Synopsis
Quality control is one of the essential parts of digital pathology and histopathology. Especially in histopathology, not many medical experts are aware of the benefits it brings to the pathology laboratory. Quality control encompasses a wide range of processes that effectively establish and maintain high standards in the field of histopathology. To achieve higher levels of precision and accuracy, effective quality control is essential. Quality control also includes the analysis of statistical data to organize an effective system in the work environment. As someone who is involved in the process of quality control, you need to be aware that high-level quality control involves three phases, and you need to pay attention to each of the three stages to achieve a high level of quality control in your digital pathology workflow. We will now explore the most important aspects of the quality control process to emphasize the importance of it both for you and the patients.
Quality Control in Histopathology
The concept of quality control in histopathology is not very widely comprehended. Quality control checks apply to pre-analytical, analytical, and post-analytical activities. Precision and accuracy are possible to achieve through both internal and external quality control and assessment schemes. There is a mix of processes that achieve quality reporting in histopathology. With the internal and external pathology assessment, the histopathology laboratory can establish a quality assurance program and achieve quality control with the involvement of all participants in the histopathology laboratory.
Quality Control Phases
Why is quality control assessment so complicated in histopathology? Histopathology may lack objective numerical data as reports are often based on subjective assessments, individual judgments, and potentially biased interpretations. Additionally, there may be inconsistencies in reporting patterns, leading to a lack of uniformity. All these make the assessment quite an issue. Modern pathology has incorporated elements of objectivity in slide interpretation. Quality control applies in three phases of operation.
Pre-analytical phase
All processes involved in submitting stained slides for analysis can be grouped under the pre-analytical phase. The evolving dimensions of the pre-analytical phase encompass various factors such as patient satisfaction, staff satisfaction, and overall process effectiveness.
A Critical Stage
Various studies have confirmed that most errors in the laboratory happen due to issues in the pre-analytical phase. It is no different for the histopathology laboratory. The core responsibility at this initial phase is to ensure the documented instructions containing relevant information are made available at all points of specimen collection within the laboratory.
Common Errors
Some of the most common errors in the histopathology laboratory in this phase involve patient identification, anatomic location identification, and the laterality of biopsy. These errors, although common, are avoidable.
Fixing the Errors
Laboratories must design their referral form for histopathology and immunohistochemistry and make it available to all sample collections. A dialogue with the clinician about the importance of properly filled forms may be needed. The standard operating procedure (SOP) should be written in simple language that can be understood by all. The SOP should be available at the workplace, and all the employees should be aware of its contents.
Key Attributes of Pre-analytical Phase:
| Factors Involved | Requirements |
|---|---|
|
Patient Satisfaction |
Communication channel with clinician |
|
Staff satisfaction |
SOP documentation |
|
Overall process effectiveness |
SOP made available at all workstations |
Analytical phase
When you consider the subjectivity of the reports, it’s no wonder why the assessment of analytical aspects in histopathology is not easy. Error detection and avoidance in histopathology have been written about very often.
A Must-have
Various modes of internal audits have been described and recommended, each with its advantages. Error detection and avoidance in histopathology have been frequently discussed among experts and addressed in various reports. Several types of internal audits have been described and recommended, each with its advantages.
Best Case Scenario
For departments with more than one histopathologist, intra-department consultation, comparison with other reports, random case review, and hierarchical form of reporting, as also intra and inter-departmental conferences are recommended. If the laboratory is run by a single histopathologist, it is recommended to do a random blinded review of reported cases, external consultations, review by experts, and participation in continued medical education programs.
Key Attributes of Analytical Phase
| Factors Involved | Requirements |
|---|---|
|
Error detection |
Random blinded review |
|
Internal audits |
External consultations |
|
Intra and inter-departmental conferences |
Continued medical education programs |
Post-analytical phase
This phase involves report generation without transcription errors, report transmission to the right people, storage of reported material and data, and safe disposal of specimens thereafter. Newer models include billing issues, patient safety issues, turnaround time, and general customer satisfaction.
Basic Responsibility
Tracking turnaround time is critical as laboratories should aim to approve most cases within 48 hours of receiving the sample. The use of microscopes can also help reduce turnaround time, especially for small biopsies. The reaction time of frozen sections must also be controlled, and possible bottlenecks eliminated.
Ensure Report Credibility
There should be regular contact with users to ensure that reports are received promptly for optimal use in clinical management and that clinicians are satisfied that results are presented clearly and unambiguously. There should also be discussions on test selection, considering the clinical relevance of the tests performed, the introduction of new tests, and the evaluation of benefits versus costs.
Key Attributes of Post-analytical Phase
| Factors Involved | Requirements |
|---|---|
|
Report generation |
Monitor turnaround time |
|
Report transmission |
Eliminate potential bottlenecks |
|
Safe disposal of specimens |
Overlook frozen section |
What Does Quality Control in Histopathology Involve?
Quality control in histopathology includes quality control (QC), quality assurance (QA), and total quality management (TQM). The definitions of these elements depend on the level of process and organizational commitment, with TQM representing the highest level of involvement. In practice, it is important to prioritize all these elements to ensure the production of accurate histopathology reports that can be easily accessed and reviewed within a given period. However, a solid foundation for an accurate histopathological report begins with the acquisition of high-quality histological sections.
Why is Quality Control in Histopathology Important?
Quality is the degree to which healthcare services strive to provide accurate desired outcomes for patients and are consistent with current professional knowledge. Histopathology reports contain interpretations, explanations, evaluations, and clinical judgments. A service that can facilitate the whole process of quality control in your histopathology laboratory is PreciCloud. The service is an all-in-one platform that enables easy handling of virtual slides and quick and effective collaboration. You can share and discuss your specimens without any issues. So, explore PreciCloud and see how you can improve your QC reports.
Conclusion
The importance of quality control in digital pathology, involving histopathology, is crucial. Quality control is the analysis of the service and involves a few processes that need to be performed on a high level to get high-quality service. Good quality control means control over every aspect of the work. Better quality control, the better quality of work. Although quality control processes represent a complex unit, they can be divided into three phases: pre-analytical, analytical, and post-analytical. During the first, pre-analytical phase you examine for the satisfaction of the patients, and the satisfaction of the staff, but also pass through all the processes that involve slide submission. The pre-analytical phase also serves to avoid possible errors that often happen. The second, analytical phase involves consultation, comparison, and review. The third, post-analytical phase consists of report generation and transmission. Quality control in digital pathology is a complex process, but also very important, and all its aspects require attention. PreciCloud can facilitate these processes because you can very easily collaborate with the staff and get efficient results quickly.
