ISO 15189:2012 Technical Requirements for Cytopathology Laboratory Information Systems

Cytopathology Laboratory Workflow

A modern cytopathology laboratory, especially when there are research and training activities, nowadays is composed of many branches (Figure 1). The laboratory director performs the management and quality control, and assurance procedures; assisted by the quality manager and in several cases by an assigned technical manager. The core of the laboratory subsequently is composed of units and smaller branches, each one responsible for performing specific examinations. The number of examination types performed is in the range of a few hundred due to the addition of molecular examinations. In cytopathology laboratories, usually most of the work volume is related to test Papanicolaou, for cervical cancer screening.

Figure 1.

Structure of a modern cytopathology laboratory

The Cytopathology Laboratory Cycle And The Laboratory Information Systems

The modern cytopathology laboratory follows a typical cycle for the daily workflow (Figure 2). The physician (usually a doctor from a clinic or another person, for example, a midwife) requests specific examinations and dispatches (unless it is already dispatched) a biological sample to the laboratory. Subsequently the sample is received, checked and marked (a unique identifier is assigned) in order to be traceable during the subsequent process. The creation of a worksheet that assigns examination (and additionally pre and post examination) tasks to persons or medical analyzers follows. Usually, many samples requiring the same examination are grouped together; the examinations are handled as a batch or in parallel from cytopathologists or medical modalities (analyzers). Each analysis is checked for correctness via an appropriate quality control (QC) and verification procedure. At this stage if the QC is passed the results are released to the requester, otherwise the analysis should be repeated. In some rare cases, errors may be found after the release of results; in this case the released examination results are invalidated and the requester is informed for the adverse event.