Organization of internal quality control of histological examinations in a centralized pathology service.

<jats:p>Background. Centralization of pathology services improves throughput and standardization of diagnostics, yet it shifts the bulk of manageable risk outside the laboratory – to the interface with referring institutions. Objective: to describe and evaluate a management model of internal quality control of histological examinations in a centralized pathology service, based on adverse event reporting, internal audits and monitoring of pathology reports. Materials and methods. A retrospective descriptive analysis of data from the Centralized Pathology Department of Medsi Group of Companies for April 2026 and for April–June 2026. Data sources: the adverse event reporting portal, records of histological specimens, checklist-based internal audits, and the Kompas system for monitoring pathology reports. The internal network of clinics and assets and the external B2B referral network were analysed separately. Descriptive statistics were applied: absolute values, proportions, and ratios of adverse events to specimens received. Results. In April 2026, 995 adverse events were reported for 12,943 histological specimens from 101 referring institutions (7.69% across the internal network); 990 events, or 99.5%, were attributed to the pre-analytical extra-laboratory stage. Two leading categories accounted for 783 events, or 78.7%: incorrect completion of the referral form – 628, and a spilled formalin container – 155; in 470 cases the defect involved an unfilled item 18. For April–June 2026, 3,098 events were reported for 53,620 specimens (5.78%): internal network – 2,714 for 37,608 (7.22%), external B2B referral network – 384 for 16,012 (2.40%); monthly values were 5.75%, 6.78% and 4.74%. Kompas covered 492 documents; 1,280 checks identified 238 error entries: 164, or 69%, attributable to ten physicians and 74, or 31%, to all the others. Conclusions. Manageable risk is concentrated at the pre-analytical extra-laboratory stage; its management is ensured by a single standard, measurement of the “adverse events per specimen” indicator, non-punitive reporting of deviations, risk-based auditing, and a closed loop of corrective actions. Practical application. Organization of internal quality control in centralized diagnostic units: pathology, clinical and microbiological laboratories, radiology services, and cytology screening services.</jats:p>