Analysis of quality assurance: a novel step in fixing the turn-around time of surgical pathology reports as a part of quality management system

Introduction: Lab investigations are essential in patient and quality management system. The essential aspect of quality which goes often overlooked is turnaround time (TAT), a key performance indicator of laboratory. Most laboratories put undue stress on only reliability, but nowadays the clinician is more inclined towards getting the result done in a shorter time. Analyzing outliers in TAT in a lab gives insight of causes delay and the areas need improvement. Laboratories in developing countries are yet to use TAT and analyze them for laboratory improvement. Methodology/Strategy: Analysis was conducted for a period of four months on Histopathology specimens. The initial step was to trace the flow process. Laboratory improvement strategy was developed by designing a time log sheet attached to all histopathology request forms at the time of receiving specimens. All the data including and all sub process in the flow path were documented and an attempt was made for corresponding remedial measures. Results: Root cause analysis revealed that the processes of slide allocation and delivery to pathologists, report editing by transcriptionists, report verification by pathologists are the sub-processes where most delays occur and set to be a target area for our improvement and subsequent remedial actions were drafted to ensure quality assurance. Conclusions: The study re-emphasized the fact that small and simple change can lead to huge improvements in surgical pathology laboratory TAT and not necessarily complex changes. It also helps in mapping out the workflow process using time log sheet, had led to process and systems improvement by Focusing and fixing sub processes which showed that 94% of all histopathology cases being reported within the standard TAT.