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Changes in Surgical Pathology Case Volume and Amendment Rates During the COVID-19 Pandemic
Cynthia K Harris1, J Y Kwong2, M H Cohen2
1Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Surgical pathology volume decreased during COVID-19, yet amendment rates increased by 65.5%. Reduced workload did not improve error rates, highlighting multifactorial causes for errors in surgical pathology.
Area of Science:
- Pathology
- Medical diagnostics
Background:
- The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare, leading to reduced surgical pathology volumes.
- Understanding the effect of this reduced workload on the quality of pathology reports is crucial.
Purpose of the Study:
- To compare surgical pathology specimen volume and amendment rates between pre-pandemic (2019) and pandemic (2020) periods.
- To analyze changes in the types of amendments issued, specifically identification (ID), report defect (RD), and diagnostic information (DI).
Main Methods:
- Retrospective analysis of pathology reports from March to June 2019 and March to June 2020.
- Extraction and subclassification of all issued amendments by two pathologists.
Main Results:
- A 52.1% reduction in surgical pathology volume was observed in 2020 compared to 2019.
- The overall amendment rate increased by 65.5% (0.9% in 2019 vs. 1.4% in 2020).
- Amendments for diagnostic information (DI) increased by 23.2%, while identification (ID) and report defect (RD) amendments decreased.
Conclusions:
- Reduced surgical pathology workload during the pandemic did not correlate with improved error rates.
- Pandemic-related circumstances underscore the complex factors influencing error rates in surgical pathology.
Objectives:
Surgical pathology volume decreased during the peak of the coronavirus disease 2019 (COVID-19) pandemic. We looked at the 4 months with the greatest reduction in surgical pathology volume during the COVID-19 pandemic and compared them with those same months in 2019 to determine changes in specimen volume. We compared the amendment rates during those periods and types of amendments issued (identification [ID], report defect [RD], diagnostic information [DI]).
Methods:
All pathology reports between March to June 2019 and March to June 2020 were extracted from the pathology information system. All amendments issued were extracted over the same period and then subclassified by two pathologists.
Results:
There was a 52.1% reduction in surgical pathology volume between the 4-month periods in 2019 and 2020 (P = .04). The amendment rate was 0.9% in 2019 compared with 1.4% in 2020, representing a 65.5% increase in amendments overall. There was a 53.3% reduction in amendments issued for ID, a 3.8% reduction in RD, and a 23.2% increase in amendments issued for DI. The change in amendments was not statistically significant.
Conclusions:
These findings suggest that a reduction in workload would not improve error rates. The circumstances of the pandemic highlight the many factors contributing to error rates in surgical pathology.
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