1. Define your pathology variances. As a first step, ASCs should define what possible pathology variances could potentially cause a breakdown in the pathology collection process, such as illegible writing on pathology requisitions and missing or incorrect demographics. Lisa Sinsel, RN, quality standards coordinator at Fort Worth (Texas) Endoscopy Center and Southwest Fort Worth Endoscopy Center, says her endoscopy center accomplished this in order to collect the data and evaluate it for trends.
“For example, we could assess if there were any trends by staff member, procedure type, specimen location and so on. That allowed us to focus our plan of correction accordingly,” Ms. Sinsel says. “From there, we provided education to the staff on our findings from the data we collected and then reviewed the most appropriate method to collect pathology.”
2. Create a log to improve tracking of specimens and pathology results. Linda Beaver, RN, MSN, MHA, administrator at Gateway Endoscopy Center in St. Louis, says her endoscopy center created a specimen log, which is kept in each procedure room. The logs, which are printed at the end of each day and kept in a large binder, include patient information, biopsy information, which location of the colon the biopsy was taken and so on.
“This way we can also determine if we haven’t received a specimen back where exactly it is,” Ms. Beaver says. “The log also gives us a way to track if patient data is wrong, like a birthday or name. If there is a positive result for colon cancer, we call the physicians to verify that the results came back positive.”
From: Best Practice: Create Daily Logs to Better Track Specimens and Pathology Results
3. Implement technology and a “time out” for pathology collection. Karen Smith, nursing director at Central Illinois Endoscopy Center in Peoria, Ill., says her ASC installed an electronic medical record to ensure pathology collections were carried out correctly and safely. The EMR system was tailored so that physicians and assisting staff members were all required to “time out” while identifying specimens. This ensures specimens are marked to the correct patient before they are sent to pathology labs for testing.
“We don’t want to make a mistake and label the wrong specimen with a patient’s name, so at the end of the procedure, staff members have to indicate in the EMR that they stopped and acknowledged the correct patient’s identity and birthday to the specimen,” Ms. Smith says. “There was a case at a local hospital where somebody’s name was written on the wrong biopsy which later showed cancer. So that patient, even though they didn’t have cancer, had to undergo surgery for it.”
From: 3 Tips for Using EMRs to Prevent Wrong Procedures for the Wrong Patients
