title: Continuous quality improvement of Pap smears in an ambulatory care facility.
abstract: This article describes how the H. Claude Hudson Comprehensive Health Center (Los Angeles) implemented a continuous quality improvement program to reduce the unacceptably high rate of nonrepresentative Papanicolaou (Pap) smears (those lacking endocervical component). A review of the literature and telephone surveys indicated that the optimal Pap smear technique includes the use of a cervical cytobrush. Several cytobrushes were evaluated and one was chosen to be used facilitywide. Clinicians were given in-services on the proper cervical sampling techniques using the cytobrush. The rate of nonrepresentative Pap smears decreased approximately 12% during a five-month period; this has been attributed to uniform implementation of the cytobrush technique in nonpregnant patients, in-service education, and cooperative teamwork.
authors.affiliation: H. Claude Hudson Comprehensive Health Center, Los Angeles County Department of Health Services, CA 90007.
authors.forename: J A
authors.initials: JA
authors.lastname: Pachciarz
authors.forename: M I
authors.initials: MI
authors.lastname: Abbott
authors.forename: B
authors.initials: B
authors.lastname: Gorman
authors.forename: C E
authors.initials: CE
authors.lastname: Henneman
authors.forename: M
authors.initials: M
authors.lastname: Kuhl
mesh_terms: D019411:Clinical Laboratory Techniques / Q000592:standards; D003151:Community Health Centers / Q000592:standards*; D005188:False Negative Reactions; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D065006:Papanicolaou Test; D011785:Quality Assurance, Health Care; D014626:Vaginal Smears / Q000295:instrumentation / Q000592:standards*