Nongyn turnaround time-applying the requirement to your lab
Jonathan H. Hughes, MD, PhD
In the August 2002 issue of CAP TODAY, the Laboratory Accreditation Program checklist's
new guideline for the turnaround time of nongynecologic cytology specimens
was presented and discussed. The checklist question reads as follows: 0YP.06532
Phase I: Are 90 percent of reports on routine nongynecologic cytology cases
completed within two working days of receipt by the laboratory performing the evaluation?
This question was added to underscore the importance of turnaround time as a measure of laboratory
service quality and because the CAP believes that a goal of two working days
TAT for routine nongynecologic cytology specimens is reasonable for most laboratories.
Since we last discussed this topic in August of last year, the Nongynecologic Working Group has received
inquiries from a number of laboratories requesting further explanation and
clarification of the new guideline. Most of these inquiries have come from
smaller laboratories that use reference labs for screening or final diagnosis,
and for which a two-day TAT is not possible. The CAP recognizes that there
is considerable heterogeneity in the size and practice characteristics of
the laboratories participating in the accreditation program. Because of this
diversity, the recommended TAT of two working days is meant to serve as a
guideline only. Each laboratory is responsible for defining its own TAT parameters
that are reasonable for the types of specimens processed and that take into
account limiting factors such as the use of reference laboratories. In many
instances, a laboratory may be able to set a TAT of two working days for a
subset of routine specimens, and then provide reasonable justification for
specimens that require longer times because of special circumstances, such
as special stains, flow cytometry, or reference laboratory processing/screening.
As is the case with all of the accreditation program checklist questions, the new nongyn cytology
TAT requirement is meant to serve as a guideline for maximizing the quality
of pathology services and patient care within the practical constraints of
the individual laboratory. Each laboratory should monitor TAT continually
and carefully, be able to show it has an ongoing quality assurance plan for
minimizing TAT, and be able to justify those cases for which a two-day TAT is not achievable.
Dr. Hughes, a member of the Nongynecologic Working Group of the CAP Cytopathology Committee, is with Laboratory Medicine Consultants, Ltd., Las Vegas.