[Histonet] Histonet Digest, Vol 141, Issue 5 unexpected AP findings

[Steve McClain]

We have pathologists call nearly all unexpected findings.

Experience has shown that some findings we initially viewed as "insignificant" later proved to be problematic. 

We document calls to and from physicians (slide reviews also) in the reporting database record and usually in the report with an addendum report where treatment options are discussed.

Pre-emptive communication is preferable to   cases falling through the cracks. For example, yesterday I called the surgeon about a toe amputation with fungal osteomyelitis, not because it needed treatment, because it probably does not require systemic antifungals.  

Significant diseases ( melanoma, lymphoma, leukemia, metastasis, Merkel cell carcinoma, sarcoma) to surgeons whom I do not know are also called. A) it may be useful to steer/ refer the patient toward surgeon where appropriate; B) it is useful to communicate "lethal diagnoses" redundantly even in the age of electronic records. C) additional clinical data can be obtained when needed. D) direct communication shortens the time until action/treatment is scheduled.

 When the patient calls requesting their own report or wants to discuss w pathologist, the surgeons are alerted, more as a courtesy than a requirement. Those calls are documented in an addendum report.

These are common examples, I am sure there are others.

Steve A. McClain, MD

> On Aug 5, 2015, at 13:26, "histonet-request at lists.utsouthwestern.edu" <histonet-request at lists.utsouthwestern.edu> wrote:
> 
> ANP.12175 Significant/Unexpected Findings
> 
> 
> 
> How is everyone handling Significant or Unexpected Findings in Surgical Pathology?  I would like to find out how other places handle these.
> 
> Do your pathologists call them?
> 
> Do you flag them for the clinician in an electronic medical record?
> 
> Do you have a "Call Center" that handles them similiar to clinical lab "critical values"?
> 
> Do you have a secretary contact the office and notify them you are faxing a report that needs to be flagged for the physician?
> 
> 
> 
> I greatly appreciate your feedback!
> 
> 
> 
> Dana
> 
> Dana Spencer, CT(ASCP)
> Pathology Section Manager, Anatomic Pathology
> Vidant Medical Center
> 2100 Stantonsburg Road
> Greenville, NC 27835
> (252) 847-5790
> dana.spencer at vidanthealth.com