Assessment of histopathology and cytology request form documentation quality using six Sigma and Pareto analysis in Benghazi, Libya

Six Sigma and Pareto analysis were applied to identify critical deficiencies in documentation practices during the pre-analytical phase of histopathology services in Libya. The results highlight an urgent need to implement standardized staff training protocols, redesign request forms with mandatory fields, enforce accountability mechanisms, and establish robust quality monitoring systems. Low-cost tools-such as Excel-based compliance trackers and manual logbooks-can serve as effective interim solutions to enhance documentation compliance and support continuous quality improvement in resource-limited settings.