Authors (including presenting author) :
Rock LEUNG (1), T K KWOK (10), WM NG (2), S Y WONG (5), Kevin LAW (5), WY LOK (7), SP TANG(6), Jacky FUNG (8), Matthew LO (9), Samuel LUK (3), Eva CHAN (3), Simon SO (4), Viola LI (10), HN TONG (11), Katherine M C PANG (1), S L LEE (1)
Affiliation :
(1) Quality & Safety, HKWC (2) Quality and Safety, QMH (3) Department of Pathology, QMH (4) Department of Microbiology, QMH (5) Information Technology and Information Section, QMH (6) Department of Surgery, QMH (7) Department of Anaesthesia, Pain and Perioperative Medicine, QMH (8) Department of Cardiothoracic Surgery, QMH (9) Administrative Services Department, QMH (10) TWH (11) DKCH
Introduction :
Missing of laboratory specimens may result in significant impact for patient management, especial for precious specimen which might only be obtained with specific or invasive medical procedures. Although very traditional way of specimen tracking using paper records “log book” may serve some benefits, complete end-to-end tracing with real-time update and alert of clinical parties on delayed arrival of specimens is not feasible. Evidence showed that the later the alert, the more remote the possibility of finding the missing specimen. The HKWC Quality and Safety Department (Q&S) collaborated with the clinical departments, laboratories, Information Technology Section, and Administrative Services Department to develop a “Tracking System for Precious Pathology Specimens” in January 2019.
Objectives :
1. To track the specimens flow from clinical departments to laboratories in real-time manner. 2. To notify the concerned departments in timely manner once precious specimens were not received by laboratories.
Methodology :
The tracking system was an out-sourced system. With handheld scanner to facilitate specimen identification, the system allowed logging of time and specimen identification records on critical check points, i.e., collection & arrival at laboratory and the data was stored in cloud-based database. The General Clinical Request System (GCRS) number of the specimen was employed as the identifier for tracking. Tracking down to the level of personnel who handled the transportation, the specimen collection boxes which carried the specimens as well as the clinical sites at which the specimens were located could be achieved by the system. The system provided real-time update through Wi-Fi and cell phone network so that staff could easily access the database for the real-time status of the transportation. The system also automatically generated reports of untransported precious specimens every day so that supervisors could be alerted via email, hence, searching for suspected lost specimen e in a timely manner.
Result & Outcome :
From August 2019 to Nov 2020, a total of 40159 precious specimens were tracked. A total of 9223 specimen collection boxes were transported. No specimen was lost in the implementation period. This system was also extended to Tung Wah Hospital and Duchess of Kent Children’s Hospital in 2021 1Q and 2022 2Q, respectively. Conclusion: With the implementation of the tracking system, suspected loss of pathology specimens can now be handled in a timely manner. The system was also highly accepted by end-users. The integration of the tracking system with General Clinical Request System (GCRS), Automatic Dispatching System (ADS) and Laboratory Information System (LIS) for comprehensive specimen tracing would allow a more complete audit trail for specimen tracking and potential missing specimen notification.
