The value of monitoring frozen section-permanent section correlation data over time.
BACKGROUND
The effectiveness of the long-term monitoring of errors detected by frozen section-permanent section correlation is unknown.


OBJECTIVE
To determine factors important in laboratory improvement in frozen section-permanent section discordant and deferral rates by participation in a multi-institutional continuous quality improvement program.


METHODS
Participants in the College of American Pathologists Q-Tracks program self-reported the number of anatomic pathology frozen-permanent section discordant and deferred cases in their laboratories by prospectively performing secondary review of intraoperative consultations. Laboratories participated in the program for 1 to 5 years and reported their data every quarter. We calculated mean and median discordant and deferred case frequencies and used mixed linear modeling to determine if length of participation in the program was associated with improved performance.


METHODS
One hundred seventy-four laboratories self-reported data.


METHODS
Mean frozen-permanent section discordant and deferred diagnostic frequencies and changes in these frequencies over time were measured.


RESULTS
The mean and median frozen-permanent section discordant frequencies were 1.36% and 0.70%, respectively. The mean and median deferred diagnostic frequencies were 2.35% and 1.20%, respectively. Longer participation in the Q-Tracks program was significantly associated (P = .04) with lower discordant frequencies; 4- or 5-year participation showed a decrease in discordant frequency of 0.99%, whereas 1-year participation showed a decrease in discordant frequency of 0.84%. Longer participation in the Q-Tracks monitor was associated with lower microscopic sampling frequencies for discordant diagnoses (P = .04). Increased length of participation in the Q-Tracks program was significantly associated (P = .04) with lower deferred diagnostic frequencies.


CONCLUSIONS
Long-term monitoring of frozen-permanent section correlation is associated with sustained improvement in performance.
Raab
Stephen S
SS
Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15232, USA. raabss@upmc.edu
Tworek
Joseph A
JA
Souers
Rhona
R
Zarbo
Richard J
RJ
D003951:Diagnostic Errors / Q000517:prevention & control*; D005629:Frozen Sections; D006761:Hospitals; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D010340:Pathology, Surgical / Q000193:education / Q000379:methods* / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D011786:Quality Control; D014481:United States