From Specimen to Signature: A Retrospective Audit of Turnaround Times in Routine Pathology Reporting at the Department of Pathology, Bangladesh Medical University

Background Turnaround time (TAT) is a critical quality indicator in diagnostic pathology, influencing clinical decision-making, patient management, and healthcare efficiency. Systematic benchmarking of TAT across routine and specialized pathology services is essential for identifying workflow strengths and performance gaps, particularly in high-volume tertiary care settings. This study aims to evaluate and benchmark TAT performance across histopathology, cytopathology, and specialized laboratory tests at the Department of Pathology, Bangladesh Medical University, and to compare observed performance against established TAT standards and compliance benchmarks. Methodology A retrospective audit was conducted, analyzing TAT data for histopathology, cytopathology, immunohistochemistry, immunofluorescence, and cytogenetic tests over the study period. TAT was calculated in working days from specimen receipt to final report authorization. Performance metrics included average, median, interquartile range, maximum TAT, and percentage of reports delivered within predefined target TAT. Observed performance was benchmarked against institutional and international quality standards, with compliance defined as ≥90% on-time reporting. Results Histopathology specimens demonstrated average TATs of seven to eight working days across large, medium, and small samples; however, compliance varied significantly by specimen size, ranging from 77.10% for large specimens to 89.51% for small specimens. Cytopathology services showed superior performance, with average TATs of three to five working days and high compliance rates (86.48%-96.22%), particularly for fluid cytology and liquid-based cytology. Specialized tests exhibited wide variability in TAT and compliance. Fluorescent in situ hybridization (FISH) achieved 100% compliance. Direct immunofluorescence (DIF) showed the lowest performance, with only 67.7% of reports delivered within the target timeframe. Conclusions This study highlights substantial variability in TAT performance across pathology subspecialties, driven largely by specimen complexity and test-specific workflow demands. While cytopathology and FISH diagnostic tests demonstrated excellent efficiency and compliance, large histopathology specimens and DIF represent key areas for targeted quality improvement. Continuous TAT monitoring using compliance-based and variability-sensitive metrics can support process optimization and enhance diagnostic service delivery in tertiary care pathology laboratories.