Prioritizing Patient Safety and Minimizing Waste: Institutional Review of Cases and a Proposed Process for Designing a Surgical Pathology Gross-Only Examination Policy.

Autor:	Harris CK; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Pyden A; Department of Pathology, Division of Pathology and Laboratory Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA., Onken AM; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA., Yarsky B; Division of Quality and Performance Improvement, Children's Hospital of Los Angeles, Los Angeles, CA, USA., Hayne C; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA., Glickman J; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA., Heher YK; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	American journal of clinical pathology [Am J Clin Pathol] 2022 Nov 03; Vol. 158 (5), pp. 598-603.
DOI:	10.1093/ajcp/aqac093
Abstrakt:	Objectives: Gross-only examination policies vary widely across pathology departments. Several studies-particularly a College of American Pathologists' Q-Probes study-have looked at the variations in gross-only policies, and even more studies have addressed the (in)appropriateness of certain specimen types for gross-only examination. Few, if any, studies have tackled the important task of how to revise and safely implement a new gross-only examination protocol, especially in collaboration with clinical colleagues. Methods: We reviewed the grossing protocols from three anatomic pathology centers to identify common gross-only specimen types. We compiled an inclusive list of any specimen types that appeared on one or more centers' lists. We performed a retrospective review of the gross and microscopic diagnoses for those specimen types to determine if any diagnoses of significance would have been missed had that specimen been processed as a gross-only. Results: We reviewed 940 cases among 13 specimen types. For 7 specimen types, the gross diagnoses provided equivalent information to the microscopic diagnoses. For 6 specimen types, microscopic diagnoses provided clinically meaningful information beyond what was captured in the gross diagnoses. Conclusions: To improve the value of care provided, pathology departments should conduct internal reviews and consider transitioning specimen types to gross-only when safe. (© The Author(s) 2022. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu