The use of key performance indicators for external quality control in histological dissection

• Main Author: Griffiths, Matthew Paul
• Published: University of the West of England, Bristol 2016
• Subjects: 600
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.680877

The recent reports into standards in the NHS (Francis, 2013) and quality in pathology (Barnes, 2014) have focused scrutiny on the way in which we work in pathology and how we can provide assurance that this is of a sufficiently high standard. There are a number of external quality assurance schemes covering pathology generally and histopathology specifically (UKNEQAS), however, there is no scheme of any kind covering the process of histological surgical dissection. This is an area undergoing development currently, as it changes from an area which is the sole preserve of medically qualified pathologists, to an area utilising a number of highly trained biomedical scientists. The concept of biomedical scientist led dissection has been around for some years, being codified into a document of best practice in 2005 (IBMS, 2005). This document placed the responsibility for the work of the BMS in the hands of the pathologist, without structured oversight or a quality assurance programme. Ten years on and specimen dissection, including the developing area of BMS led dissection, remains without any formal structured form of quality assurance. This work builds on the points made by Barnes (2014), taking the guidance of the RCPath and IBMS to form a series of key performance indicators (KPI) in relation to specimen dissection. These KPI can be used as an indicator of individual practice, highlighting areas of variation, weakness or strength. Once these are identified, a tailored feedback and training event provides an opportunity to address these errors & omissions, or to enable areas of strength to be shared. The results of this thesis show that introducing training events serves to drastically reduce variation by, and between, dissectors, driving up standards in the department.