Internal Audit of an Oral Pathology Laboratory: Perspectives on Finances and Operational Management

Background Internal audits are essential tools for enhancing the operational efficiency, quality, and effectiveness of healthcare departments. Audits enable the departments and laboratories to meet the changing needs of the healthcare environment by giving a detailed picture of the department's operations and highlighting areas for possible growth and development. Aims and objectives This study focuses on the biopsies received in the Oral Pathology Department at Saveetha Dental College, aiming to evaluate biopsy trends, financial performance, and resource utilization over one year. Materials and methods The oral pathology department audit covered the period from 1st April 2023 to 31st March 2024. The institutional human ethical committee and scientific review board approved the retrospective audit. It involved a comprehensive analysis of biopsy data, financial records, and material usage. Data on different biopsy types (excisional, incisional, frozen sections), immunohistochemistry, cytology, and special stains were collected and analyzed across four quarters. Financial performance was assessed by comparing total income and expenses, while resource utilization was examined through the use of histopathological blocks and other consumables. Statistical analysis (chi-square) was performed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). A P-value less than 0.05 was considered statistically significant. Results We received 1100 cases during the study period. Excisional biopsies were the most common, with 474 (43.09%) cases, followed by incisional biopsies with a total of 432 (39.27%). Out of total cases of 1100, the second quarter (July-September 2023) had the highest case volume of 305 (27.72%), while the third quarter (October-December 2023) recorded the lowest of 250 (22.72%) cases. A financial audit revealed an annual deficit of ₹1,03,321 primarily due to higher expenses towards laboratory reagents. The overall expense incurred per case was ₹448.5. Tissue blocks cost ₹85.23 per case (19.00%) of the average cost per case. The chi-square test analysis was insignificant among the different types of biopsies and the reagent consumption across the four quarters.  Conclusion The audit identified critical areas for improvement in both clinical workload and financial management. High volumes of biopsies, but net financial deficits highlight the need for better cost management and resource utilization strategies to maintain sustainability without compromising diagnostic quality.