TURNAROUND TIME IN HISTOPATHOLOGY LABORATORIES: DETERMINANTS OF DIAGNOSTIC EFFICIENCY

Abstract

Histopathology turnaround time (TAT) is an important measurement of quality in laboratories that has an impact on how patients are treated and how therapies may be made available for the patient, as well as on the clinical outcomes of that therapy. Delays and/or waiting for a histopathology report increases the anxiety of a patient, as well as compromises the treatment plan for the patient due to delays in starting therapy. Literature published between January 2010 and December 2025 was included in this systematic review using PubMed, Scopus, Google Scholar, and institutional quality reports assessing TAT in histopathology and surgical pathology. Twenty studies relevant to workflow efficiency, TAT, digital pathology, artificial intelligence (AI), lean methodology, telepathology, and quality improvement were selected. Study selection followed PRISMA guidelines. Due to heterogeneity, no meta-analysis was performed; instead, descriptive statistical analysis and thematic synthesis were used. The systematic review assesses the primary factors that delay histopathology TAT, types of interventions that increase productivity in the laboratory and improve the quality of the reports to clinicians based on workflow efficiencies. Analytical delay (85%) had the highest reporting of delay to TAT, followed by delay in the pre-analytical phase (65%), staffing availability (55%), post-analytical phase delays (45%), and lack of clinical information (40%). The average TAT for routine biopsy specimens was reported as 2–3 days; for large surgical specimens, as 5–7 days; for immunohistochemistry, as 7–10 days. Digital pathology, telepathology, use of lean methodology, and use of AI tools will create opportunities to improve TAT.