Department of Pathology, T.N Medical College and B.Y.L Nair Hospital, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2021 Jan-Mar;64(1):136-139. doi: 10.4103/IJPM.IJPM_640_20.
An audit aims to verify conformance to required processes, assess their implementation, and define the targets of quality control.
To evaluate preanalytic and analytic phases of surgical histopathology in a tertiary healthcare center.
An observational retrospective and prospective study over 3 months each of year 2013 and 2014.
Biopsy, small resections, large organ resections, bone marrow aspirate/biopsy (BMA/BMB), and frozen section samples received in surgical histopathology were categorized as I to V, respectively. A manual audit was done for preanalytical phase (adequacy of clinical information and grossing adequacy) and analytical phase [turnaround time (TAT) and tissue section quality].
Qualitative data was assessed by Chi-Square test. Quantitative data was assessed using One-Way Analysis of Variance.
Among 3179 total cases, category I to V had 1558 (49%), 1099 (34.6%), 342 (10.8%), 124 (3.8%), and 56 (1.8%) cases, respectively. Category I had shortest TAT but maximum number of inadequately sent specimens and recuts. Category III had maximum cases with inadequate clinical history, grossing errors, additional sections, and longest TAT. Category IV had maximum cases with poor quality sections. Category V had maximum cases with inadequate demographic details and clinical investigations. BMB (114, 91.9%) was more useful than BMA for diagnosis. Mean TAT for fixed tissues and frozen tissues was 3.6 ± 1.8 days and 26.6 ± 11.2 min, respectively.
Total 25% of annual workload was studied by an observational, manual audit. Quality indicators were achieved as per international norms despite limited resources. Remedial actions were suggested for technicians, clinicians, and pathologists to minimize errors.
审核旨在验证是否符合所需流程，评估其实施情况，并确定质量控制目标。
评估三级保健中心外科组织病理学的分析前和分析阶段。
2013 年和 2014 年各进行了为期 3 个月的观察性回顾性和前瞻性研究。
将外科组织病理学收到的活检、小切除、大器官切除、骨髓抽吸/活检（BMA/BMB）和冷冻切片样本分别归类为 I 至 V 类。对分析前阶段（临床信息和大体检查充分性）和分析阶段（周转时间（TAT）和组织切片质量）进行了手动审核。
使用卡方检验评估定性数据。使用单因素方差分析评估定量数据。
在 3179 例总病例中，I 至 V 类分别有 1558 例（49%）、1099 例（34.6%）、342 例（10.8%）、124 例（3.8%）和 56 例（1.8%）。I 类的 TAT 最短，但不合格送检标本和重新切割的数量最多。III 类有最多的病例伴有不充分的临床病史、大体检查错误、附加切片和最长的 TAT。IV 类有最多的切片质量差的病例。V 类有最多的病例伴有不充分的人口统计学资料和临床检查。BMB（114 例，91.9%）比 BMA 更有助于诊断。固定组织和冷冻组织的平均 TAT 分别为 3.6 ± 1.8 天和 26.6 ± 11.2 分钟。
通过观察性、手动审核研究了年度工作量的 25%。尽管资源有限，但仍符合国际规范的质量指标。建议技术人员、临床医生和病理学家采取补救措施，以尽量减少错误。
