[The cervico-vaginal cytology workload. A complex task in planning laboratory activities].
Measurement of professional work efforts are desired by health care administrators as a means of comparing the efficiency of the laboratory activities in an attempt to predict proper staffing levels and funding. In view of the complexity of measuring pathology workload, it is not surprising that the evaluation of this effort has never been adequately quantitated and that, as a consequence, literature data are scant. We reviewed all available information on cervical cytology workload. Most data refer to cytoscreener workload while very few indications concerning the cytopathologist's performance can be obtained. The vast majority of reported figures derive from the English literature and show extreme variability: for cytoscreener/cytotechnologist, the workload figures are between 3,000-15,000/year, 40-150/day and 3-20/hour. In addition, data are scarcely comparable since the true "object" of the workload measurement is not always evident: just Pap-test microscopic screening or pre- and post-analytical procedures too? In the Italian milieu , a reasonable cytoscreener workload would range from 6 slide/hour (i.e. 45-50/day or 10,000/year) if the duty is limited to the screen only, to 4 slide/hour (i.e. 30-35/day or 7,000/year) for people involved in slide preparation or ancillary duties. For both events, upper and lower workload limits are suggested. We conclude that professional attention must be given to determine appropriate workloads in order to minimize suboptimal performance and improve the cost-effectiveness of laboratory activities.
Andrion
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Dipartimento dei Servizi Diagnostici, U.O. di Anatomia e Istologia Patologica, Ospedale Martin, ASL 2, Torino. andrion@inrete.it
Dalla Palma
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P
D019411:Clinical Laboratory Techniques / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D004526:Efficiency; D006285:Health Planning; D006801:Humans; D007558:Italy; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D013677:Medical Laboratory Science / Q000191:economics; D014626:Vaginal Smears / Q000191:economics / Q000592:standards; D000078329:Workforce; D016526:Workload / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data