2009, Number 2
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Rev Med Inst Mex Seguro Soc 2009; 47 (2)
A Proposal to Evaluate the Productivity and Accuracy in Diagnostic Studies
Alvarado-Cabrero I
Language: Spanish
References: 17
Page: 199-204
PDF size: 145.08 Kb.
ABSTRACT
Objective: to assess the productivity in an Oncology Hospital (OH) and to assess the diagnostic accuracy.
Methods: an analysis focused on the specimen type received in three General Hospitals (GHs) and one OH was carried. Diagnostic categories were established according with the complexity of the steps involved in the production of a pathology report, the analysis also took in consideration costs. Three monthly plans were created for monitoring the accuracy diagnosis.
Results: four categories of specimen type and diagnostic complexity were found. At the OH, 13 381 cases was studied, of which 7745 (56 %) belong to the number 4 difficult cases category. About 2500 specimens came from each of the three GHs involved, of which 1825 cases (73 %) belong to the routine cases category. The income rate for the OH was that of 52 714 940 pesos as compared with $4 413 800 for the GHs. Routine interdepartmental conferences were selected as the way for improvement in the accuracy of diagnosis.
Conclusions: vast majority of cases evaluated at the OH are complex and difficult compared with the cases studied at a GHs.
REFERENCES
International Organization for Standarization. ISO standards. Disponible en http://www.iso.org/iso/iso_catalogue.htm
Ramsay AD, Galagher PJ. Local audit of surgical pathology: 18 month’s experience of peer review- based quality assessment in an English teaching hospital. Am J Surg Pathol 1992;16(5): 476-482.
Diamond I. Quality assurance and/or quality control. Arch Pathol Lab Med 1986;110(10):875-876.
Rickert RR. Quality assurance in anatomic pathology. Clin Lab Med 1986;6(4):697-706.
Cowan DF. Quality assurance in anatomic pathology. An information system approach. Arch Pathol Lab Med 1990;114(2):129-134.
Zardawi IM, Bennett G, Jain S, Brown M. Internal quality assurance activities of a surgical pathology department in an Australian teaching hospital. J Clin Pathol 1998;51(9):695-699.
Kilshaw D. Quality assurance. 2. Internal quality control Med Lab Sci 1987;44(1):73-83.
Association of Directors of Anatomic and Surgical Pathology. Recommendations for quality assurance and improvement in surgical and autopsy pathology. Human Pathology 2006;37(8):985-988.
Association of Directors of Anatomic and Surgical Pathology. Recommendations on quality control and quality assurance in anatomic pathology. Am J Surg Pathol 1991;15(10):1007-1009.
Association of Directors of Anatomic and Surgical Pathology. Critical diagnoses (critical values) in anatomic pathology. Am J Surg Pathol 2006;30 (7):897-899.
Pereira TC, Liu Y, Silverman JF. Critical values in surgical pathology. Am J Clin Pathol 2004;122(2): 201-205.
Abt AB, Abt LG, Olt GJ. The effect of interinstitution anatomic pathology consultation on patient care. Arch Pathol Lab Med 1995;119 (6):514-517.
Kronz JD, Westra WH, Epstein JL. Mandatory second opinion surgical pathology at a large referral hospital. Cancer 1999;86(11):2426-2435.
Frable WJ. Surgical Pathology- second reviews, institutional reviews, audits and correlations. What’s out there?, error or diagnostic variation? Arch Pathol Lab Med 2006;130(5):620-625.
Tsung JS. Institutional pathology consultations. Am J Surg Pathol 2004;28(3):399-402.
Nagtegaal ID, Kranenbarg E, Hermans J, van de Velde C. Pathology data in the central databases of multicenter randomized trials need to be base on pathology reports and controlled by trained quality managers. J Clin Oncol 2000;18(8):1771-1779.
Hocking GR, Niteckis VN, Cairns BJ. Hayman JA. Departmental audit in surgical anatomical pathology. Pathology 1997;29(4):418-421.