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Wrong Tissue in Block.

Kaitlin D Weaver1, Yanel De Los Santos1, Maira Gaffar1

  • 1Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.

American Journal of Clinical Pathology
|May 3, 2021
PubMed
Summary
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Implementing block confirmation in Epic Beaker Laboratory Information System significantly reduced wrong tissue in block (WTIB) errors. This workflow improvement enhanced specimen identity in surgical pathology.

Area of Science:

  • Medical Informatics
  • Surgical Pathology
  • Laboratory Workflow Optimization

Background:

  • Specimen identity is paramount in surgical pathology.
  • Epic Beaker Laboratory Information System mandates sequential scanning for specimen and block confirmation.
  • Wrong tissue in block (WTIB) errors pose a significant risk to patient care.

Purpose of the Study:

  • To evaluate the impact of block confirmation on WTIB errors.
  • To assess the effectiveness of Epic Beaker's customizable features in improving laboratory workflow.
  • To quantify the reduction in grossing errors after implementing specific system features.

Main Methods:

  • A retrospective review of WTIB incidents was conducted before and after implementing block confirmation.
Keywords:
EPIC Beaker Laboratory Information SystemGrossing errorsWrong tissue in block

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  • Block confirmation was initially mandated, followed by the implementation of a 'hard stop' feature.
  • The Epic Beaker system's barcoding and custom features were utilized to enforce workflow protocols.

    • Main Results:

    • WTIB incidents decreased from 0.043% (17/38,848 cases) before implementation to 0.005% (2/42,411 cases) after implementing block confirmation with a hard stop.
    • This represents an 88.4% reduction in WTIB errors.
    • Statistical analysis showed a significant P < .001 reduction in WTIB incidents.

    Conclusions:

    • The Epic Beaker system's adaptability allows for tailored workflow solutions.
    • Barcoding and custom-built features within the LIS are effective in reducing WTIB errors.
    • Improved workflow protocols, enforced by system features, significantly enhance specimen identity and reduce pathology errors.