Histology Workflow Annamarie Dockery Christopher Scano Craig Dise MD Joe Immordino

1. Histology Workflow Annamarie Dockery Christopher Scano Craig Dise MD Joe Immordino Marilyn Ilvento Michael Overa Nancy Mitchell Ron Delacruz Veronica Fraser 99 Beauvoir Avenue Summit, NJ 07901 (T) 908-522-2194 (F) 908-522-2320 • Abstract • Goals: • Decrease the time it takes to process pathology slides • Increase our Z score to at least 3.38 • Reduce our DPMO to 30,396 • Reduce average time to slide availability to 120 minutes from the current 232 minutes • Create continuous flow processing • Implement rapid tissue processor • Reduce overtime • Methodologies utilized: • Six Sigma • We implemented changes in 2 phases • Phase 2 included the addition of the rapid tissue processor • Our process capability improved dramatically. • We reduced the number of defects by 67% • Results/Changes • Adjusted staff schedules • Reallocated tasks • Reorganized tech workflow to accommodate new rapid tissue processor • Reorganized case priority • Utilize partially full racks • Added a third shift • Adjusted Transcription and Pathology Assistant hours • Increased process batches from one to four per day • The overnight run has a larger volume and consists of mostly major • specimens versus biopsies. • Decreased utilization of xylene, alcohol and paraffin • Decrease in Overtime • Decreased turn around time from 232 minutes to an average of 117 minutes. • Since results are available within the same day the specimen is received, • physicians can make same • day diagnosis. • Reduced the total number of steps to process slides. (red steps were eliminated) • Instead of one batch overnight. Slides are processed continuously throughout the day. • Introduction • Project Objective: To create a continuous flow process • to improve overall turn around time, patient care, and • physician and patient satisfaction. • Problems/Opportunities • The single batch overnight process ran approximately 12 hours and did not include the final phase of slide preparation for pathology review • Pathologists and physicians are unable to make a diagnosis and treat the patient in a timely manner due to the delays and turn around time of the current process • Improve efficiency and increase employee satisfaction • Current process and turn around time differs dramatically at the two hospitals. Standardize processes and decrease turn around time • Average turn around time was 232 minutes • Standard deviation was 44 minutes • DPMO was 986,257 • Z score was 0 • Conclusion • Staff is empowered • Processing time has decreased • Increased efficiency • Overtime has decreased