Frozen Section Quality Assurance: Using Separate Frozen Section Slide Preparation Times and Interpretative Time Measurements to Improve Process

Objectives: Composite frozen section turnaround time has limited value, precluding assessment of certain processes: slide preparation (technical) and diagnosis (interpretation). We examined whether measuring these elements could identify delays, hypothesizing that longer times were related to (1) inefficient technical processes and (2) case-specific diagnostic challenges. Methods: Technical and interpretive times were determined for 1,992 specimens submitted for frozen section in 2017; the data were sorted by surgical specialty. Mean and quartile times were determined for each category with all specimens assessed equally, including those with multiple frozen section blocks. Results: Technical times were significantly longer than interpretive times. Specialty grouping facilitated trend identification and enabled assessment of technical and interpretation challenges. We identified technical issues with certain gross specimens involving overdissection and interpretation delays for specific neoplasms and margins. Conclusions: Measuring technical and interpretative times and subcategorizing by specialty has aided the assessment of frozen section processing in our laboratory, enabling case isolation for process improvement. Key Words: Frozen section; Turnaround time; Quality improvement