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Title: Improving lead time in CVC frozen section practice (author: Jeffrey Myers)

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Title: Improving lead time in CVC frozen section practice (author: Jeffrey Myers). Goal : To improve TAT for frozen sections so that, all cases are reported in ≤ 20 minutes with a mean TAT of 15 minutes or less.

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Title: Improving lead time in CVC frozen section practice (author: Jeffrey Myers)

  • Goal: To improve TAT for frozen sections so that,
  • all cases are reported in ≤ 20 minutes with a
  • mean TAT of 15 minutes or less

Background: Thoracic surgery cases occasionally require frozen section support for intraoperative decision making. A small laboratory with frozen section capability is staffed by a single medical technologist or histotechnologist and supported by either a Room 1 resident (8:00 am to 12:00 am) or the Room 1 fellow (12:00 – 6:00 pm) and a scheduled faculty member. After 5:00 pm frozen section requests are supported by the on-call residents and fellow/attending.

Analysis/root cause:

Travel and grossing times highly variable

  • Investigation/current state:
  • Workload for this rotation is highly variable, with a mean of 130 frozen section slides/month JAN-APR2008 and a range of 73 (FEB) to 216 (MAR)
  • Variability in travel and grossing time multifactorial
  • Competing priorities for trainees and faculty
    • Rm 1 grossing a particular challenge for residents
  • Lack of commitment to viewing this as both urgent and important
  • Lack of standard work for specimen grossing

turnaround time (TAT), measured from time of specimen receipt to first contact with OR, is drifting upward, with 36% of cases exceeding current CAP expectations of ≤ 20 minutes in the last week of April

travel + grossing time account for > 60% of the lead time