Meenakshi Mission Hospital & Research Center, India
Title: Role of internal quality audits in surgical pathology: Outcome in an Indian tertiary care hospital
Anil Malleshi Betigeri is currently working as Chief of Laboratory services "Meenakshi Mission Hospital & Research Center". Meenakshi Mission Hospital & Research Center (MMHRC) is a SRTrust-run hospital, which caters people in and around Madurai District. For the past 25 years the Laboratory services of MMHRC, has been the pillar of strength, keeping best interest of patient first in mind. The presently, our 850 bed multispecialty hospital runs on the smooth integrated quality tract set between clinical information and laboratory data. Laboratory services of MMHRC got accredited for department of Biochemistry and Hematology. Laboratory services of MMHRC are supported by computerized information, advanced scientific technology and Quality management system. In the past he has worked as consultant Histopathologist in various government & private organization. In these organizations, he has implemented quality standards in Anatomic pathology as per national accreditation requirements. He was initiated & coordinated tumor board meetings, mortality meetings and various research projects. He has been reviewer in two journals and publications (International & National), including an e-Book (Quality design in anatomical pathology) to his credit so far. Considering patient's safety, he has always felt the need to work with multidisciplinary team to solve problematic cases. It is important for us to make our colleagues know what criteria/terminology we use by mutual consensus. In developing country like India, where Healthcare is undergoing transformational change, it is important for us to incorporate regulatory standards to provide quality patient care. He believe "Healthcare as an Industry, which needs regulation. Caring of patients needs Human touch; our professional success depends on how effectively we co-ordinate as a team"
In developing countries like India, accreditation is still a voluntary, rather a mandatory process. External Quality Assurance Schemes in Surgical pathology are still at nascent stage. Most pathologists (and few other clinicians) probably subconsciously accept intra/inter observer bias in practicing this subjective specialty. However, they usually overlook it; partly because they have no secure alternate quality assurance methods to cost effectively substitute locally standardized customer satisfaction benchmarks. In this, art of practicing science, it is important to highlight that, if morphological features cannot be reliably, reproducible and quantified by group of fellow pathologists, any conclusion that is clinically important is almost meaningless and, at worst misleading. Presently there is more frequent case consultation and discussion through electronic media, than ever before. But, still uniformity in diagnostic terminology, grading systems, and criteria across all the pathologist community is yet to be achieved. Greatest fear of such audit is the manipulation. Finding deficiency and correcting that deficiency do not necessarily go together. However, if a solution is found, outcome in the experience gained by fellow pathologist are many fold and invaluable for visible practice of evidence based medicine. Here in we discuss role of internal audit in creating good working environment by collective decision making, team work mentality, formulating local policies and procedures with common goal of quality patient care.