Comparison of disagreement and error rates for three types of interdepartmental consultations.
Previous studies have documented a relatively high rate of disagreement for interdepartmental consultations, but follow-up is limited. We reviewed the results of 3 types of interdepartmental consultations in our hospital during a 2-year period, including 328 incoming, 928 pathologist-generated outgoing, and 227 patient- or clinician-generated outgoing consults. The disagreement rate was significantly higher for incoming consults (10.7%) than for outgoing pathologist-generated consults (5.9%) (P = .06). Disagreement rates for outgoing patient- or clinician-generated consults were not significantly different from either other type (7.9%). Additional consultation, biopsy, or testing follow-up was available for 19 (54%) of 35, 14 (25%) of 55, and 6 (33%) of 18 incoming, outgoing pathologist-generated, and outgoing patient- or clinician-generated consults with disagreements, respectively; the percentage of errors varied widely (15/19 [79%], 8/14 [57%], and 2/6 [33%], respectively), but differences were not significant (P >.05 for each). Review of the individual errors revealed specific diagnostic areas in which improvement in performance might be made. Disagreement rates for interdepartmental consultation ranged from 5.9% to 10.7%, but only 33% to 79% represented errors. Additional consultation, tissue, and testing results can aid in distinguishing disagreements from errors.
Renshaw
Andrew A
AA
Department of Pathology, Baptist Hospital of Miami, FL 33176, USA.
Gould
Edwin W
EW
D003951:Diagnostic Errors / Q000706:statistics & numerical data; D034462:Dissent and Disputes; D006801:Humans; D007400:Interprofessional Relations; D015588:Observer Variation; D010336:Pathology / Q000592:standards*; D012017:Referral and Consultation