Measuring the significance of workload on performance of cytotechnologists in gynecologic cytology - A study using rapid prescreening

BACKGROUND. Workload is extensively regulated and often used as a measure of quality in gynecologic cytology. Whether workload correlates with the sensitivity of screening in gynecologic cytology is not known. METHODS. The sensitivity of gynecologic cytology screening was measured over an 8-month period using the result of full screening coupled with the results of rapid prescreening. Sensitivity results were then correlated with daily workload volumes and the experience level of individual cytotechnologists. RESULTS. Rapid prescreening had an average sensitivity of 41.9% for atypical squamous cells of undetermined significance (ASCUS) and above. Full screening had a corrected sensitivity of 82.2% for ASCUS and above. Rapid prescreening increased the sensitivity of the laboratory to 89.9%. The sensitivity of full screening was significantly different between cytotechnologists (79.2% vs 99%, P <.001), but was not correlated with years of experience, sensitivity of rapid prescreening, or workload (all P > .05). When sensitivity and workload were examined on a monthly basis, there was no significant difference between sensitivity either as a group or individually at the highest and lowest workloads (P > .40 for all). CONCLUSIONS. Screeners sensitivity in gynecologic cytology appears to be unrelated to the experience level of individual cytotechnologists or to their workload at the levels examined.