Quality Indicators for Error Minimisation in Histopathology: Experience at a Tertiary Care Centre EC06-EC09
Pooja Sharma Kala,
53/1, Teg Bahadur Road, Lane iii, Dehradun, Uttarakhand, India.
Introduction: Quality Indicators (QI) are parameters defined by Quality Management System (QMS) in a laboratory to assess and monitor quality of results generated. A regular and periodic review of these QI also help improves the quality of laboratory results. These QI are often underutilised or less commonly followed-up in histopathology laboratory/Surgical Pathology.
Aim: This study was conducted with the aim to evaluate QI and their role in improving the quality in histopathology.
Materials and Methods: This cross-sectional study was conducted in histopathology laboratory of a tertiary care hospital and teaching institute located in Dehradun, Uttarakhand, India from January 2016 to June 2018. A set of nine QI were evaluated biannually and the data was analysed using ANOVA test followed by Post-hoc Tukey test.
Results: During the study period, number of unacceptable samples (QI-1) was zero. Number of errors at registration and/or accession (QI-2) was five (0.05% with respect to total number of specimens). Completeness of equipment (QI-3) and performance in External Quality Assurance Programs (EQAP) (QI-4) were satisfactory throughout. Number of amended reports (QI-5) was three (0.03%). There were two (0.02%) complains/negative feedbacks from users (QI-7). QI-8 (laboratory safety and environment) and QI-9 (effectiveness of document control system) were maintained during the study period. Turn Around Time (TAT) (QI-6) as a QI which was deranged mostly (4.5%). Reasons for delayed TAT were further analysed. It was found that pre analytical factors were commonest and statistically significant reasons behind the delayed TAT as compared to analytical and postanalytical ones. Root cause analysis and future preventive actions were undertaken, accordingly to improve the quality.
Conclusion: Periodical review of QI helps in understanding the flaws in the analytic cycle and appropriate actions undertaken accordingly helps in improving the quality in histopathology.