on the requisition. We have set a goal of 40 minutes from frozen order to sign out. This may be lowered to 30 - 35 minutes depending on how our data looks over several months. Our pathology dept. is located on the first floor and the OR on second floor of same building. As for noting collect times for multiple specimens, same case: We have always required the OR to generate a requisition for each container. The collect time is written on each requisition. This is no different than writing the collect date/time and initials that nursing/phlebotomy does for each tube of blood drawn hospitalwide. Would be interested in hearing from others on how this is handled. Becky Garrison Pathology supervisor Shands Jacksonville Jacksonville, FL 32209 904-24-6237 -----Original Message----- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Della Speranza, Vinnie Sent: Tuesday, June 23, 2009 4:02 PM To: histonet Subject: [Histonet] tracking turnaround time of intraoperative consultations CAP utilizes the term "intraoperative consultation" to describe the utilization of frozen (cryo) sections to provide a rapid diagnosis back to a surgeon in the operating room. The CAP checklist requires a turnaround time of 20 minutes for single specimen submitted for intraoperative consultation. My understanding is that the turnaround time is measured from the time the sample is received in the laboratory until the time the report is issued to the surgeon. Is anyone tracking or measuring turnaround time from the time the consult is "ordered" in/by the Operating Room until the time the result is issued? If so, would you share how you are able to determine the time the "test was ordered" and to what extent you have elicited the cooperation of Operating Room personnel. We receive many complex surgical cases and our intraoperative consults frequently consist of multiple surgical samples from the same patient arriving in the lab at the same time. Our head and neck cases, for example, consist of 6-8 biopsies that are sent to pathology at the same time. In this example, we have no knowledge of which biopsies was excised first or last and because the surgeon chooses to allow multiple samples to accumulate before sending them all off to the lab, it's clear that the true "pre-analytical" time will not be the same for each sample. If you are tracking turnaround from the time of order to the time of result reporting, how are you determining what is an acceptable turnaround time? CAP's standard is the only national standard I am aware of for frozen section turnaround times. Vinnie Della Speranza Manager for Anatomic Pathology Services Medical University of South Carolina 165 Ashley Avenue Suite 309 Charleston, South Carolina 29425 Tel: (843) 792-6353 Fax: (843) 792-8974 _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet