Electronic whiteboard implementation as a quality management tool optimizes IVF laboratory standardization and improves
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ASSISTED REPRODUCTION TECHNOLOGIES
Electronic whiteboard implementation as a quality management tool optimizes IVF laboratory standardization and improves clinical outcomes Phillip A. Romanski 1
&
Ann M. Thomas 1 & Jay Patel 1 & Dan Zhang 1 & Catherine Racowsky 1
Received: 30 July 2020 / Accepted: 8 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To test whether an electronic whiteboard in the IVF laboratory increases the likelihood that critical evaluation procedures are performed within optimum pre-set time ranges. Methods A retrospective cohort study of oocyte retrievals in our IVF clinic between 06/01/2012 and 05/31/2018 was included. The electronic whiteboard was introduced on 04/06/2014. Prior to implementation, embryologists strived to adhere to the set evaluation times without a formal guide. The primary outcomes were the proportion of embryologist evaluations performed in optimum time ranges and the proportion of usable embryos per patient. Results A total of 4645 retrievals met inclusion criteria. Implementation of the whiteboard was associated with (1) an increase in the proportion of fertilization checks performed within the optimum time range for ICSI cycles (+ 5.1%, RR = 1.06, CI = 1.02–1.10); (2) an increase in the proportion of day 3 evaluations performed within the optimum time range, whether assisted hatching was performed (+ 23.6%, RR = 1.48, CI = 1.36–1.60) or not (+ 13.8%, RR = 1.23, CI = 1.12–1.35); and (3) an increase in the proportion of day 5 evaluations within the optimum time range (+ 15.5%, RR = 1.23, CI = 1.12–1.35). Additionally, the mean number of usable embryos per patient increased from 2.8 to 4.5 after the whiteboard was implemented (RR = 1.25, CI = 1.19–1.31). Conclusion The use of an electronic whiteboard that posts optimum times for performing critical procedures significantly increases the proportion of evaluations that occur within these ranges. Such improved standardization led to positive downstream effects on the number of usable embryos per patient. We suggest that electronic whiteboard implementation driven by real-time data collection should be considered in all IVF laboratories. Keywords Electronic whiteboard . IVF laboratory . Quality management . Embryo evaluation . Clinical outcomes
Introduction A key component of a successful in vitro fertilization (IVF) program is a reliable IVF laboratory. Both the American Society for Reproductive Medicine and the European Society for Human Reproduction and Embryology have published requirements and practice guidelines for the IVF laboratory [1–3]. Due to the complex processes that occur in the laboratory, a quality management program
* Phillip A. Romanski [email protected] 1
Department of Obstetrics, Gynecology and Reproductive Biology, Brigham & Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
is required to maintain the standardized performance that is expected and to monitor the staff’s adherence to these established standa
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