Intraoperative Communications Between Pathologists and Surgeons: Do We Understand Each Other?

Context.--Clear communication between pathologists and surgeons during intraoperative consultations is critical for optimal patient care. Objective.--To examine the concordance of intraoperative diagnoses recorded in pathology reports to surgeon-dictated operative notes and assess the impact of an i...

Descripción completa

Detalles Bibliográficos
Publicado en:Archives of Pathology & Laboratory Medicine Vol. 147; no. 8; pp. 933 - 940
Autores principales: Wiggett, Amanda, Fischer, Gabor
Formato: research tables/charts Journal Article
Publicado: College of American Pathologists Aug2023
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=169944769&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 169944769
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00039985
        1FS
      jtl: Archives of Pathology & Laboratory Medicine
      issn: 00039985
      maglogo: N
    pubinfo:
      dt: Aug2023
      vid: 147
      iid: 8
      pid: 2550
      pub: College of American Pathologists
      place: Northfield, Illinois
    artinfo:
      ui:
        169944769
        169944769
        169944769
        10.5858/arpa.2020-0632-OA
        169944769
      ppf: 933
      ppct: 7
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Intraoperative Communications Between Pathologists and Surgeons: Do We Understand Each Other?
      aug:
        au:
          Wiggett, Amanda
          Fischer, Gabor
        affil: Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada
      sug:
        subj:
          Interprofessional Relations
          Surgeons
          Pathologists
          Communication
          Intraoperative Complications
          Intraoperative Period Standards
          Human
          Diagnostic Errors Prevention and Control
          Intraoperative Care Standards
          Pathology, Clinical
          Misinformation
          Descriptive Statistics
      ab: Context.--Clear communication between pathologists and surgeons during intraoperative consultations is critical for optimal patient care. Objective.--To examine the concordance of intraoperative diagnoses recorded in pathology reports to surgeon-dictated operative notes and assess the impact of an intervention on the discrepancy rates. Design.--Discrepancies between the intended communication by pathologists and the interpretation by surgeons were characterized as minor with no crucial clinical impact, and major with the potential of altering patient management. After analysis, a corrective intervention was implemented with education, information sharing, and a change in protocol, and a comparative analysis was conducted. Results.--We examined 223 surgical cases with 578 intraoperative consultations. In 23% (51) of the cases, the intraoperative diagnosis was not recorded in the operative reports. We found minor discrepancies in 34% (59) and major discrepancies in 2% (3) of the remaining cases. Deferrals accounted for 24% (14 of 59) of the minor and 33% (1 of 3) of the major discrepancies. Among the discrepant cases, 56% (35 of 62) were multipart cases, including all major discrepancies. Following intervention, no major discrepancies were found in 101 cases with 186 intraoperative interpretations. The cases with no operative documentation reports decreased from 23% to 16% (16 of 101). Minor discrepancies were found in 11% (9 of 85) of the cases, indicating significant improvement (P < .001). Conclusions.--Intraoperative diagnoses can be miscommunicated and/or misinterpreted, possibly impacting intraoperative management, particularly in multipart cases and those involving deferrals. This study highlights the importance of auditing intraoperative communications and addressing the findings through a local intervention.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N