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
Hauptverfasser: Ababneh, E, Dermawan, J, Thomas, M, Wang, X, Blank, A, Bakhshwin, A, Terzioglu, M, Miller, B, Shah, A, Griffith, C, Chute, D
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container_end_page S125
container_issue Supplement_1
container_start_page S125
container_title American journal of clinical pathology
container_volume 154
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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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. 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing &amp; 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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subjects Histology
Hyphae
Sinusitis
title Optimizing the Handling of Invasive Fungal Sinusitis Surgical Specimens
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