An Audit of Turnaround Time in Histopathology: A Comparative Study of Two Years in a Teaching Health Facility
DOI:
https://doi.org/10.30442/Keywords:
Audit, Grossing, Laboratory specimen, Laboratory reporting, Tissue processing, Transcription, Turnaround TimeAbstract
Background: Pathology laboratory turnaround time (TAT) is an important quality indicator of laboratory performance. Delay in the issuance of reports contributes to prolonged patients' treatment-waiting time, decreases satisfaction, and increases patient morbidity and the cost of treatment.
Aim: To evaluate the TAT in the Histopathology Unit of the Department of Morbid Anatomy and Histopathology of a Nigerian teaching hospital and compare the findings with those of similar studies elsewhere.
Methods: This was a retrospective descriptive study of all the consecutive surgical samples received in the Department of Morbid Anatomy and Histopathology of Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria, in the years 2016 and 2021. In determining the TAT, specimen handling as a process was divided into four stages: grossing time, tissue processing time, reporting time, and transcription time.
Results: The mean TAT for 2016 and 2021 were 15.23±10.05 days and 18.10±9.61 days, respectively. In 2016 and 2021, respectively, 57.0% and 43.6% of cases were grossed, processed with slides reported, and results typed, corrected, and signed within 14 days. There was no significant linear relationship between TAT for 2016 and 2021(r = 0.018 and p = 0.685).
Conclusion: The tasks of grossing specimens, reporting slides and verification of results were major contributors to TAT, with tissue processing also playing a significant role. These findings underscore the importance of proper funding and implementation of a quality management system to optimise workflow in histopathology.
References
1. Pati HP, Singh G. Turnaround Time (TAT): Difference in Concept for Laboratory and Clinician. Indian J Hematol Blood Transfus 2014;30:81–84. https://doi.org/10.1007/s12288-012-0214-3
2. Ajani MA, Adegoke OO, Nwanji ID, Nwadiokwu JI. Histopathology turnaround time of surgical biopsies in a Nigerian tertiary healthcare facility. Niger J Med 2021;30:326–328.
3. Emmanuel I, Abaniwo S, Nzekwe P, Richard SK, Abobarin O, Longwap A, et al. Laboratory Turnaround Time of Surgical Biopsies at a Histopathology Service in Nigeria. Niger Med J 2020;61:180–183. https://doi.org/10.4103/nmj.NMJ_173_20
4. Rishikha J, Shajeedth SN, Shetty JK, Naik VR. Comparison of turnaround times (TAT) in pathology laboratories from developed and developing countries, and its impact on treatment. Manipal J Med Sci 2021;6:36–42.
5. Masamba LPL, Mtonga PE, Kalilani Phiri L, Bychkovsky BL. Cancer pathology turnaround time at Queen Elizabeth Central Hospital, the largest referral center in Malawi for oncology patients. J Glob Oncol 2017;3:734–739. https://doi.org/10.1200/JGO.2015.000257
6. Uchendu OJ. Challenges of practising histopathology in a developing country: The Nigerian perspective. Ann Biomed J 2013;12:68–74.
7. Muvugabigwi G, Nshimiyimana I, Greenberg L, Hakizimana E, Ruhangaza D, Benewe O, et al. Decreasing histology turnaround time through stepwise innovation and capacity building in Rwanda. J Glob Oncol 2018;4:1–6. https://doi.org/10.1200/JGO.17.00081
8. Zarbo RJ, Gephardt GN, Howanitz PJ. Intra-laboratory timeliness of surgical pathology reports: Results of two College of American Pathologists Q-Probes studies of biopsies and complex specimens. Arch Pathol Lab Med 1996;120:234–244.
9. Royal College of Pathologists. Key Performance Indicators in Pathology. 2013 [cited 2020, 5 May]. Available from: https://www.rcpath.org/uploads/assets/e7b7b680-a957-4f48aa78e601e42816de/Key-Performance-Indicators-in-Pathology-Recommendations-from-the-Royal-College-of-Pathologists.pdf
10. Faculty of Pathology, Royal College of Physicians of Ireland. Histopathology National Quality Improvement Programme Data Report 2015. 2016 [cited 2020, 5 May]. Available from: https://rcpi-live-cdn-s3.amazonaws.com/wp-content/uploads/2016/09/Histopathology-National-Quality-Improvement-Programme-DataReport-2015-Track-updates.pdf
11. Macbaria BN, Ndiangui FM, Chumba DK. Evaluation of turnaround time of biopsy and surgical specimens in Moi Teaching and Referral Hospital, Eldoret, Kenya. Kenya J Health Sci 2015;3:16–22.
12. Butt S, Amin S, Shabbir HF, Rasa HNI, Rathore S, Rizwan M. Turnaround time of surgical pathology reports in a tertiary care teaching hospital. Pak J Med Health Sci 2019;13:330–331.
13. Nwafor CC, Ekpo MD. Timeliness of surgical pathology results: A departmental audit of histopathological services. Sub-Saharan Afr J Med 2019;6:96–100. https://doi.org/10.4103/ssajm.ssajm_30_16
14. Ntiamoah P, Monu NR, Abdulkareem FB, Adeniji KA, Obafunwa JO, et al. Pathology services in Nigeria: Cross-sectional survey results from three cancer consortia. J Glob Oncol 2019;5:1–9. https://doi.org/10.1200/JGO.19.00138
15. Sabageh D, Daramola AO, Rotimi O. Histopathology practice and training in Nigeria: A model. Niger J Med 2016;25:197–200.
16. Adeyi OA. Pathology services in developing countries—The West African experience. Arch Pathol Lab Med 2011;135:183–186. https://doi.org/10.5858/2008-0432-CCR.1
17. Lukić V. Laboratory Information System – Where are we today? J Med Biochem 2017;36:220–224. https://doi.org/10.1515/jomb-2017-0021
18. Seifert RP, Casler V, Al Qaysi N, Gothi SR, Williams L, Christensen PR, et al. Informatics-driven quality improvement in the modern histology lab. JAMIA Open 2020;3:530–535. https://doi.org/10.1093/jamiaopen/ooaa066
19. Volmar KE, Idowu MO, Souers RJ, Karcher DS, Nakhleh RE. Turnaround time for large or complex specimens in surgical pathology: A College of American Pathologists Q-Probes study of 56 institutions. Arch Pathol Lab Med 2015;139:171 177.
20. Ribé A, Ribalta T, Lledó R, Torras G, Asenjo MA, Cardesa A. Evaluation of turnaround times as a component of quality assurance in surgical pathology. Int J Quality Health Care 1998;10:241–245. https://doi.org/10.1093/intqhc/10.3.241
21. Mubarak M. Quality assurance in histopathology laboratories. J Clin Transl Pathol 2023;3:184–189. https://doi.org/10.14218/JCTP.2023.00035
22. Mesfin EA, Taye B, Belay G, Ashenafi A, Girma V. Factors affecting quality of laboratory services in public and private health facilities in Addis Ababa, Ethiopia. EJIFCC 2017;28:205–223.
23. Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA. Laboratory medicine in Africa: A barrier to effective health care. Clin Infect Dis 2006;42:377–382. https://doi.org/10.1086/499363
24. Malami SA, Iliyasu Y. Local audit of diagnostic surgical pathology as a tool for quality assurance. Niger J Med 2008;17:186–190.
25. Alshieban S, Al-Surimi K. Reducing turnaround time of surgical pathology reports in pathology and laboratory medicine departments. BMJ Qual Improv Rep 2015;4:u209223.w3773. https://doi.org/10.1136/bmjquality.u209223.w3773
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria, OOUTH, Sagamu, Nigeria)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.
