Changing the Culture of Tumor Tissue Biobanking in a Tertiary Referral Hospital Using an Audit and Feedback Strategy

We examined whether the introduction of an audit and feedback strategy applied to specimens dissected at the John Hunter Hospital anatomical pathology department improved the number of formalin fixed tumor specimens sampled by anatomical pathology registrars for the Hunter Cancer Biobank. During the audit period (1/7/16 to 30/6/17) a total of 949 tumor specimens were sampled for the biobank compared with 393 of the previous year (1/7/15 to 30/6/16) resulting in a 141% increase in specimens biobanked. A targeted group of previously underrepresented specimen types, including brain, lung, and lymph node tumors were studied in depth to establish which specimens were sampled and which potentially biobankable specimens were “missed”. In this targeted group there was a 285% increase in the number of specimens biobanked and a statistically significant (p < 0.001) increase in tumor sampling in all three specimen types over the audit period compared with the previous year. In conclusion, the introduction of an audit and feedback strategy improved tumor tissue collection for biobanking. A potential drawback of email feedback is that overfixation may occur due to administrative time lag and these specimens must be documented accordingly because some tests are dependent on an optimal fixation time. Taking extra blocks for biobanking on all potential tumor specimens with excess tumor tissue at the time of cut-up can alleviate this problem.