Implementation of modern tools in autopsy practice-the way towards contemporary postmortal diagnostics.

Langer, Rupert; Tröhler, Alexandra; Schnüriger, Beat; Perren, Aurel; Blank, Annika; Banz Wälti, Yara; Trippel, Mafalda; Candinas, Daniel; Lugli, Alessandro (2019). Implementation of modern tools in autopsy practice-the way towards contemporary postmortal diagnostics. Virchows Archiv, 474(2), pp. 149-158. Springer 10.1007/s00428-018-2482-2

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Medical, legal, and socioeconomic issues have contributed to the decline of autopsy rates. Pathology-related factors, however, with changing clinical duties on the one hand and decreasing interest and lack of substantial technical developments in this field on the other, may have contributed to this condition as well. We present our experience of a restructuring project that culminated in the introduction of a modernized postmortal diagnostic (PMD) unit: Workflows of PMD procedures and space organization were restructured according to LEAN management principles method. Classical autopsy suites were transformed into postmortal operating rooms. A PMD pathologist staff was designated to perform postmortal operative diagnostics (i.e., using laparotomy and thoracotomy approaches) with the intention of gradually replacing classical autopsy procedures. Postmortal minimal invasive diagnostics (PMID) using laparoscopy and thoracoscopy were successfully implemented with the expertise of clinical colleagues. Reorganization of workflow reduced turn-around times for PMD reports from a median of 33 days to 15 days. Short-term analysis revealed that this combined effort leads to a slight increase in the number of adult postmortal examinations 1 year after the introduction of this project. A change of culture in postmortal diagnostics may contribute to a better reputation of postmortal examinations from the perspective of clinicians, the general public, and affected relatives of the deceased. It may also serve to demonstrate that the pathology community is keen not only to preserve but also to further develop this valuable tool for medical quality control and education.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology

UniBE Contributor:

Langer, Rupert; Schnüriger, Beat; Perren, Aurel; Blank, Annika; Banz Wälti, Yara; Trippel, Mafalda; Candinas, Daniel and Lugli, Alessandro

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

0945-6317

Publisher:

Springer

Language:

English

Submitter:

Rupert Langer

Date Deposited:

27 Nov 2018 17:44

Last Modified:

06 Feb 2019 18:09

Publisher DOI:

10.1007/s00428-018-2482-2

PubMed ID:

30426205

Additional Information:

#ppe

BORIS DOI:

10.7892/boris.121505

URI:

https://boris.unibe.ch/id/eprint/121505

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