QUALITY DESIGN IN ANATOMICAL PATHOLOGY

Quality is a pervasive term which is often overused and seldom achieved. Dr Walter Shewhart invented the statistical control chart in 1930s [1] which was utilized by the United States during world war-II the United States along with basic quality control methods to produce military supplies in large quantities cheaply, but with good quality. In manufacturing, quality is a measure of excellence or a state of being free of defects, deficiencies, and significant variation, brought about by the strict and consistent adherence to measurable and verifiable standards to achieve uniformity of output that satisfies specific customer or user requirement. According to American National Standards Institute, the definition of quality, accepted by the CAP (College of American Pathologists), is “The totality of features and characteristics of a product or service that bear on its ability to satisfy given needs.” Some have defined quality as “Conformance to specification”, others have suggested that quality is meeting or exceeding customer expectations. The Institute of Medicine (IOM) quality metric defined 6 domains of quality: safety, effectiveness, efficiency, timeliness, equity, and patient centeredness [5]. To accomplish this, basic notions such as quality and product must be defined and understood. Elements of quality that are important in generation of the end product i.e. surgical pathology report include accuracy, timeliness, reproducibility, and completeness. The aim of quality should focus on measuring the complete process from the clinician’s perspective.