Formatting pathology reports: applying four design principles to improve communication and patient safety

Abstract

Context: Eighty-two million surgical pathology and cytology reports were issued in the United States during 2007; a subset of these reports will be misunderstood by readers. Recent attention has focused on standardizing the content of pathology reports, particularly for common malignancies, to facilitate transmission of required information. Comparatively little attention has been focused on the format of reports--the arrangement of headlines, text blocks, and other report elements to optimize communication.

Objective: To provide guidance to report designers and authors about how to format reports to maximize the speed, fidelity, and ease of information transfer.

Data sources: Review of relevant literature from commercial publishing and aviation and the fields of cognitive psychology and pathology, supplemented with an analysis of 10,000 pathology reports and the author's personal experience as a practicing pathologist.

Conclusions: Four evidence-based and time-tested principles can help pathologists format information to communicate more effectively: (1) use of diagnostic headlines to emphasize key points, (2) maintenance of layout continuity with other reports and over time, (3) optimization of information density for readers, and (4) reduction of extraneous information or "clutter." Practical advice is also provided to help pathologists minimize corruption of formatting as reports are transmitted electronically between medical information systems.