Pre-Accessioning in Anatomic Pathology – Utilizing a Cloud-Based Laboratory Information System Reducing Error in Anatomic Pathology and Improving Patient Safety

Abstract

Abstract Introduction/Objective Typical workflow in Anatomic Pathology (AP) starts from accessioning of cases to sign out. Most Laboratory Information System (LIS) follow this cycle of sample tracking. However, at certain times, either samples are not received or get lost in transit without lab being notified. There is a need of pre-accessioning in AP especially for samples received from outpatients’ sites, so labs not only track samples during transit but also reduce typographical errors (name, DOB, Unique ID) and assess workload before arrival. Methods/Case Report From 2020-2022, we initiated e-requisition utilizing online cloud-based portal for submitting AP cases obtained at physician offices, clinics, and outreach satellite sites. Insurance information and clinical history were scanned and uploaded with e-requisition submission. Retrospective analysis was performed, and data was analyzed and compared for errors, QA metrics and workflow analysis on samples obtained with PRE (840 cases) and without pre-accessioning NON-PRE (1280 cases). Results (if a Case Study enter NA) PRE and NON-PRE (handwritten and manual submission) were compared. Results were as follows for PRE vs NON-PRE: 1) Typographical errors (0.1% vs 8%); 2) Insufficient clinical history and ICD-10 (1% vs 9%); 3) Sample types errors (0.2% vs 5%); and 4) Efficient workflow for data entry per case at accessioning (1min vs 4min) Conclusion We demonstrated pre-accessioning feature for AP samples utilizing cloud-based portal of LIS is an important tool that can 1) prevent/reduce laboratory accessioning errors; 2) help labs monitor sample tracking from the time sample is obtained to the time it got accessioned in the lab; 3) help labs improve turn around time in their workflow for quick accessioning and 4) improve patient safety by reducing errors for AP samples; and 5) can be integrated with any clinical electronic medical record.