Currently, there is no process for non-diagnostic specimen disposal within the Providence Health Care (PHC) network in British Columbia, Canada. Therefore, the Anatomical Pathology unit at Saint Paul’s hospital accepts all specimens sent to them from any department or physician’s office within the PHC catchment area. Naturally, some specimens that enter the system at Saint Paul’s hospital do not have any added diagnostic value and constitute diagnostic service waste. The aim of this project was to retrospectively identify waste specimens so that they can be removed from the system in the future, halting the practice of Indiscriminate pathology investigations and reducing costs while improving the department’s efficiency. Using the Laboratory Information System at St. Paul’s hospital, a list of 407,407 records examined by pathologists in 2019 was created. The list was further refined through the removal of duplicate entries, yielding 34,872 unique accessioned cases in 2019. Following this, a glossary based on the BC Agency for Pathology and Laboratory medicine guidelines for specimens not required for submission to pathology was generated. The specimens that did not fit the definitions of waste were removed, which refined the data set to 1,650 potential cases that were potential non-contributory diagnostic waste. The list was further refined according to the glossary by expert pathologist, Dr. Myles who analysed the data set, reducing the list to 1,214 preliminary cases that could be classified as waste. The pathology reports for these cases were then examined by Dr. Myles and the number of processed tissue blocks were recorded, as well as any commentary that was used to identify the cases as wasteful with no diagnostic value. Out of all 1,214 cases examined, 55 we’re flagged as potentially diagnostic as they indeed needed pathologist analysis and only one case brought forward new diagnostic information. The final list of waste specimens resulted in a diagnostic waste prevalence of 0.03 (1,159/34,872 unique accessioned cases). Therefore in 2019, 3% of all the cases seen by pathologists at Saint Paul’s hospital did not yield any diagnostic value and could be classified as wasteful. The data collected in this study can be used in congruence with future studies to estimate the financial impact of wasteful specimens on the healthcare system. The unprecendented burden of the COVID-19 pandemic on the healthcare system has forced departments to look inwards for ways to increase their operating budgets. The findings of this study can be used to model the impact of changing how wasteful specimens are processed, helping to inform policy and procedures that maximize utility and free-up resources for Canadian laboratories.
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