Key Lab matrix in Histopathology lab
Turnaround Time (TAT) in Laboratory:
Turnaround Time in laboratory is a very important Lab matrix in Histopathology lab. We track it right from the beginning – from the time the specimen collection to the time it reaches the lab.
To control the lab TAT for histopathology operations, we try to take the specimen early. This is because if the transport to the histopath lab is delayed, then the specimen comes delayed to the lab, delaying the following processes. The time taken for pathologists to sign out the reports is also a vital variable. So yes, we do consider time (TAT) as a necessary Lab matrix in Histopathology testing.
Lab accuracy and precision
Another very important metric to us is accuracy. Because, when we receive a specimen for a laboratory test, the first thing we want to make sure of is that the specimen collection is done in the right percentage (amount) and the request form is correctly filled. Also, the specimen and the request form are correct, labeled, and mapped, and the patient identification is correct. Each of these steps contributes to lab accuracy and precision which is essential in its own way.
Errors in Histopathology
We also track pre analytical errors in histopathology as well as analytical errors as standard laboratory practices. This will include a wrong label, slightly printed wrong labels, incorrect mapping, etc.
Quality of Lab stain
A well-stained sample is essential for accurate diagnosis and research analysis in a histology lab. This plays a crucial role in the lab accuracy and precision and reliability of laboratory results. Therefore, another Lab matrix in Histopathology is the Quality of the Lab stain itself. So, these will be the main things that a histopathologist would track as standard laboratory practices on a day-to-day basis.
There are of course Financial aspects as well but as a practicing pathologist, this is what I would monitor.
Those managing the finance will also track how we use the immunohistochemical stains. Because if the pathologist orders more lab stains, then the overall cost gets affected and this cost gets passed on to patients. Even the finance guy should be able to see if a pathologist orders more stains than the normal required. But this is not usually tracked by the individual pathologist but by someone who is in charge of financial management.
How to reduce the lab TAT for the Histopathology testing Lab?
First, we must define where the TAT starts – when the specimen collection is done or when it reaches the laboratory. Usually, in most cases, we measure when the specimen reaches the histopath lab.
Usually, specimen processing is done in batches. If a laboratory process the blocks once a day and the hospital sends the sample early in the morning, the sample processing is done in the afternoon. In this case, the slide will be ready by 11:00 the next morning.
It doesn’t matter how early in the morning you send the samples – if you want to reduce the turnaround time for the histopathology testing lab you need to process the samples at least twice a day.
How to avoid errors in histopathology?
The request form must be written in better writing. Unlike clinical chemistry, which does not require you to look at request forms before reporting, histopath lab requires clinicopathological correlation. You have to see what’s stated in the request form and see what is on the slide and put it together.
Mainly we have difficulty when:-
- They have handwritten forms.
- They don’t fill up the forms clearly with the pertinent data; they write something irrelevant to the case.
We need to be completely digital as far as possible. Even the specimen details should not be written manually but recorded digitally so that the number of errors is reduced to a large extent.
Is batching the best option to maintain Lab matrix in Histopathology?
You need to balance both economy and time otherwise the cost of the Lab matrix in Histopathology test will become too high.
Histopathology testing is not a test that most patients who come to the hospital will do, it is still an important laboratory test. You can’t do it individually you have to batch it, which will increase the time to process.
One batch in the morning and one batch in the evening at 4 pm. Any specimen which comes in will be processed and the slides will be ready by 11:00 a.m. The reports will be ready within 2 days. So, the Turnaround Time in laboratory is still 2 days which for histopath lab is a good enough metric.