A Proposed Set of Metrics to Reduce Patient Safety Risk From Within the Anatomic Pathology Laboratory.
BACKGROUND
Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk.


METHODS
Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes.


RESULTS
: Our group developed a universal, comprehensive list of 47 metrics for patient specimen handling in the anatomic pathology laboratory. Steps within the specimen workflow sequence are categorized as high or low risk. In general, steps associated with the potential for specimen misidentification correspond to the high-risk grouping and merit greater focus within quality management systems. Primarily workflow measures related to operational efficiency can be considered low risk.


CONCLUSIONS
Our group intends to advance the widespread use of these metrics in anatomic pathology laboratories to reduce patient safety risk and improve patient care with development of best practices and interlaboratory error reporting programs.
Medical Affairs, Ventana Medical Systems Inc., Tucson, AZ.
Peter
P
Banks
Laboratory Services, Memorial Hermann Southeast Hospital, Houston, TX.
Richard
R
Brown
Department of Laboratory Medicine, Monash Medical Centre, Clayton, Victoria, Australia.
Alex
A
Laslowski
Department of Pathology, East Carolina University, Greenville, NC.
Yvonne
Y
Daniels
Biorepositories and Biospecimens Research Branch, Cancer Diagnosis Program, National Institutes of Health, Bethesda, MD.
Phil
P
Branton
Division of Pathology, Puget Sound Gastroenterology Medical Center, Lynnwood, WA.
John
J
Carpenter
Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI.
Richard
R
Zarbo
Department of Pathology, Universitair Ziekenhuis Brussels, Brussels, Belgium.
Ramses
R
Forsyth
Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Science Guangdong Province, China.
Yan-Hui
YH
Liu
Anatomic & Clinical Pathology, Nebraska Methodist Health System, Inc, Omaha, NE.
Shane
S
Kohl
Leiter Departement Institute, Luzerner Kantonsspital, Lucerne, Switzerland.
Joachim
J
Diebold
Department of Pathology, Nihon University School of Medicine, Tokyo, Japan.
Shinobu
S
Masuda
Operations Division, Mayo Clinic, Mayo College of Medicine, Rochester, MN.
Tim
T
Plummer
Medical Affairs, Ventana Medical Systems Inc., Tucson, AZ.
Eslie
E
Dennis
D006801:Humans; D007753:Laboratories / Q000592:standards*; D010338:Pathology, Clinical / Q000592:standards*; D061214:Patient Safety; D011785:Quality Assurance, Health Care / Q000592:standards*
anatomic pathology; best practices; patient safety; workflow metrics