Histopathology services in a rural African hospital: how audit can improve service.
Audit is about doing things right. We undertook a detailed audit of the histopathological service at a rural district hospital in Africa because delays in obtaining biopsy results had been noted by clinicians. A wide range of serious pathology was found in the 100 consecutive biopsies reviewed. It took 26 days on average from the time a biopsy was taken to the time the result was returned to the clinician, and most of this delay was administrative in nature, occurring after the pathologist had reviewed the specimen at the regional laboratory. Because of these delays, only 22% of patients biopsied were ever informed of their results. By performing this audit, reporting the results, and acting against the problems discovered, the service rapidly improved. This study illustrates the importance of simple, routine audit in district hospitals in developing countries.
Kettle
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Centre for Epidemiological Research in Southern Africa, South African Medical Research Council, Hlabisa Hospital, South Africa.
Wilkinson
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D001706:Biopsy / Q000592:standards*; D006767:Hospitals, District; D006780:Hospitals, Rural; D006801:Humans; D008485:Medical Audit; D010337:Pathology Department, Hospital / Q000592:standards*; D011787:Quality of Health Care; D012189:Retrospective Studies; D013019:South Africa; D013997:Time Factors