INTRODUCTION TO QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY-3

PURCHASING AND INVENTORY

This is essential for efficient, cost-effective laboratory operations and uninterrupted availability of reagents, consumables, supplies and services.  It also ensures prevention of wastages, guarantees proper storage and continuous viability of reagents.

Benefits include availability of reagents as and when due, getting high quality reagents at appropriate cost and validity of reagents at all time.

The inventory management system is triggered by requests for what the laboratory need after careful analysis.  Quotations are received from suppliers who deliver into a central store where inspection is made before it is accepted by the laboratory and stored in the appropriate location and under standard conditions of storage.

Tools like logbooks and registers are essential for proper inventory.  Provision has been made in the Medical Laboratory Policy for a centralized national procurement system with a central store area that distributes directly to the laboratories.

Purchasing and inventory is very challenging in the histopathology laboratory.  Identified ones include, balancing availability of reagents/consumables with their expiry dates, monitoring of expiry dates and overstocking.  There must be an established policy and procedure for inventory management.  Inclusively, responsibility for implementation must be well assigned to appropriate personnel.

 PROCESS CONTROL

Process control in the histopathology laboratory starts from proper sample collection and fixation. The different sampling techniques in histology has been comprehensively discussed (Sampling Techniqes inHistopathology).

Process control therefore covers the pre-analytic, analytic and post-analytic phase in specimen handling.

There should be a histopathology laboratory handbook that details how to collect, receive and handle histopathology biopsies and the information made available to stakeholders. The handbook is a powerful tool to quickly acquaint a new entrant/recruit with the ‘what to do’ and ‘how to do’ in the histopathology laboratory.

Process control also captures the use and proper storage of reagents and other consumables.

An efficient quality control management system must be well established to ensure reliable results at all times. All methods and techniques should be controlled.  Positive blocks should be sourced and kept for the use of histo-scientists on the bench. For example, blocks of uterus, fibroadenoma and appendix should be sourced as H&E control.

A policy on sample handling should be in place to drive process control so as to allow for proper tracking samples received in the laboratory.  This policy should also highlight how samples will be disposed.

INFORMATION MANAGEMENT

Information management is the circulatory system of the quality management system.  It links all the processes, procedures, policies, and other activities in the laboratory. 

Information management could either be in digital form or paper form.  Most histopathology laboratories in the developing Countries still depend on paper communication and information management.

Information management reveals the tracking system in the laboratory for all samples received and how they were handled till the final product was released and report generated.

The backbone of the information management system in the histopathology laboratory include:

·         Request form

·         Histology day book

·         Data sheets

·         Decal register

·         Processing register

·         H&E Slides register

·         Special stains register

·         Immuno register

·         Post mortem (PM) register

·         Audit checklist

·         Log books

·         Inventory register

·         Dispatch register

·         Slides screening register etc

For an effective information management system, the importance of planning and staff training cannot be overemphasized.  

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