报告解剖病理学中的关键/紧急/重要结果:细节决定成败

IF 0.1 Q4 PATHOLOGY
M. Kallen, C. Otis, Paul N. Staats
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引用次数: 0

摘要

关键值报告是实验室管理的一个重要方面,代表了患者护理交付的重大潜在挑战,以及解剖学和临床病理学设置中质量改进倡议的高价值目标。一个反复出现的问题涉及成功联系不可用的医疗保健提供者并获得意外和/或时间敏感的结果。我们报告一例在常规髋关节置换术中偶然发现和意外发现肿瘤细胞的病例,该患者因各种慢性问题(包括外周动脉疾病和创伤性跌倒)而接受手术治疗。这一异常结果被证明是一种广泛传播的转移性黑色素瘤的首次表现。尽管我们成功地联系了多个相关的医疗保健提供者,了解了这一意想不到的发现,并承认了对转移性黑色素瘤的关注,但没有成功地联系一个医疗保健提供者,了解了病理结果,导致了多方的挫折和适当的患者转诊的轻微延误。事件的顺序提供了一个机会来审查关于解剖病理学紧急诊断报告的护理标准,并评估围绕这一问题发表的文献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reporting Critical/Urgent/Significant Results in Anatomic Pathology: The Devil Is in the Details
Abstract Critical value reporting is an important facet of laboratory management and represents a significant potential challenge in patient care delivery, as well as a high-value target for quality improvement initiatives in both anatomic and clinical pathology settings. A recurring problem concerns successfully contacting unavailable health care providers with unexpected and/or time-sensitive results. We report a case of an incidentally detected and unexpected finding of tumor cells in a routine hip arthroplasty, in a patient under surgical management for a variety of chronic issues including peripheral arterial disease and traumatic fall. The abnormal result proved to be the first presentation of a widely disseminated metastatic melanoma. Although multiple associated health care providers were successfully contacted with the unexpected finding and acknowledged awareness of the concern for metastatic melanoma, one provider was not successfully contacted with the pathology result, leading to frustrations among multiple parties and a slight delay in appropriate patient referral. The sequence of events presents an opportunity to review standards of care regarding urgent diagnosis reporting in anatomic pathology and assess the published literature surrounding this issue.
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CiteScore
0.30
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