Intraoperative Communications Between Pathologists and Surgeons: Do We Understand Each Other?

Area of Science:

• Pathology
• Surgical Communication
• Healthcare Quality Improvement

Background:

• Effective intraoperative consultations between pathologists and surgeons are crucial for patient care.
• Discrepancies in intraoperative diagnoses can arise from communication or interpretation issues.

Purpose of the Study:

• To assess the concordance between pathology reports and surgeon operative notes for intraoperative diagnoses.
• To evaluate the effectiveness of an intervention aimed at reducing discrepancies in intraoperative diagnostic communication.

Main Methods:

• A retrospective analysis of 223 surgical cases with 578 intraoperative consultations was performed.
• Discrepancies were categorized as minor or major, with a corrective intervention implemented thereafter.
• A comparative analysis was conducted post-intervention to assess changes in discrepancy rates.

Main Results:

• Initially, 23% of cases lacked intraoperative diagnoses in operative reports, with minor discrepancies in 34% and major discrepancies in 2%.
• Multipart cases and deferred diagnoses were associated with higher discrepancy rates.
• Following the intervention, major discrepancies were eliminated, and minor discrepancies decreased significantly (P < .001), with a reduction in undocumented diagnoses from 23% to 16%.

Conclusions:

• Intraoperative diagnostic miscommunication can impact patient management, especially in complex cases.
• Auditing intraoperative communications and implementing targeted interventions are essential for improving accuracy.
• The study demonstrates the value of a local intervention in enhancing the reliability of intraoperative diagnostic communication.