Personal performance profiles: a useful adjunct to quality assurance in cervical cytology

In our laboratory, which processes approximately 40,000 smears annually, the reporting patterns of each individual primary screener have been continuously monitored over a 6-year period. The detection rates for minor abnormalities (borderline/mild dyskaryosis) and major abnormalities (moderate dyskaryosis and worse) are published quarterly in the laboratory. Individual continuous monitoring rapidly identifies screeners with low detection rates. It is a useful adjunct to existing methods of quality assurance; rescreening can be more appropriately directed to smears reported by screeners with low detection rates. It also identifies training needs and may be used to assess the value of update courses for each screener. It is a faster method of identifying poor performance than rapid review of all smears. The reporting rate of inadequate smears is also calculated and published on a quarterly basis. This promotes a degree of uniformity within the laboratory in the rate at which smears are reported as inadequate, and also reduces the inadequate rate.