Chih-En Tseng a, b, Chin-Lon Lin b, c, Shi-Shie Huang d, Kuan-Chung Lin d, Shu-Mei Chang a, Sou-Hsin Chien b, e
aDepartment of Anatomic Pathology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
bSchool of Medicine, Tzu Chi University, Hualien, Taiwan
cDepartment of Cardiology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
dDepartment of Information Services, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
eDepartment of Plastic Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
Abstract
Objective
To explore the feasibility of computer-aided monitoring of surgical pathology workflow.
Materials and Methods
We analyzed the four subprocesses in the surgical pathologic process: (1) arranging surgical pathology examination to receipt of the examination sheet and sample by the laboratory; (2) receipt of the sample to issuance of the pathology report; (3) issuance of the pathology report to automatic forwarding of positive pathology reports by e-mail to the physician; (4) receipt of the positive report to physician response acknowledging receipt.
Results
About 99.2% of the 20,287 samples arrived at the surgical pathology laboratory within 1 work day after the examination was ordered. The pathological report was finished within 1, 2, 3, and 4 work days in 48.7%, 86.4%, 95.8%, and 98.1% of cases, respectively, and was overdue (over 4 working days) in 1.9% of cases. The two main reasons for overdue reports were decalcification of bone samples (41.7%) and complex processing of samples (37.1%). There were 2239 (11%) positive pathological reports that required automatic computer forwarding; the highest percentage (84.3%) of these was reports of malignancies. Automatic computer forwarding succeeded in 99.6% of cases. Physicians replied to confirm receipt of positive reports within 24 and 120 hours after receipt in 52.4% and 83.6% of cases, respectively.
Conclusion
The use of the computer to monitor surgical pathology work-flow is feasible. This method can be used for quality assurance in surgical pathology workflow.
Keywords
Computer-aided monitor; Quality assurance; Surgical pathology; Workflow
