complications from unnecessary procedures, and misdiagnosis. Applying this to the hypothetical AP laboratory indicates that approximately 2 errors per month directly affect the patient. Our current system in pathology is not only inefficient and wasteful of resources but it also does not proactively avoid patient harm. It is recognized across multiple industries that to advance beyond error rates of a few per 1000, automation is needed.
The UW AP Department had 2 goals in making improvements through automation: to decrease mislabeling opportunities and to increase efficiency. Our action plan was to use bar code technology to eliminate all steps requiring hand entering of data after the case was initially accessioned. Such steps include hand entering/hand writing accession numbers on cassettes, slides, or containers and typing in accession numbers when importing images, dictating, or opening a case. Our greatest opportunity for improving efficiency was to reduce labor by changing workflow. To do this, we used bar codes to eliminate as many manual processes as possible, thereby freeing up staff for other duties. Examples include automatic order completion in histology, automating the specimen discard system, and management of digital images. Bar coding also allows for real-time tracking of all case material (slides, cassettes, specimens). By increasing the transparency in specimen progress throughout the laboratory, we expected decreases in interruptions to histology and office staff (eg, "Is the special stain ready yet?" or "Who has the slide that I need for conference next hour?").
University of Washington prioritized projects and implemented in stages. We started with projects that required the fewest developer hours but yielded the most...