Surgical pathology report defects. A College of American Pathologists Q-probes study of 73 institutions.

Context.--The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. Objective.--To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Design.--Participants...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 138; no. 5; pp. 602 - 613
Autores principales: Volmar, Keith E., Idowu, Michael O., Hunt, Jennifer L., Souers, Rhona J., Meier, Frederick A., Nakhleh, Raouf E.
Formato: research tables/charts Journal Article
Publicado: College of American Pathologists May2014
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Archives of Pathology & Laboratory Medicine
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      dt: May2014
      vid: 138
      iid: 5
      pid: 2550
      pub: College of American Pathologists
      place: Northfield, Illinois
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        96010536
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        10.5858/arpa.2013-0099-CP
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        atl: Surgical pathology report defects. A College of American Pathologists Q-probes study of 73 institutions.
      aug:
        au:
          Volmar, Keith E.
          Idowu, Michael O.
          Hunt, Jennifer L.
          Souers, Rhona J.
          Meier, Frederick A.
          Nakhleh, Raouf E.
        affil: Department of Pathology, Rex Pathology Associates, Raleigh, North Carolina
      sug:
        subj:
          Reports Standards
          Benchmarking
          Pathology, Clinical
          Surgery, Operative
          Human Error
          Proficiency Testing, Laboratory
          Quality Assurance
          Prospective Studies
          Questionnaires
          P-Value
          Descriptive Statistics
          Kruskal-Wallis Test
          Data Analysis Software
          Human
      ab: Context.--The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. Objective.--To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Design.--Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. Results.--Seventy-three institutions reported 1688 report defects discovered in 360 218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P < .001), while misidentifications were most often discovered by clinicians (44.6%, P < .001). Misidentification rates were lower when all malignancies were reviewed by a second pathologist before sign-out (0.0 versus 0.6 per 1000, P < .001), and specimen defect rates were lower when intradepartmental review of difficult cases was conducted after sign-out (0.0 versus 0.4 per 1000, P = .02). Conclusion.--This study provides benchmarking data on report defects and defect fractions using standardized taxonomy.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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