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2016 ; 10
(1
): EC07-11
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Quality Measures in Pre-Analytical Phase of Tissue Processing: Understanding Its
Value in Histopathology
#MMPMID26894071
Rao S
; Masilamani S
; Sundaram S
; Duvuru P
; Swaminathan R
J Clin Diagn Res
2016[Jan]; 10
(1
): EC07-11
PMID26894071
show ga
INTRODUCTION: Quality monitoring in histopathology unit is categorized into three
phases, pre-analytical, analytical and post-analytical, to cover various steps in
the entire test cycle. Review of literature on quality evaluation studies
pertaining to histopathology revealed that earlier reports were mainly focused on
analytical aspects with limited studies on assessment of pre-analytical phase.
Pre-analytical phase encompasses several processing steps and handling of
specimen/sample by multiple individuals, thus allowing enough scope for errors.
Due to its critical nature and limited studies in the past to assess quality in
pre-analytical phase, it deserves more attention. AIM: This study was undertaken
to analyse and assess the quality parameters in pre-analytical phase in a
histopathology laboratory. MATERIALS AND METHODS: This was a retrospective study
done on pre-analytical parameters in histopathology laboratory of a tertiary care
centre on 18,626 tissue specimens received in 34 months. Registers and records
were checked for efficiency and errors for pre-analytical quality variables:
specimen identification, specimen in appropriate fixatives, lost specimens, daily
internal quality control performance on staining, performance in inter-laboratory
quality assessment program {External quality assurance program (EQAS)} and
evaluation of internal non-conformities (NC) for other errors. RESULTS: The study
revealed incorrect specimen labelling in 0.04%, 0.01% and 0.01% in 2007, 2008 and
2009 respectively. About 0.04%, 0.07% and 0.18% specimens were not sent in
fixatives in 2007, 2008 and 2009 respectively. There was no incidence of specimen
lost. A total of 113 non-conformities were identified out of which 92.9% belonged
to the pre-analytical phase. The predominant NC (any deviation from normal
standard which may generate an error and result in compromising with quality
standards) identified was wrong labelling of slides. Performance in EQAS for
pre-analytical phase was satisfactory in 6 of 9 cycles. CONCLUSION: A low
incidence of errors in pre-analytical phase implies that a satisfactory level of
quality standards was being practiced with still scope for improvement.