General quality practices in gynecologic cytopathology: Findings from the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference Working Group 3

Joseph Tworek*, Ritu Nayar, Lynnette Savaloja, Sana Tabbara, Nicole Thomas, Barbara Winkler, Lydia Pleotis Howell

*Corresponding author for this work

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

Context. - There are many long-standing quality monitors for cytopathology laboratories and their cytotechnologists and pathologists. Many of these monitors are based on tradition and empirical good intentions. There is no established standard as to how results of these monitors should be used in a quality assurance program. Objective. - To review practices that are typically part of a general quality program in cytopathology laboratories and to provide statements regarding good laboratory practices that laboratories may find useful in a quality assurance program in their own setting. Data Sources. - An expert working group evaluated results from a national laboratory survey, responses from follow-up questions posted on a Web site, and findings from the literature. The group created statements on good laboratory practices related to general quality practices and quality assurance in gynecologic cytopathology. These were discussed and voted on at a consensus conference. Conclusions. - Laboratories follow many metrics. Most laboratories facilitate comparison of individual metrics against the laboratory's metrics: 81.1% for cytotechnologists and 59.6% for pathologists. The majority of laboratories facilitate comparison of individual cytotechnologist metrics with other cytotechnologists, but less frequently metrics from pathologists with other individuals. The most common methods to recognize variance in performance in individuals were by identifying outliers from the data or by user-defined action limits. The most common method to address variance was an attempt to identify the cause of the variance and conduct a focused review. Quality metrics should be monitored for the laboratory as a whole and in selected cases for both individual pathologists and cytotechnologists. Results should be shared with individuals, and newly hired primary screeners should be monitored. Reviewing selected cases is a useful quality tool. Low-volume methodologies, such as conventional Papanicolaou tests, should have additional oversight.

Original languageEnglish (US)
Pages (from-to)190-198
Number of pages9
JournalArchives of Pathology and Laboratory Medicine
Volume137
Issue number2
DOIs
StatePublished - Feb 1 2013

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

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