I have recently developed an interest in lab analytic software and have posted several notes focusing on LIS add-on systems that can be used to improve lab quality, outreach, and workflow in anatomic and clinical pathology (see: Lab Analytics Emerges as Hot Area for Software Development; Leveraging Lab Analytic Data to Include Actionable Details to Improve Quality). For this note, I would like to focus on how lab analytic software can be used to monitor anatomic pathology workflow and operations. For some examples of common AP dashboard metrics, I turned to the Viewics web site listing examples of their anatomic pathology solutions (see: Anatomic Pathology Solutions). Copied from it, here is a list of the out-of-the box analytics offered by the company in this area:
Turnaround Time: Quick Identification and Drill-Down into AP TAT Outliers
Workload Detail: AP Workload in Detail by any Part Type, Location, Priority, etc.
Productivity and Staffing Analyses: Pathologist and Technologist Productivity
Specimen Monitoring: Detailed Breakdown to Identify AP Process Bottlenecks
Overdue Lists: Automated Workdrivers for Pathologists Prioritizing Cases
Grossing Statistics: Daily Accessioned vs Grossed AP Data
Histology Processing: Blocks Processed, Embedded and Cut Volume Data
Cytology Statistics: Cytology Accessioned vs Reviewed Variance Dashboard
Accession vs. Sign Out: Accession vs. Sign Out Activity and Delinquency
When I began to work in pathology, surgical pathology was largely non-automated and viewed as more of an "art" than a science. Clinical pathology (CP), even several decades ago, was highly automated. LIS support for CP was critical and, even then, there were LIS modules designed to periodically generate CP lab management reports such as test turnaround time (TAT). Work flow analysis in surgical pathology was not a common topic of conversation but slide quality issues pertaining to staining and mounting of thin sections have always been a source of concern. It's reassuring that pathologists and the managers of surgical pathology labs can now easily monitor the metrics shown above on their AP dashboard. It's a great start. I can't see how a lab could manage without access to such data.
I need to think more about this but the above list of AP metrics seems to address several kinds of problems. First of all, there are metrics that would identify cases that may be sitting on the desk of a pathologist waiting for special stains (e.g., overdue lists). Secondly, there are workflow problems that can be ameliorated by process changes, new equipment, or the reassignment of personnel (e.g., AP process bottlenecks). Finally, there are personnel productivity issues that may be related to the skill or diligence of personnel (e.g., AP TAT outliers; pathologist overdue lists). I need to give some more thought to how these AP metrics can be translated into actionable items that can then be used to increase the efficiency and effectiveness of a surgical pathology lab.