title: Effectiveness of random and focused review in detecting surgical pathology error.
abstract: Different error detection methods yield different error proportions and have variable benefits for surgical pathology divisions with limited resources. We performed a nonconcurrent cohort study at a large institution that practices subspecialty surgical pathology sign-out to compare the effectiveness and usefulness of error detection using a targeted 5% random review process and a focused review process. Pathologists reviewed 7,444 cases using a targeted 5% random review process and 380 cases using a focused review process. The numbers of errors detected by the targeted 5% random and focused review processes were 195 (2.6% of reviewed cases) and 50 (13.2%), respectively (P < .001). The numbers of major errors for the targeted 5% random and focused review processes was 27 (0.36%) and 12 (3.2%), respectively (P < .001). Focused review detects a higher proportion of errors and may be more effectively used for design of error reduction initiatives.
authors.affiliation: Department of Pathology, University of Colorado Denver, Aurora, CO 80045, USA.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Raab
authors.forename: Dana M
authors.initials: DM
authors.lastname: Grzybicki
authors.forename: Laura K
authors.initials: LK
authors.lastname: Mahood
authors.forename: Anil V
authors.initials: AV
authors.lastname: Parwani
authors.forename: Shih-Fan
authors.initials: SF
authors.lastname: Kuan
authors.forename: Uma N
authors.initials: UN
authors.lastname: Rao
mesh_terms: D003951:Diagnostic Errors; D005762:Gastroenterology / Q000592:standards; D006801:Humans; D008485:Medical Audit / Q000379:methods*; D019300:Medical Errors; D010340:Pathology, Surgical / Q000379:methods / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D011897:Random Allocation