Comfere Nneka I, Peters Margot S, Jenkins Sarah, Lackore Kandace, Yost Kathleen, Tilburt Jon
Department of Dermatology and Department of Laboratory Medicine and Pathology, Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
J Cutan Pathol. 2015 May;42(5):333-45. doi: 10.1111/cup.12485. Epub 2015 Apr 21.
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.
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.
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.
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.
临床医生与皮肤病理学家之间的沟通失误很常见。我们的主要目标是描述皮肤活检申请表中不完整或不准确的临床信息给皮肤病理学家带来的担忧和挑战。
采用解释性序列混合方法研究设计，先向美国皮肤病理学会（ASDP）的1103名成员发送调查问卷，随后进行两场焦点小组讨论。
共有54%（598/1103）的皮肤病理学家完成了问卷。大多数皮肤病理学家（80%；436/548）认为他们的角色是提供组织病理学诊断以及一份具有临床意义的报告。纸质或电子申请表是最常见的沟通方式（85%；458/541），36%（193/537）的受访者对其不满率最高。标本不足成为影响对所提供临床信息质量判断的一个重要因素。44.7%（261/584）的皮肤病理学家平均每天花费30分钟或更多时间寻找相关临床信息以辅助其组织病理学解读。
ASDP的皮肤病理学家对申请表中临床信息的质量以及为进行准确、及时且具有临床意义的诊断而收集信息所花费的时间表示出极大不满。这些发现对皮肤科护理的质量、安全性和效率具有影响。
