Ansar Farrukh, Rauf Mohammad S, Kinwan Khan Muhammad, Rauf Uzma, Ahmad Muhammad Bilal, Ishtiaq Ayesha, Butt Muhammad Zuama Zafar, Abdul Hameed Fatima, Ali Sabahat, Amin Amna
Medicine, Alkhidmat Raazi Hospital, Rawalpindi, PAK.
Medicine, Northwest School of Medicine, Peshawar, PAK.
Cureus. 2025 Mar 27;17(3):e81317. doi: 10.7759/cureus.81317. eCollection 2025 Mar.
Introduction Incomplete histopathology request form documentation can compromise diagnostic accuracy and delay patient management. This study aimed to assess and improve documentation completeness using a structured quality improvement approach. Methods A clinical audit was conducted at a tertiary care hospital using the Plan-Do-Study-Act (PDSA) cycle. In the first audit cycle, 250 histopathology request forms were reviewed for completeness. Based on the findings, targeted interventions were implemented, including a standardized request form, clinician engagement, and improved accessibility to forms. A second audit cycle assessed 150 forms to evaluate the impact of these interventions. Results Significant improvements were observed across all documentation parameters. Clinical history documentation increased from 0% to 62%, while presenting complaints improved from 3.2% to 73%. Physical examination findings were recorded in 96% of cases compared to 73.6% initially, and radiological findings improved from 44.4% to 95%. Laboratory investigation results increased from 41.2% to 81%, while drug/medication history documentation rose from 6% to 48%. Specimen details also showed improvement, with biopsy time documentation increasing from 3.2% to 66% and provisional diagnosis documentation rising from 49.2% to 78%. Conclusion A structured quality improvement approach led to significant enhancements in documentation completeness. Ongoing audits, clinician training, and digital solutions are recommended for sustaining these improvements.
引言 组织病理学申请表文档不完整可能会影响诊断准确性并延误患者治疗。本研究旨在使用结构化质量改进方法评估并提高文档完整性。方法 在一家三级医院采用计划-执行-研究-行动(PDSA)循环进行临床审核。在第一个审核周期中,审查了250份组织病理学申请表的完整性。根据审核结果,实施了针对性干预措施,包括标准化申请表、临床医生参与以及提高表格的可获取性。第二个审核周期评估了150份表格,以评估这些干预措施的效果。结果 在所有文档参数方面均观察到显著改善。临床病史记录从0%增至62%,就诊主诉从3.2%增至73%。96%的病例记录了体格检查结果,而最初这一比例为73.6%,影像学检查结果从44.4%增至95%。实验室检查结果从41.2%增至81%,用药史记录从6%增至48%。标本细节也有所改善,活检时间记录从3.2%增至66%,初步诊断记录从49.2%增至78%。结论 结构化质量改进方法显著提高了文档完整性。建议持续进行审核、开展临床医生培训并采用数字解决方案以维持这些改进。