Cancer tracking: Clinician compliance and program outcome.
OBJECTIVE
Certain laboratory tests are critical for patient care and must be communicated rapidly. Professional societies have developed guidelines for reporting of "critical values" and significant or unexpected surgical pathology findings. Urgent diagnoses requiring rapid reporting include new or unexpected diagnoses of malignancy. The University of Missouri established a "cancer-tracking" protocol in which all diagnoses of malignancy require acknowledgment by the responsible clinician.


METHODS
We reviewed 5 months of compliance with the cancer-tracking protocol. The protocol requires the Department of Pathology to send a letter to the responsible clinician requesting acknowledgment of the report. In total, 1,155 confirmation requests were sent to the physicians named on the request form.


RESULTS
Following the first letter, 692 acknowledgments were received, and 356 acknowledgments followed the second letter. In 107 (9%) cases, no response was received.


CONCLUSIONS
Confirmation that the physician caring for a patient receives a pathology diagnosis is important for patient management and quality assurance. While the surgical pathology report was placed in the chart, it was impossible to confirm that the responsible physician had reviewed the report in 9% of cases. Techniques for communication and confirmation of transmission of anatomic pathology diagnoses need to be developed.
From the Department of Pathology & Anatomical Sciences, University of Missouri, Columbia. layfieldl@health.missouri.edu.
Lester J
LJ
Layfield
From the Department of Pathology & Anatomical Sciences, University of Missouri, Columbia.
Jennifer L
JL
Schnabel
D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis*; D010340:Pathology, Surgical / Q000379:methods* / Q000592:standards; D010820:Physicians / Q000706:statistics & numerical data*
Critical values; Follow-up; Malignancy; Urgent diagnosis