An Analysis of Diagnostic Discrepancies in the Pathology Departments of Wigan and Salford

TL;DR

This audit examines diagnostic errors in a pathology department to improve accuracy and patient care.

Contribution

The study identifies key areas and methods for reducing diagnostic discrepancies in pathology.

Findings

56% of discrepancies were in microscopy (category B).

Gastrointestinal and breast specialties had the most errors.

MDT reviews were most effective for error detection.

Abstract

Aim: The aim of this audit is to evaluate diagnostic discrepancies occurring between April 2022 and March 2024 within the Wigan and Salford pathology (PAWS) department. The audit measures the rate and category of errors, identifies the stages at which they occurred, assesses the methods by which they were detected, and considers their impact on patient care, comparing the results to national standards and published data to identify trends and areas of improvement.

Materials and methods: This study was conducted through retrospective analysis of data extracted from the minutes of discrepancy meetings held during the specified two-year period. Each recorded discrepancy was reviewed and categorised according to error type, stage of occurrence, subspecialty and sample type, and method of identification.

Results: This audit found that 56% of the identified discrepancies were of category B (discrepancies in microscopy). Specialties most involved in discrepancies were gastrointestinal tract (GIT) and breast, with biopsy samples being the most specimen type that is prone to error. It was also concluded that the multidisciplinary team (MDT) review was the most effective safety netting method for error identification and rectification at PAWS labs.

Conclusion: The findings highlight the importance of having scheduled time for pre-MDT discussions in an era where histopathology departments are increasingly overstretched. We also highlight the importance of utilising in-lab imaging technologies to better assess post-radiotherapy specimens and biopsies. Strengthening these safety-netting strategies has the potential to reduce diagnostic discrepancies and improve overall patient care.

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