title: Low-cost workflow improvement reduces gastrointestinal block use 17% by altering classic histotechnology testing.
abstract: OBJECTIVE
  Gastrointestinal (GI) biopsy specimens were previously limited to four per cassette to facilitate established internal technical work practices and histotechnology best practice guidelines. We evaluated the workflow of these biopsy specimens.
  
  
  METHODS
  We implemented three specific changes: (1) up to 10 GI biopsy specimens could be placed in each cassette, (2) histotechnologists would no longer orient GI biopsy specimens, and (3) embedding would be in a straight line rather than diagonal. We evaluated the effects of these changes on total block numbers, quality of slides, and perceptions of staff.
  
  
  RESULTS
  The mean number of cassettes used was reduced 17% for GI biopsy cases, or an overall decrease of 3% of total blocks processed by our histopathology laboratory. Slide quality was unchanged. Staff reported increased job satisfaction.
  
  
  CONCLUSIONS
  This simple, low-cost, low-effort process change yielded immediate and significant time savings for grossing and histology staff, increased job satisfaction, and challenges conventional histotechnology teaching.
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Bryan
authors.initials: B
authors.lastname: Steussy
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Michael
authors.initials: M
authors.lastname: Gailey
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Kent
authors.initials: K
authors.lastname: Becker
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Emily
authors.initials: E
authors.lastname: Fuller
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Melissa
authors.initials: M
authors.lastname: Jans
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Sue
authors.initials: S
authors.lastname: Lewis
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Leana
authors.initials: L
authors.lastname: Guerin
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kirby
authors.affiliation: From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City. robert-a-robinson@uiowa.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Robinson
mesh_terms: D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D016591:Histocytological Preparation Techniques / Q000191:economics* / Q000379:methods*; D006801:Humans; D007588:Job Satisfaction; D010340:Pathology, Surgical / Q000191:economics* / Q000379:methods*; D013997:Time Factors; D057188:Workflow
keywords: Biopsies; Cassette volume; Embedding; Histology; LEAN; Microtomy; Process improvement; Productivity