PATHOGROSS: A QUALITY IMPROVEMENT INITIATIVE TO ENHANCE EFFICIENCY, SAFETY, AND WORKFLOW IN HISTOPATHOLOGICAL GROSSING – A PROSPECTIVE INTERVENTIONAL COMPARATIVE STUDY

Abstract

Background: Grossing is a critical step in histopathology that directly influences diagnostic accuracy, specimen handling, and turnaround time. Conventional grossing boards lack integrated features for measurement, organization, and instrument handling, leading to workflow inefficiencies and increased processing time. To address these limitations, a quality improvement intervention was developed in a modified grossing board (PATHOGROSS).

Objective: It is to design, develop, and evaluate the effectiveness of the PATHOGROSS modified grossing board in improving workflow efficiency, measurement accuracy, specimen organization, and turnaround time in histopathological grossing.

Methods: This prospective within-subject crossover interventional comparative study was conducted over one year in a tertiary care pathology laboratory. Fifteen operators performed standardized grossing procedures on 60 surgical specimens using both conventional and PATHOGROSS boards, serving as their own controls. Workflow parameters assessed included turnaround time, measurement accuracy, cassette handling, instrument handling, and overall workflow efficiency using a 5-point Likert scale. Statistical analysis was performed using paired t-test and Wilcoxon signed-rank test, with p < 0.05 considered significant.

Results: The PATHOGROSS board showed improvement in all parameters measured. The mean time to completion was reduced from 20.42 ± 9.27 minutes with the standard board to 9.55 ± 3.89 minutes (p < 0.001). Measurement accuracy improved from 2.50 ± 0.50 to 4.50 ± 0.50, cassette handling from 2.00 ± 0.00 to 4.50 ± 0.50, instrument handling from 1.00 ± 0.00 to 5.00 ± 0.00, and workflow efficiency from 2.97 ± 0.90 to 4.43 ± 0.50 (all p < 0.001). All cases using PATHOGROSS achieved high-performance grading compared to predominantly low-to-moderate performance with the conventional board.

Conclusion: The PATHOGROSS modified grossing board increases the speed of grossing, reduces turnaround time, and leads to better specimen organisation and measurement accuracy in gross histopathological. Its integrated features provide a practical yet efficient solution for increasing the productivity of the laboratory, particularly in high-volume settings.