Optimizing the Handling of Invasive Fungal Sinusitis Surgical Specimens
Abstract Introduction/Objective Invasive fungal sinusitis (IFS) is an aggressive disease characterized by invasion of fungal hyphae into tissue/neurovascular bundles. This project assessed the handling of IFS specimens and implemented protocols to improve turnaround time (TAT). Methods A retrospecti...
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Veröffentlicht in: | American journal of clinical pathology 2020-10, Vol.154 (Supplement_1), p.S125-S125 |
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creator | Ababneh, E Dermawan, J Thomas, M Wang, X Blank, A Bakhshwin, A Terzioglu, M Miller, B Shah, A Griffith, C Chute, D |
description | Abstract
Introduction/Objective
Invasive fungal sinusitis (IFS) is an aggressive disease characterized by invasion of fungal hyphae into tissue/neurovascular bundles. This project assessed the handling of IFS specimens and implemented protocols to improve turnaround time (TAT).
Methods
A retrospective review of cases accessioned with a clinical concern for IFS from 2014-2019 was performed. TAT for each step in the specimen processing was recorded. A flowchart was created using stakeholder interviews and a revised protocol was developed after assessing critical needs. Assessment of interventions was performed following implementation of the new protocol. The protocol will be evaluated by prospective direct case-by-case feedback and after a 6-month interval (projected August/2020). At 6-months, goals are a 24 hours median time between frozen section and sign-out and elimination of outliers (greater than 2 working days).
Results
We identified 53 specimens from 32 patients in the pre-intervention period (36 cases positive for IFS). Median time from frozen section to final sign-out was 28 (5-312) hours. Four areas for improvements were identified:
(1) triaging specimens to different protocols according to arrival time, (2) optimized triaging for available histology processors, (3) standardized GMS ordering, and (4) standardized case delivery/communication with sign-out staff. Interventions include: protocol for processing specimens based on time of day, new histology protocols to expedite GMS performance, an email group for rapid communication with staff pathologists and histology, and a worksheet/checklist to track each case. After implementation of the protocol, 8 cases from 7 patients were received. Median time from frozen section to final sign-out was reduced to 20 (2 – 50) hours.
Conclusion
The protocol for handling IFS specimens became live on 2/1/2020. It has reduced TAT of suspected IFS cases, from a median of 28 hours to 20 hours. The longest interval to sign-out went from312 hours to 50 hours. |
doi_str_mv | 10.1093/ajcp/aqaa161.273 |
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Introduction/Objective
Invasive fungal sinusitis (IFS) is an aggressive disease characterized by invasion of fungal hyphae into tissue/neurovascular bundles. This project assessed the handling of IFS specimens and implemented protocols to improve turnaround time (TAT).
Methods
A retrospective review of cases accessioned with a clinical concern for IFS from 2014-2019 was performed. TAT for each step in the specimen processing was recorded. A flowchart was created using stakeholder interviews and a revised protocol was developed after assessing critical needs. Assessment of interventions was performed following implementation of the new protocol. The protocol will be evaluated by prospective direct case-by-case feedback and after a 6-month interval (projected August/2020). At 6-months, goals are a 24 hours median time between frozen section and sign-out and elimination of outliers (greater than 2 working days).
Results
We identified 53 specimens from 32 patients in the pre-intervention period (36 cases positive for IFS). Median time from frozen section to final sign-out was 28 (5-312) hours. Four areas for improvements were identified:
(1) triaging specimens to different protocols according to arrival time, (2) optimized triaging for available histology processors, (3) standardized GMS ordering, and (4) standardized case delivery/communication with sign-out staff. Interventions include: protocol for processing specimens based on time of day, new histology protocols to expedite GMS performance, an email group for rapid communication with staff pathologists and histology, and a worksheet/checklist to track each case. After implementation of the protocol, 8 cases from 7 patients were received. Median time from frozen section to final sign-out was reduced to 20 (2 – 50) hours.
Conclusion
The protocol for handling IFS specimens became live on 2/1/2020. It has reduced TAT of suspected IFS cases, from a median of 28 hours to 20 hours. The longest interval to sign-out went from312 hours to 50 hours.</description><identifier>ISSN: 0002-9173</identifier><identifier>EISSN: 1943-7722</identifier><identifier>DOI: 10.1093/ajcp/aqaa161.273</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Histology ; Hyphae ; Sinusitis</subject><ispartof>American journal of clinical pathology, 2020-10, Vol.154 (Supplement_1), p.S125-S125</ispartof><rights>American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><rights>American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,27929,27930</link.rule.ids></links><search><creatorcontrib>Ababneh, E</creatorcontrib><creatorcontrib>Dermawan, J</creatorcontrib><creatorcontrib>Thomas, M</creatorcontrib><creatorcontrib>Wang, X</creatorcontrib><creatorcontrib>Blank, A</creatorcontrib><creatorcontrib>Bakhshwin, A</creatorcontrib><creatorcontrib>Terzioglu, M</creatorcontrib><creatorcontrib>Miller, B</creatorcontrib><creatorcontrib>Shah, A</creatorcontrib><creatorcontrib>Griffith, C</creatorcontrib><creatorcontrib>Chute, D</creatorcontrib><title>Optimizing the Handling of Invasive Fungal Sinusitis Surgical Specimens</title><title>American journal of clinical pathology</title><description>Abstract
Introduction/Objective
Invasive fungal sinusitis (IFS) is an aggressive disease characterized by invasion of fungal hyphae into tissue/neurovascular bundles. This project assessed the handling of IFS specimens and implemented protocols to improve turnaround time (TAT).
Methods
A retrospective review of cases accessioned with a clinical concern for IFS from 2014-2019 was performed. TAT for each step in the specimen processing was recorded. A flowchart was created using stakeholder interviews and a revised protocol was developed after assessing critical needs. Assessment of interventions was performed following implementation of the new protocol. The protocol will be evaluated by prospective direct case-by-case feedback and after a 6-month interval (projected August/2020). At 6-months, goals are a 24 hours median time between frozen section and sign-out and elimination of outliers (greater than 2 working days).
Results
We identified 53 specimens from 32 patients in the pre-intervention period (36 cases positive for IFS). Median time from frozen section to final sign-out was 28 (5-312) hours. Four areas for improvements were identified:
(1) triaging specimens to different protocols according to arrival time, (2) optimized triaging for available histology processors, (3) standardized GMS ordering, and (4) standardized case delivery/communication with sign-out staff. Interventions include: protocol for processing specimens based on time of day, new histology protocols to expedite GMS performance, an email group for rapid communication with staff pathologists and histology, and a worksheet/checklist to track each case. After implementation of the protocol, 8 cases from 7 patients were received. Median time from frozen section to final sign-out was reduced to 20 (2 – 50) hours.
Conclusion
The protocol for handling IFS specimens became live on 2/1/2020. It has reduced TAT of suspected IFS cases, from a median of 28 hours to 20 hours. The longest interval to sign-out went from312 hours to 50 hours.</description><subject>Histology</subject><subject>Hyphae</subject><subject>Sinusitis</subject><issn>0002-9173</issn><issn>1943-7722</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkE1Lw0AQhhdRsFbvHgMeJe3sV5I9SrEfUOihel42m0nd0m7SbFLQX9-E9u5peIfnnYGHkFcKEwqKT83e1lNzMoYmdMJSfkdGVAkepylj92QEACxWNOWP5CmEPQBlGYgRWWzq1h3dn_O7qP3BaGl8cRhCVUYrfzbBnTGad35nDtHW-S641oVo2zU7Z4dVjdYd0Ydn8lCaQ8CX2xyT7_nn12wZrzeL1exjHVsKksU5lQUFU-QIMjFZUiqBloncIM-yEgqUmCmJwuSqMLlFKXMuEkU5QCmSHPmYvF3v1k116jC0el91je9faiaBKZGIlPUUXCnbVCE0WOq6cUfT_GoKetClB136pkv3uvrK-7VSdfX_9AUoRG48</recordid><startdate>20201028</startdate><enddate>20201028</enddate><creator>Ababneh, E</creator><creator>Dermawan, J</creator><creator>Thomas, M</creator><creator>Wang, X</creator><creator>Blank, A</creator><creator>Bakhshwin, A</creator><creator>Terzioglu, M</creator><creator>Miller, B</creator><creator>Shah, A</creator><creator>Griffith, C</creator><creator>Chute, D</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20201028</creationdate><title>Optimizing the Handling of Invasive Fungal Sinusitis Surgical Specimens</title><author>Ababneh, E ; Dermawan, J ; Thomas, M ; Wang, X ; Blank, A ; Bakhshwin, A ; Terzioglu, M ; Miller, B ; Shah, A ; Griffith, C ; Chute, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1052-b15d10adbe056a86f94ec24bae388f0de5e895e4ab9dabce55b34691300f46be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Histology</topic><topic>Hyphae</topic><topic>Sinusitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ababneh, E</creatorcontrib><creatorcontrib>Dermawan, J</creatorcontrib><creatorcontrib>Thomas, M</creatorcontrib><creatorcontrib>Wang, X</creatorcontrib><creatorcontrib>Blank, A</creatorcontrib><creatorcontrib>Bakhshwin, A</creatorcontrib><creatorcontrib>Terzioglu, M</creatorcontrib><creatorcontrib>Miller, B</creatorcontrib><creatorcontrib>Shah, A</creatorcontrib><creatorcontrib>Griffith, C</creatorcontrib><creatorcontrib>Chute, D</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>American journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ababneh, E</au><au>Dermawan, J</au><au>Thomas, M</au><au>Wang, X</au><au>Blank, A</au><au>Bakhshwin, A</au><au>Terzioglu, M</au><au>Miller, B</au><au>Shah, A</au><au>Griffith, C</au><au>Chute, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimizing the Handling of Invasive Fungal Sinusitis Surgical Specimens</atitle><jtitle>American journal of clinical pathology</jtitle><date>2020-10-28</date><risdate>2020</risdate><volume>154</volume><issue>Supplement_1</issue><spage>S125</spage><epage>S125</epage><pages>S125-S125</pages><issn>0002-9173</issn><eissn>1943-7722</eissn><abstract>Abstract
Introduction/Objective
Invasive fungal sinusitis (IFS) is an aggressive disease characterized by invasion of fungal hyphae into tissue/neurovascular bundles. This project assessed the handling of IFS specimens and implemented protocols to improve turnaround time (TAT).
Methods
A retrospective review of cases accessioned with a clinical concern for IFS from 2014-2019 was performed. TAT for each step in the specimen processing was recorded. A flowchart was created using stakeholder interviews and a revised protocol was developed after assessing critical needs. Assessment of interventions was performed following implementation of the new protocol. The protocol will be evaluated by prospective direct case-by-case feedback and after a 6-month interval (projected August/2020). At 6-months, goals are a 24 hours median time between frozen section and sign-out and elimination of outliers (greater than 2 working days).
Results
We identified 53 specimens from 32 patients in the pre-intervention period (36 cases positive for IFS). Median time from frozen section to final sign-out was 28 (5-312) hours. Four areas for improvements were identified:
(1) triaging specimens to different protocols according to arrival time, (2) optimized triaging for available histology processors, (3) standardized GMS ordering, and (4) standardized case delivery/communication with sign-out staff. Interventions include: protocol for processing specimens based on time of day, new histology protocols to expedite GMS performance, an email group for rapid communication with staff pathologists and histology, and a worksheet/checklist to track each case. After implementation of the protocol, 8 cases from 7 patients were received. Median time from frozen section to final sign-out was reduced to 20 (2 – 50) hours.
Conclusion
The protocol for handling IFS specimens became live on 2/1/2020. It has reduced TAT of suspected IFS cases, from a median of 28 hours to 20 hours. The longest interval to sign-out went from312 hours to 50 hours.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/ajcp/aqaa161.273</doi></addata></record> |
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source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
subjects | Histology Hyphae Sinusitis |
title | Optimizing the Handling of Invasive Fungal Sinusitis Surgical Specimens |
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