Role of Management in establishing quality performance in the cytology in the laboratory

The EU guidelines recommend that the laboratory manager should have overall responsibility for Quality Assurance in the cytology laboratory. His or her duties will involve:

• Establishing a Quality Assurance program in the laboratory
• Developing  a basic set of standards (Quality standards) for the laboratory
• Arranging participation of laboratory personnel in External Quality Assurance programs
• Ensuring Standard Operating Procedures are in place and are adhered to
• Ensure Health and Safety regulations are observed
• Arranging training, certification, accreditation and continuing professional education for laboratory personnel
• Arranging annual  review of laboratory performance and staff appraisal
• Monitor local cervical screening program

Monitoring the local cervical screening program

1. Collaborate with local/ regional / national health authority in monitoring cervical screening program
2. Agree formula for record keeping and annual returns with the above authorities
3. Institute and monitor fail safe procedure for follow up of abnormal smears
4. Prepare annual return of number of smears processed annually by laboratory classified by age, source (GP, colposcopy clinic , well women clinic etc).
5. Prepare annual return  of number of smears classified by final report (inadequate / negative /ASCUS , LSIL , HSIL)
6. Prepare annual return on number of women referred  for colposcopy and colposcopic biopsy findings. Determine Sensitivity and specificity and PPV of cytology report  on basis of histological findings.
7. Compare laboratory performance against agreed Quality Standards.
8. Provide feedback for smear takers i.e. number of inadequate smears
9. Set up review panel of cases of invasive cancer
10. Prepare annual report