Local audit of diagnostic surgical pathology as a tool for quality assurance.

BACKGROUND: Internal audit has been rarely done for quality assurance of histology laboratories in Nigeria. We reviewed the steps involved in the production of reports with a view to assessing the performance of the histopathology laboratory of Aminu Kano Teaching Hospital, Nigeria. METHODS: A randomly selected 2 per cent sample of the total histology workload of the center for the year ending December 2005 amounting to 2877 cases was systematically reviewed. RESULTS: Analysis of the accumulated data showed a concordance rate of 94.8% between the original and review histological diagnoses, comparable to other published studies. Significant defects were observed to be due to missing demographic information on request forms (22.8%), poor technical quality of slide sections (18.4%) and typographical errors by typists (12.3%) In a minority of cases microscopic description was inadequate or inappropriate (7.0%) and some were inaccurate (2.7%). The turnaround time ranged from 2 to 16 days (mean 6.2 days) with results of 75.8 per cent of the specimens completed within 7 days. CONCLUSION: From the study we have shown that local audit is feasible in Nigerian laboratories and is an excellent method for detecting errors and improving performance in Surgical Pathology to optimize the scarce resources available to patient care in our country.