Mia Gruzin¹, Claire Long²,Habib Taouk³,Juliana Leon⁴, Erosh Gunasekera², Fabrice De Bond², Ebony Richardson¹, Sharon Young¹, Pei Dai², Geetha Rathnayake², Luke Soo²,  Philippa Charlesworth², Leslie Burnett^1
1Garvan Institute of Medical Research, Sydney; ²Virtus Health Specialist Diagnostics; ³Health Equity Matters, ⁴ICON plc

Introduction:  Pathology results are ultimately communicated through the pathology report. Suboptimal reports risk misinterpretation, compromising safe and effective patient care. We developed a quantitative tool to measure pathology report quality and applied it to drive quality improvement cycles across multiple Pathology Disciplines.

Methods: A generic set of core requirements applicable to all pathology reports was developed using ISO15189, NPAAC and NATA standards. Additional discipline-specific requirements (including PITUS) were developed for Andrology, Chemical Pathology/Endocrinology, Genetic Pathology, and Immunology. Using reports from the same laboratory over time, or across different laboratories at the same time, we measured compliance with these requirements. We then tested the effectiveness of various improvement strategies.

Results: Initial compliance for all laboratories was variable. Providing “real-time” feedback on deficiencies led to immediate and sustained improvement, whereas “3-monthly interval” feedback led to lesser improvement. Providing “no” feedback led to no improvement.

Discussion:  Measurement of pathology report quality is an underutilised opportunity to significantly improve laboratory performance. Real-time feedback enabled already-accredited laboratories to identify unanticipated deviation, address root causes, and achieve statistically significant sustained improvements in pathology report quality. Our tool can be readily applied and adapted across multiple Pathology Disciplines to maximise post-analytical report quality. 

Author contribution statement: Conceptualisation: LB; Data curation and formal analysis: MJG, CL, HT, JL, EG, FDB, ER, SY; Investigation, Methodology and Software: HT, JL; Project administration and supervision: LB; Visualisation: MJG, LB; Writing - original draft: MJG, LB; Writing - review and editing: MJG, CL, PD, GR, LS, PC, LB.