Quality in Cancer Diagnosis (diagnostic pathology)

Summary

The quality of oncologic pathology testing currently is focused on the evaluation of testing steps involved in the ordering, procuring, processing, interpreting, reporting, and decision making based on pathology test results. Most errors in cancer diagnosis are related to several factors and not simply a pathologist's interpretation. Clinical practitioners may improve the safety of oncologic pathology testing services by facilitating communication between clinical services and pathology laboratories at all levels of testing.


The CDC has sponsored several initiatives in the past decade to investigate the state of laboratory medicine with an emphasis on patient safety.244,245 In September 2007, the CDC convened the 2007 Institute on Critical Issues in Health Laboratory Practice: Managing for Better Health to develop an action plan for the immediate and long-term future. At the 2007 Institute, experts in laboratory medicine practice, clinicians, payers, health services researchers, and patient representatives identified gaps in the current quality of laboratory medicine. This identification is an early step in promoting research for filling these gaps and informing laboratory medicine stakeholders on best practices. These experts identified gaps in the current knowledge of best patient safety practices for laboratory/hospital information system integration, standardizing error measures, effect of workforce vacancy rates on safety, communication methods at handoff points, longitudinal tracking of safety measures, and adoption of quality improvement systems currently used in business and industry.245 Research in these areas as well as other areas, such as subspecialty pathology practice models, training, and laboratory organization, are needed to improve the state of safety in all phases of oncologic pathology diagnostic testing and screening practice.