The development of key performance criteria for monitoring laboratory performance in gynaecological cytopathology

Abstract

Aim The aim of the Royal College of Pathologists of Australia Quality Assurance Program (RCPA QAP) Performance Monitoring Project is to develop key performance criteria across all disciplines which can be used to identify suboptimal laboratory performance earlier than the usual 3 year NATA accreditation cycle. In Cytopathology, a review of retrospective data from both gynaecological slide surveys and Performance Measures was undertaken to assist in developing criteria relating to gynaecological cytopathology. The aim of the review was to determine any relationship between results from QAP gynaecological slide surveys and Performance Measures data. Method Seven years of Australian participant data from conventional gynaecological surveys (GYN), liquid-based gynaecological surveys (LBC) and Performance Measures (PM) were extracted from the Cytopathology QAP database (2004–2010). Results from participants with one or more major error in any year in GYN or LBC surveys were compared with their PM data. Results from participants with one or more Performance Measure outside the National Standard in any year were compared with their GYN and LBC survey results. Results Participants with one or more major error in any year in the GYN or LBC surveys had more PerformanceMeasures outside the national standard compared to those with no major errors (GYN 36% vs 26%; LBC 39% vs 23%). Participants with one or more Performance Measure outside the standard in any year returned twice as many GYN major errors compared to those with no Performance Measures outside the standard (1% vs 0.5%). There were twice as many major errors for LBC than for GYN survey results (1.27% vs 0.7%). While there is a tendency for participants with one or more major errors or Performance Measures outside the standard to do more poorly in all indicators, it did not preclude participants in the better performing group from returning major errors or having Performance Measures outside the standard. Conclusion This retrospective study showed a relationship between results from routine gynaecological slide surveys and Performance Measures data. The RCPA Cytopathology Performance Monitoring Committee proposes to establish performance monitoring criteria using results from both gynaecological slide surveys and Performance Measures data. These results will be utilised in the pilot phase of the project planned for 2012. The outcomes of the pilot phase will help determine the effectiveness of these criteria in assisting NATA to identify laboratories that may require early review. Conflict of interest statement This research was supported by the Department of Health and Ageing. The Department had no role in analysing the data or preparing this abstract.