Assessment of Quality of Frozen Section Services at a Large Academic Hospital Before and After Relocation

• Published in: American journal of clinical pathology Vol. 158; no. 5; pp. 655 - 663
• Main Authors: Onyenekwu, Chinelo P, Czaja, Rebecca C, Norui, Rashda, Hunt, Bryan C, Miller, James, Jorns, Julie M
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 03.11.2022
• Subjects: Analysis; Diagnostic Errors; Discordance; Frozen Sections - methods; Hospitals; Humans; Market surveys; Pathology; Pathology, Surgical - methods; Referral and Consultation; Surveys; Intraoperative; Frozen section; Discrepancy
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/ajcp/aqac109

Abstract Objectives To determine outcomes following relocation of frozen section services (FSS) and the implementation of a dedicated gastrointestinal frozen service. Methods We reviewed our FSS 6 months prior to and following FSS relocation. Satisfaction surveys were sent to surgeons and pathologists. Survey feedback resulted in a pilot of gastrointestinal subspecialist frozen section coverage. Results There were 1,607 and 1,472 specimens from 667 and 602 patients pre- and post-FSS relocation, respectively. There was a decline in median specimen delivery time to pathology (12 vs 10 minutes, P < .001) and an increase in median time from receipt in pathology to intraoperative diagnosis (20 vs 22 minutes, P = .008) in cases with intrapathology consultation but no change without consultation (median, 19 minutes). Intrapathology consultation decreased from 19.7% (317/1,607) to 11.5% (169/1,472) (P < .001). Discordance rates between frozen section and permanent section remained low and similar (2.0% [33/1,607] vs 2.7% [40/1,472], P = .24). There was no significant change in discordance with dedicated gastrointestinal subspecialty frozen section interpretation. Conclusions Relocation of FSS and dedicated subspecialty interpretation may improve surgeon satisfaction but can also create workflow challenges. Pathology departments need to achieve a balance between satisfaction and adequacy to establish best frozen section coverage models.