World Journal of Dentistry

Register      Login

VOLUME 15 , ISSUE 5 ( May, 2024 ) > List of Articles

ORIGINAL RESEARCH

Internal Auditing of Oral and Maxillofacial Pathology Laboratory: An Institutional Study

Sangamithra Surendran, Karthikeyan Ramalingam, Pratibha Ramani

Keywords : Internal audit, Laboratory information system, Oral pathology laboratory, Quality assessment, Turnaround time

Citation Information : Surendran S, Ramalingam K, Ramani P. Internal Auditing of Oral and Maxillofacial Pathology Laboratory: An Institutional Study. World J Dent 2024; 15 (5):436-441.

DOI: 10.5005/jp-journals-10015-2401

License: CC BY-NC 4.0

Published Online: 28-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aims: This study aims to internally audit an oral and maxillofacial pathology laboratory from January 2021 to December 2022. Materials and methods: The information related to oral pathology laboratory activities documented in the Dental Information Archival Software (DIAS) of Saveetha Dental College was utilized for this study. Data on biopsies, cytology, income, and expenditure were analyzed using Statistical Package for the Social Sciences (SPSS) software version 23 (IBM, Armonk, United States of America). The mean and standard deviation were calculated for all the key components across all the quarterly data. Results: Incisional biopsies decreased by 9%, while excisional biopsies increased by 26.5%. Cytology receipt decreased by 15%, and frozen section biopsies increased by 10%. Total biopsies increased by 7.3%, maintaining consistent turnaround times (TATs). Revenue increased by ₹29,012.5, and expenditure decreased by ₹23,191. Conclusion: The introduction of the DIAS into oral pathology laboratory activities reduced TAT for incisional and excisional biopsies. We could consistently improve our biopsy cases, increase revenue, and decrease expenditure. Clinical significance: Protocols favoring excisional biopsies over incisional ones may explain decreased incisional biopsies. Clear protocols for biopsy selection are essential for diagnostic accuracy. Internal auditing ensured compliance and optimized resource utilization in our oral pathology laboratory. Integrating internal auditing into laboratory practices is crucial for maintaining high standards of patient care and confidence in healthcare services.


PDF Share
  1. Singer. Guidelines for Laboratory Quality Auditing. CRC Press; 2014.
  2. Singer DC, Stefan RI, Van Staden JF. Laboratory Auditing for Quality and Regulatory Compliance. CRC Press; 2019.
  3. Singer DC, Upton RP. Guidelines for Laboratory Quality Auditing. Asq Press; 1993.
  4. Burnett D. Medical laboratory accreditation - the road ahead. J Assoc Lab Autom 1999;4(4):71–71. DOI: 10.1016/S1535-5535-04-00021-8
  5. Zuk JA, Kenyon WE, Myskow MW. Audit in histopathology: description of an internal quality assessment scheme with analysis of preliminary results. J Clin Pathol 1991;44(1):10–16. DOI: 10.1136/jcp.44.1.10
  6. Wisconsin. Legislature. Legislative Audit Bureau. Performance Evaluation Report, Department of Health and Social Services, Clinical Laboratory Evaluation and Certification Program. Legislative Reference Bureau; 1979.
  7. Shaw CD, Costain DW. Guidelines for medical audit: seven principles. BMJ 1989;299(6697):498–499. DOI: 10.1136/bmj.299.6697.498
  8. Osaro E, Charles AT. Laboratory Total Quality Management for Practitioners and Students of Medical Laboratory Science. AuthorHouse; 2012.
  9. Mifsud AJ, Shafi MS. Internal audit in a microbiology laboratory. J Clin Pathol 1995;48(6):560–563. DOI: 10.1136/jcp.48.6.560
  10. Anderson MA. GLP Quality Audit Manual. CRC Press; 2019.
  11. Malami SA, Iliyasu Y. Local audit of diagnostic surgical pathology as a tool for quality assurance. Niger J Med 2008;17(2):186–190. DOI: 10.4314/njm.v17i2.37381
  12. Akinyamoju AO, Adeyemi BF, Adisa AO, et al. Audit of oral histopathology service at a Nigerian tertiary institution over a 24-year period. Ethiop J Health Sci 2017;27(4):383–392. DOI: 10.4314/ejhs.v27i4.9
  13. Georgia B, Ramalingam K, Ramani P, et al. Evaluating the efficacy of new laboratory information system in turn around time (TAT) for oral biopsies. J Pharm Neg Res 2022;13(4):1147–1152. DOI: 10.47750/pnr.2022.13.s04.135
  14. Dawande PP, Wankhade RS, Akhtar FI, et al. Turnaround time: an efficacy measure for medical laboratories. Cureus 2022;14(9):e28824. DOI: 10.7759/cureus.28824
  15. Chung HJ, Lee W, Chun S, et al. Analysis of turnaround time by subdividing three phases for outpatient chemistry specimens. Ann Clin Lab Sci 2009;39(2):144–149. PMID: 19429800.
  16. Bhatt RD, Shrestha C, Risal P. Factors affecting turnaround time in the clinical laboratory of the Kathmandu University Hospital, Nepal. EJIFCC 2019;30(1):14–24. PMCID: PMC6416806.
  17. Hawkins RC. Laboratory turnaround time. Clin Biochem Rev 2007;28(4):179–194. PMID: 18392122.
  18. S S, Ramalingam K, Ramani P. Cost utility analysis in pathology laboratory testing: review of literature and proposal of new descriptive model for cost analysis. J Pharmaceut Negat Result 2022;13(4):1133–1138. DOI: 10.47750/pnr.2022.13.s04.133
  19. Valenstein PN, Emancipator K. Sensitivity, specificity, and reproducibility of four measures of laboratory turnaround time. Am J Clin Pathol 1989;91(4):452–457. DOI: 10.1093/ajcp/91.4.452
  20. Srinivasaragavan D, Ramalingam K, Ramani P. Root cause analysis: unraveling common laboratory challenges. Cureus 2024;16(2):e53393. DOI: 10.7759/cureus.53393
  21. Errani C, Traina F, Perna F, et al. Current concepts in the biopsy of musculoskeletal tumors. Sci World J 2013;2013:538152. DOI: 10.1155/2013/538152
  22. Kasraeian S, Allison DC, Ahlmann ER, et al. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. Clin Orthop Relat Res 2010;468(11):2992–3002. DOI: 10.1007/s11999-010-1401-x
  23. Rougraff BT, Aboulafia A, Biermann SJ, et al. Biopsy of soft tissue masses: evidence-based medicine for the musculoskeletal tumor society. Clin Orthop Relat Res 2009;467(11):2783–2791. DOI: 10.1007/s11999-009-0965-9
  24. Mouseli A, Barouni M, Amiresmaili M, et al. Cost-price estimation of clinical laboratory services based on activity-based costing: a case study from a developing country. Electron Physician 2017;9(4):4077–4083. DOI: 10.19082%2F4077
  25. Yusefzadeh H, Ghaderi H, Bagherzade R, et al. The efficiency and budgeting of public hospitals: case study of Iran. Iran Red Crescent Med J 2013;15(5):393–399. DOI: 10.5812/ircmj
  26. Färe R, Grosskopf S, Knox Lovell CA. The Measurement of Efficiency of Production. Springer Science & Business Media; 2013.
  27. Abolhallaje M, Jafari M, Seyedin H, et al. Financial management reforms in the health sector: a comparative study between cash-based and accrual-based accounting systems. Iran Red Crescent Med J 2014;16(10):e15472. DOI: 10.5812/ircmj.15472
  28. Barnum H, Kutzin J, World Bank. Public hospitals in developing countries: resource use, cost, financing. 1993. DOI: 10.12691/jbe-2-2-2
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.