East Kent Hospitals University NHS Foundation Trust is one of the UK‘s largest NHS Hospital Trusts, serving a population of 759,000 comprising five hospital sites. The Cellular Pathology department provides a centralised service for the population of East Kent in the UK, located at the William Harvey Hospital, Ashford.
Prior to CEREBRO specimen tracking technology introduction, we were reliant upon a combination of laboratory information system (LIS)-generated and manual data collection throughout the workflow, which was often incomplete or missing and of unreliable quality, making workflow analysis difficult and often of limited value. After an initial six-month pilot in 2013 with the Leica Biosystems CEREBRO specimen tracking solution, we fully implemented CEREBRO in the summer of 2014. The CEREBRO pilot had proven it was able to significantly improve patient safety and facilitate the management of the workflow with effective monitoring of each part of the process. Our experience pre-CEREBRO had found that the majority of errors occur in the preanalytical phase, such as accessioning, grossing, embedding, microtomy and case assembly. Such errors occurred in approximately 0.25 percent of cases. CEREBRO provides a robust system that tracks and verifies the identity of every specimen at every point of the workflow. Six months into the full implementation, the preanalytical mislabelling errors have already reduced to 0.12 percent. CEREBRO specimen tracking has clear patient safety advantages. The ability to scan a barcode and feel confident that identifiers are being compared and matched throughout the process significantly reducing the need for ‘eyeball’ checking and the subsequent impact on ensuring the correct specimen is for the correct patient. In addition to patient safety, CEREBRO offers the ability to monitor quality by attaching a note to an individual specimen, cassette or slide at any step of the process. In East Kent we are developing key quality indicators to monitor processes within the laboratory using the audit trail of notes posted. Using CEREBRO’s ability to date and time stamp every part of the process and identify the client and individual user it is possible to record and therefore count per individual the various quality issues identified. Efficiency is also enhanced by CEREBRO’s ability to produce exception reports that can list specimens that are going to breach set turnaround times at different stages of the process. CEREBRO specimen tracking has provided assurances of enhanced patient safety compared with previous manual systems as well as releasing some efficiency throughout the process flow. This provides a high level of confidence that the slides the pathologists are reporting and requesting extra tests on are for the correct patient.
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