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. 2015 May;42(5):333-45.
doi: 10.1111/cup.12485. Epub 2015 Apr 21.

Dermatopathologists' concerns and challenges with clinical information in the skin biopsy requisition form: a mixed-methods study

Nneka I Comfere  1 , Margot S Peters  1 , Sarah Jenkins  2 , Kandace Lackore  2 , Kathleen Yost  3 , Jon Tilburt  4
Affiliations

Dermatopathologists' concerns and challenges with clinical information in the skin biopsy requisition form: a mixed-methods study

Nneka I Comfere et al. J Cutan Pathol. 2015 May.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: dermatologist; dermatology; dermatopathology.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1
ASDP Survey Questionnaire (view online at: need online link here)
Figure 2
Figure 2
Impact of quality of clinical information on diagnostic performance
Figure 2
Figure 2
Impact of quality of clinical information on diagnostic performance
Figure 2
Figure 2
Impact of quality of clinical information on diagnostic performance
Figure 2
Figure 2
Impact of quality of clinical information on diagnostic performance
Figure 2
Figure 2
Impact of quality of clinical information on diagnostic performance
Figure 2
Figure 2
Impact of quality of clinical information on diagnostic performance
Figure 3
Figure 3
Focus Group Select Comments
See this image and copyright information in PMC

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