Nneka I Comfere1, Margot S Peters1, Sarah Jenkins2, Kandace Lackore2, Kathleen Yost3, Jon Tilburt4. 1. Department of Dermatology and Department of Laboratory Medicine and Pathology, Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. 2. Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. 3. Health Sciences Research-Epidemiology, Mayo Clinic, Rochester, MN, USA. 4. Division of General Internal Medicine, Biomedical Ethics Research Unit and Knowledge & Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Communication failures between clinicians and dermatopathologists are prevalent. Our primary objective was to characterize the concerns and challenges of dermatopathologists posed by incomplete or inaccurate clinical information in the skin biopsy requisition form. METHODS: An explanatory sequential, mixed-methods study design comprised of a survey sent to 1103 members of the American Society of Dermatopathology (ASDP), followed by two focus group sessions. RESULTS: A total of 54% (598/1103) of dermatopathologists completed the questionnaire. Most dermatopathologists (80%; 436/548) viewed their roles to be providers of histopathological diagnosis and a report that is clinically meaningful. Paper or electronic requisition forms were the most common communication method (85%; 458/541) and were associated with the highest rates of dissatisfaction in 36% (193/537) of respondents. Inadequacy of specimens emerged as an important factor influencing judgment of the quality of provided clinical information. 44.7% (261/584) of dermatopathologists spent 30 minutes or more on average every day searching for relevant clinical information to assist with their histopathologic interpretation. CONCLUSION: ASDP dermatopathologists expressed significant dissatisfaction with the quality of clinical information in the requisition form and the time spent gathering information necessary for accurate, timely and clinically meaningful diagnosis. These findings have implications for the quality, safety and efficiency of dermatologic care.
BACKGROUND: Communication failures between clinicians and dermatopathologists are prevalent. Our primary objective was to characterize the concerns and challenges of dermatopathologists posed by incomplete or inaccurate clinical information in the skin biopsy requisition form. METHODS: An explanatory sequential, mixed-methods study design comprised of a survey sent to 1103 members of the American Society of Dermatopathology (ASDP), followed by two focus group sessions. RESULTS: A total of 54% (598/1103) of dermatopathologists completed the questionnaire. Most dermatopathologists (80%; 436/548) viewed their roles to be providers of histopathological diagnosis and a report that is clinically meaningful. Paper or electronic requisition forms were the most common communication method (85%; 458/541) and were associated with the highest rates of dissatisfaction in 36% (193/537) of respondents. Inadequacy of specimens emerged as an important factor influencing judgment of the quality of provided clinical information. 44.7% (261/584) of dermatopathologists spent 30 minutes or more on average every day searching for relevant clinical information to assist with their histopathologic interpretation. CONCLUSION:ASDP dermatopathologists expressed significant dissatisfaction with the quality of clinical information in the requisition form and the time spent gathering information necessary for accurate, timely and clinically meaningful diagnosis. These findings have implications for the quality, safety and efficiency of dermatologic care.
Authors: Gordon D Schiff; Omar Hasan; Seijeoung Kim; Richard Abrams; Karen Cosby; Bruce L Lambert; Arthur S Elstein; Scott Hasler; Martin L Kabongo; Nela Krosnjar; Richard Odwazny; Mary F Wisniewski; Robert A McNutt Journal: Arch Intern Med Date: 2009-11-09