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Reducing post-mortem report turnaround times at Tygerberg Forensic Pathology Service in South Africa: A quality
Janette Verster1, Abebe Sorsa Badacho2, Juliet Nyasulu3
1Division of Forensic Medicine, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
Background:
Delays in issuing post-mortem reports at Tygerberg Forensic Pathology Service hindered judicial processes in unnatural death cases. Key challenges included inconsistent work ethics, heavy workloads, and complex forensic cases.
Methods:
The project aimed to reduce the average turnaround time for finalised post-mortem reports from 20 days to 10 days within three months. Root causes were identified using fishbone analysis. The intervention applied the Plan-Do-Check-Act (PDCA) cycle and introduced a cloud-based autopsy spreadsheet to track daily case progress, enabling staff to update status and monitor report issuance.
Results:
The targeted turnaround time of 10 days was achieved. Process measures showed improved compliance with daily updates, streamlined case management, and better alignment with prescribed timelines. Balancing measures supported ongoing quality assurance. Enablers included clear communication, centralized tracking, and strong leadership, while barriers involved case complexity and variations in staff work ethics.
Conclusion:
This quality improvement initiative successfully reduced turnaround times, improved transparency, and fostered accountability. It demonstrated that modest interventions, combined with teamwork and structured monitoring, can significantly enhance efficiency. Extending to a Plan-Do-Study-Act (PDSA) cycle is recommended for long-term impact. The project offers a practical model for quality improvement in complex healthcare settings.
