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GME Quality and Safety Bonus Program

Pathology Quality and Safety Homepage


Resident Champion: Jenna Bodmer, Sterling McLaren, Colleen Klein

Faculty Champion: Miriam Post, MD, Jeffrey Kaplan, MD

Metric: Documentation/Handling of intra-operative path specimens (instead of Urinary Catheter Days All-Program Metric)

At times, surgeons are interested in obtaining an intraoperative preliminary pathological diagnosis to address a significant surgical question. Tissue (often a portion of or an entire organ) is sent to the pathology laboratory. There, the resident must begin to describe its important characteristics, identify the critical portion of the specimen to address the question, and dissect and process that tissue.  The regulated turn-around time (TAT), from tissue arrival time to communicated diagnosis time, is less than 20 minutes. Because of this time constraint, the resident working on the frozen section cannot submit all tissue required for the full pathological diagnosis of the specimen. 

Therefore, the resident who completes the first tissue examination must hand-off specimen information to another resident who will complete the examination, dictation, and submission of tissue. Hand-offs are notorious as major sources of error; this project seeks to standardize these processes to reduce the incidence of errors and confusion that occur. Additionally, we seek to address and minimized the amount of rework time spent (returning to the specimen to reapproximate measurements, etc) when hand-off is inadequate. The process proposed will standardize early tissue examination, which could reduce inter-operator variability, reduce the TAT for frozen section diagnosis, and reduce rework, and improve patient care. We are beginning this process by focusing on Whipple and uterus (hysterectomy) specimens, as these are common and typically more challenging examinations.

Goal:

Tier 1-$175 Less than 40%

Tier 2- $250 Less than 25%


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