| Inter-Institutional Comparison of Frozen Section Turnaround Time | |
| RATIONALE: CAP Laboratory Accreditation Program Inspection Checklist (1994) Question 08.1170
“the critical interval for preparing and having frozen sections ready for review as 15 minutes, measured from the time the specimen is received by the pathologist to the time the slide is available for interpretation” |
RESULTS:Laboratory Practices of Participating Institutions Laboratory Practice % of Institutions <300 Beds >300 Beds Schedule FS N=506 N=148 Yes 68 57 No 32 43 Call FS from: N=502 N=148 OR, Other 96 97 Specimen arrives 4 3 Call FS to: N=503 N=146 Path Dept, Lab, 66 70 Pathologist/ staff 34 30 |
| OBJECTIVESMeasure intra-operative frozen section turnaround time
Examine practice variables that influence frozen section turnaround time. |
RESULTSLaboratory Practices of Participating Institutions Laboratoary Practice % of Institutions
<300 Beds 300 Beds Staffing (>1 resp.) N=507 N=148 Full time 91 100 Part time, Other 18 7 FS technical staff 34 30 Monitor FS TAT N=508 N=147 Yes 20 25 No 80 75 Cryoat temp alarm N=504 N=148 Yes 21 31 No 79 69 |
| MAIN OUTCOME MEASURES
Individual Benchmark –Aggregate 90% FS (receipt to report) block completion time Institutional Benchmark — Percentage of outlier FS block TATs |
RESULTS Demographic Characteristics of Participating InstitutionsDemographic Characteristic % of Institutions
<300 Beds >300 Beds Hospital location City 50 87 Suburban, Rural 50 13 Institution type Private, nonprofit 68 57 Priv. profit, Gov’t 32 43 Teaching program 16 75 JCAHO accred. 79 69 CAP accreditation 78 77 |
| STUDY DESIGNProspective FS TAT / 4 months
30 inpatient cases / 4 specimens/case Questionnaires profiling FS practice characteristics |
RESULTS Frozen Section Block Turnaround Time Performance by Individual Pathologists (Minutes) Expressed in Percentiles N=32,868 FS Blocks
10th 25th 50th 75th 90th 4 7 10 15 20 |
| STUDY DESIGN — (Aggregate data) Record for each case: Turnaround time Number of blocks
Reason for FS request Tissue type Ancillary procedures Technical problems #/type personnel preparing FS Wait for the tissue # pathologists examining FS Simultaneous FS |
RESULTS: Frozen Section 90% Block Turnaround Time Performance by Institutions (minutes) Expressed in Percentiles Percentiles
Bed Size N 10th 25th 50t 75th 90th <150 305 12 15 17 21 25 151-300 201 12 15 18 21 26 >300 147 13 15 20 24 30 All 695 12 15 18 22 26 |
| PARTICIPANTS: 700 institutions: North America (667), Australia (12), New Zealand (1), United Kingdom (3), Hong Kong (1), Mexico (1),Norway (1) | RESULTS: Percent of OutliersAggregate 8.3%
Institutional 30% |
| STUDY DESIGN — Institutional DataDemographics Surg. path./FS case volumes
Staffing levels FS scheduling FS communication Travel time to FS area Cryostat features FS TAT goals Freezing & staining techniques |
RESULTS Percent of FS Block Turnaround Time Outliers Expressed in Percentiles Bed Size Percentiles
10th 90th <300 0 % 20% >300 0 % 26% |