Evaluation of turnaround time of biopsy and surgical specimens in Moi teaching and referral hospital, Eldoret, Kenya

Abstract

Problem statement: There has been a great concern of delayed patients care due to protracted turnaround time. This may translate into delayed decision making, long hospital stay and unnecessary expenses. Turnaround time (TAT) is an integral component of quality assurance and one of the key indicators of laboratory performance. With histopathology laboratory having most process being manual, consistently achieving shorter turnaround times is difficult. Therefore, there is need to assess the intra-laboratory TAT in the histopathology laboratory and to compare this with what is outlined in the patient service charter. Setting: Moi Teaching and Referral Hospital Histopathology Laboratory. Study population: The sample constituted all surgical/biopsy pathology specimens that were received and accessioned at the MTRH histopathology laboratory in 2009. Data was collected by three pathologists from the laboratory registers and copies of final signed reports. Objectives: To determine the time taken between receiving the surgical/biopsy pathology specimen and the time the final report is dispatched to the ordering physician, respective clinic or ward in the hospital. Methodology: A retrospective descriptive cross- sectional study. Data for all the 2333 surgical/biopsy pathology specimens processed in 2009 was analysed for different intra-laboratory Turnaround Times using Epi info data analysis software. Results: Of the 2333 surgical specimens received during the year, only 1892 had complete data to allow assessment of turnaround time. The mean turnaround time, accessioning to transmittal to the ordering physician for the 1892 specimens analysed was 16.2 ±10.2 days (range 3-59 days), from accessioning to trimming was 2.2±1.5 days (range 1-59) while reporting to dispatch of signed report was 2.5±3.2 days (range 1-44). Conclusion: The mean intra-laboratory turnaround time in the histopathology laboratory was sixteen days way above the seven days allowed in the service charter in the hospital and two days advocated by professional bodies.