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Another quality assurance issue--amended reports: what do we really know about them?
J F Stastny1, K R Geisinger, C W Michael
1Department of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298, USA.
Diagnostic Cytopathology
|February 6, 1998
Summary
Standard practices for handling significant cytology/histology discrepancies, which require amended reports under the Clinical Laboratory Improvement Amendment (CLIA), are not consistently followed. Methods vary widely among institutions, indicating a lack of standardized procedures in diagnostic pathology.
Area of Science:
- Medical Diagnostics
- Pathology Quality Assurance
- Laboratory Medicine
Background:
- The Clinical Laboratory Improvement Amendment (CLIA) mandates amended reports for significant cytology/histology discrepancies impacting patient care.
- There is limited understanding of current practices for managing these discrepancies in clinical laboratories.
Purpose of the Study:
- To survey current methods used by professionals to handle cytology/histology discrepancies.
- To identify variations in practices and the existence of institutional policies regarding amended reports.
Main Methods:
- A survey was developed by the Papanicolaou Society of Cytopathology's Quality Assurance Task Force.
- The survey was distributed to members, with 51 responses received.
- Data collected included frequency of correlations, types of discrepancies, and reporting methods.
Main Results:
- Practices for handling discrepancies vary significantly across institutions.
- An average of 107 cytologic/histologic correlations occur monthly, revealing about 2 major and 11 minor discrepancies.
- 39 responders issue written amended reports and contact clinicians for major discrepancies; 38 have written policies.
Conclusions:
- No standard practice exists for issuing amended reports following significant discrepancies.
- There is a need for standardized protocols to ensure consistent patient care when diagnostic discrepancies occur.