title: Pathology economic model tool: a novel approach to workflow and budget cost analysis in an anatomic pathology laboratory.
abstract: BACKGROUND
  The need for higher efficiency, maximum quality, and faster turnaround time is a continuous focus for anatomic pathology laboratories and drives changes in work scheduling, instrumentation, and management control systems.
  
  
  OBJECTIVE
  To determine the costs of generating routine, special, and immunohistochemical microscopic slides in a large, academic anatomic pathology laboratory using a top-down approach.
  
  
  METHODS
  The Pathology Economic Model Tool was used to analyze workflow processes at The Nebraska Medical Center's anatomic pathology laboratory. Data from the analysis were used to generate complete cost estimates, which included not only materials, consumables, and instrumentation but also specific labor and overhead components for each of the laboratory's subareas. The cost data generated by the Pathology Economic Model Tool were compared with the cost estimates generated using relative value units.
  
  
  RESULTS
  Despite the use of automated systems for different processes, the workflow in the laboratory was found to be relatively labor intensive. The effect of labor and overhead on per-slide costs was significantly underestimated by traditional relative-value unit calculations when compared with the Pathology Economic Model Tool. Specific workflow defects with significant contributions to the cost per slide were identified.
  
  
  CONCLUSIONS
  The cost of providing routine, special, and immunohistochemical slides may be significantly underestimated by traditional methods that rely on relative value units. Furthermore, a comprehensive analysis may identify specific workflow processes requiring improvement.
authors.affiliation: Department of Pathology and Microbiology, The Nebraska Medical Center, Omaha, USA.
authors.forename: David
authors.initials: D
authors.lastname: Muirhead
authors.forename: Patricia
authors.initials: P
authors.lastname: Aoun
authors.forename: Michael
authors.initials: M
authors.lastname: Powell
authors.forename: Flemming
authors.initials: F
authors.lastname: Juncker
authors.forename: Jens
authors.initials: J
authors.lastname: Mollerup
mesh_terms: D002017:Budgets / Q000379:methods*; D003361:Cost Allocation; D017048:Health Care Costs; D006652:Histological Techniques / Q000191:economics; D006801:Humans; D007150:Immunohistochemistry / Q000191:economics; D018803:Models, Economic; D010340:Pathology, Surgical / Q000191:economics*; D057188:Workflow