Assessment and Applicability of Various Elements of Quality Assurance in Histopathology Laboratory: A Study from A Tertiary Care Hospital in Eastern Region of India

Abstract

Background Quality control in histopathology is relatively newer concept and less understood because of its subjectivity. Aim:The present study was conducted to assess and determine applicability of the different elements of quality assurance in the histopathology laboratory of a tertiary care hospital in eastern region of India. Material and methods: An observational, retrospective and analytic study for one year and three months was conducted. 2000 samples were selected by simple random sampling including the biopsy specimens and cell blocks received in the histopathology laboratory. Results:Of the 2000 samples, 1880 (94%) were accepted and 120 rejected (6%) due to mainly pre analytical factors. Of the rejected samples, 35 samples (29.2%) were without proper fixative, 48 samples (40%) had incomplete requisition forms, 37 samples (30.8%) had incomplete/ absent clinical history. Lack of adherence to standard tissue fixation protocols were observed in 55 cases (2.75%). Inadequate preventive maintenance and delay in renewal of maintenance contracts were the most common cause of failure of maintenance of equipment. Improper staining was found in 35 cases (1.75%). Grossing of specimens were inadequate in 104 cases (5.2%). Concurrence in diagnosis was found in majority cases (1892 cases, 94.6%). Random case review was done with adequate precision (97.5%) and accuracy (96.6 %). Maintenance of turnaround time was found in most cases (1800 cases, 90%). Conclusion: Standard operating procedures, training of staffs, equipment maintenance, alertness to maintain turnaround time and awareness, proper report documentation and storage are the key factors to successfully uphold quality assurance.