Application of the royal college of pathologists UK workload guidelines to an Australian histopathology laboratory

Abstract

In Australia there are no benchmarks for safe workloads and staffing in common use, despite recognition of the potential effects of overload on quality. The Royal College of Pathologists UK (RC-Path) recently published Guidelines that include a points rating system for specimens and a recommendation for the points total safely achievable per reporting session. It was hypothesised that these guidelines could be utilised at Austin Health. All histopathology, gynaecological cytology and external review cases reported over June 2012 were retrospectively assigned points using the RCPath system. Routine utilisation of the system was then implemented following education sessions. Cases were allocated such that the daily points distribution was even across pathologists. Staffing levels were appropriate as measured against the RCPath recommendation. The retrospective analysis, however, showed marked variation between pathologists in the average daily points total (range 52–90, standard deviation = 11). Following implementation of the points system, greater equity in work allocation was achieved, (range 59–72, standard deviation = 4.1). Ongoing measurements will be useful to ensure that staffing levels are maintained at appropriate levels for quality reporting and patient safety, and to provide evidence to justify requests for workforce EFT increases.