Modeling Pathology Workload and Complexity to Manage Risks and Improve Patient Quality and Safety

AbstractAnatomic pathology (AP) laboratories provide critical diagnostic information that help determine patient treatments and outcomes, but the risks of AP operations and their impact on patient safety and quality of care remain poorly recognized and undermanaged. Hospital ‐based laboratories face an operational and risk management challenge because clinical work of unknown quantity and complexity arrives with little advance notice, which results in fluctuations in workload that can push operations beyond planned capacity, leading to diagnostic delays and potential errors. Modeling the dynamics of workload and complexity in AP offers the opportunity to better use available information to manage risks. We developed a stock‐and‐flow model of a typical AP laboratory operation and identified key exogenous inputs that drive AP work. To test the model, we genera ted training and validations data sets by combining data from the electronic medical records and laboratory information systems over multiple years. We demonstrate the implementation of 10‐day AP work forecast generated on a daily basis, and show its performance in comparison with actual work. Alt hough the model somewhat underpredicts work as currently implemented, it provides a framework for prospective management of resources to ensure quality during workload surges. Although full implementation requires additional model development, we show that AP workload largely depends on few and acce ssible clinical input...

Source: Risk Analysis - September 1, 2019 Category: International Medicine & Public Health Authors: David M. Vanlandingham, Wesley Hampton, Kimberly M. Thompson, Kamran Badizadegan Tags: Original Research Article Source Type: research