CONTEXT: The effectiveness of the long-term monitoring of errors detected by frozen section-permanent section correlation is unknown. OBJECTIVE: To determine factors important in laboratory improvement in frozen section-permanent section discordant and deferral rates by participation in a multi-institutional continuous quality improvement program. DESIGN: Participants in the College of American Pathologists Q-Tracks program self-reported the number of anatomic pathology frozen-permanent section discordant and deferred cases in their laboratories by prospectively performing secondary review of intraoperative consultations. Laboratories participated in the program for 1 to 5 years and reported their data every quarter. We calculated mean and median discordant and deferred case frequencies and used mixed linear modeling to determine if length of participation in the program was associated with improved performance. PARTICIPANTS: One hundred seventy-four laboratories self-reported data. MAIN OUTCOME MEASURES: Mean frozen-permanent section discordant and deferred diagnostic frequencies and changes in these frequencies over time were measured. RESULTS: The mean and median frozen-permanent section discordant frequencies were 1.36% and 0.70%, respectively. The mean and median deferred diagnostic frequencies were 2.35% and 1.20%, respectively. Longer participation in the Q-Tracks program was significantly associated (P = .04) with lower discordant frequencies; 4- or 5-year participation showed a decrease in discordant frequency of 0.99%, whereas 1-year participation showed a decrease in discordant frequency of 0.84%. Longer participation in the Q-Tracks monitor was associated with lower microscopic sampling frequencies for discordant diagnoses (P = .04). Increased length of participation in the Q-Tracks program was significantly associated (P = .04) with lower deferred diagnostic frequencies. CONCLUSIONS: Long-term monitoring of frozen-permanent section correlation is associated with sustained improvement in performance.
CONTEXT: The effectiveness of the long-term monitoring of errors detected by frozen section-permanent section correlation is unknown. OBJECTIVE: To determine factors important in laboratory improvement in frozen section-permanent section discordant and deferral rates by participation in a multi-institutional continuous quality improvement program. DESIGN:Participants in the College of American Pathologists Q-Tracks program self-reported the number of anatomic pathology frozen-permanent section discordant and deferred cases in their laboratories by prospectively performing secondary review of intraoperative consultations. Laboratories participated in the program for 1 to 5 years and reported their data every quarter. We calculated mean and median discordant and deferred case frequencies and used mixed linear modeling to determine if length of participation in the program was associated with improved performance. PARTICIPANTS: One hundred seventy-four laboratories self-reported data. MAIN OUTCOME MEASURES: Mean frozen-permanent section discordant and deferred diagnostic frequencies and changes in these frequencies over time were measured. RESULTS: The mean and median frozen-permanent section discordant frequencies were 1.36% and 0.70%, respectively. The mean and median deferred diagnostic frequencies were 2.35% and 1.20%, respectively. Longer participation in the Q-Tracks program was significantly associated (P = .04) with lower discordant frequencies; 4- or 5-year participation showed a decrease in discordant frequency of 0.99%, whereas 1-year participation showed a decrease in discordant frequency of 0.84%. Longer participation in the Q-Tracks monitor was associated with lower microscopic sampling frequencies for discordant diagnoses (P = .04). Increased length of participation in the Q-Tracks program was significantly associated (P = .04) with lower deferred diagnostic frequencies. CONCLUSIONS: Long-term monitoring of frozen-permanent section correlation is associated with sustained improvement in performance.
Authors: John C McAuliffe; Laura H Tang; Kambiz Kamrani; Kelly Olino; David S Klimstra; Murray F Brennan; Daniel G Coit Journal: JAMA Surg Date: 2019-02-01 Impact factor: 14.766