title: Exploring the links between quality assurance and laboratory resources. An audit-based study.
abstract: OBJECTIVE
  To investigate and rectify the problems related to Ziehl-Neelsen (Z-N) staining in a cytology laboratory in the context of quality assurance.
  
  
  METHODS
  An audit based quality assurance study of 1,421 patients with clinical diagnoses of tubercular lymphadenopathy who underwent fine needle aspiration cytology. Data from 8 months were audited (group 1). Laboratory practices related to selection of smears for Z-N staining were studied. A 2-step corrective measure based on results of the audit was introduced for 2 months (group 2). Results were subjected to statistical analysis using the chi 2 test.
  
  
  RESULTS
  Of 1,172 patients in group 1,368 had diagnoses other than tuberculosis. Overall acid-fast bacillus (AFB) positivity was 42%. AFB positivity in 249 patients in group 2 was 89% (P < .0001).
  
  
  CONCLUSIONS
  Several issues in the laboratory are linked to quality assurance. Solving everyday problems can have far-reaching benefits for the performance of laboratory personnel, resources and work flow.
authors.affiliation: Cytopathology Section, Department of Pathology, University College of Medical Sciences, Guru Tegh Bahadur Hospital, Delhi, India.
authors.forename: Navjeevan
authors.initials: N
authors.lastname: Singh
authors.forename: Aru
authors.initials: A
authors.lastname: Panwar
authors.forename: Vipin Fazal
authors.initials: VF
authors.lastname: Masih
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Arora
authors.forename: Arati
authors.initials: A
authors.lastname: Bhatia
mesh_terms: D044963:Biopsy, Fine-Needle; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D006801:Humans; D007194:India; D007755:Laboratories, Hospital / Q000592:standards*; D008206:Lymphatic Diseases / Q000473:pathology; D010340:Pathology, Surgical / Q000379:methods* / Q000592:standards*; D011237:Predictive Value of Tests; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D040841:Resource Allocation; D013194:Staining and Labeling / Q000592:standards*; D013647:Task Performance and Analysis; D014376:Tuberculosis / Q000473:pathology; D016526:Workload / Q000592:standards