title: Biopsy site selfies--a quality improvement pilot study to assist with correct surgical site identification.
abstract: BACKGROUND
  Determining the biopsy site location of a skin cancer before treatment is often challenging.
  
  
  OBJECTIVE
  To study the implementation and effectiveness of biopsy site selfies as a quality improvement measure for correct surgical site identification.
  
  
  METHODS
  In the first phase, the ability of dermatologic surgeon and patient to definitively identify the biopsy site and whether photography was needed to ensure site agreement were recorded. In the second phase, patients were requested to take biopsy site selfies, and after implementation, similar data were collected including whether a biopsy site selfie was helpful for definitive site identification.
  
  
  RESULTS
  In the first phase, the physician and patient were unable to identify the biopsy site 17.6% (49/278) and 25.5% (71/278) of cases, respectively. A photograph was needed in 22.7% of cases (63/278). After implementation of biopsy site selfies, the physician and patient were unable to identify the biopsy site 17.4% (23/132) and 15.2% (20/132) of cases, respectively. Biopsy site selfies were available for 64.1% of cases for which no internal image was available and critical for site identification in 21.4% of these cases.
  
  
  CONCLUSIONS
  Biopsy site selfies has proven to be helpful for correct surgical site identification by both the physician and the patient and may also provide further reassurance and confidence for patients.
authors.affiliation: *Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas; †Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Rajiv I
authors.initials: RI
authors.lastname: Nijhawan
authors.forename: Erica H
authors.initials: EH
authors.lastname: Lee
authors.forename: Kishwer S
authors.initials: KS
authors.lastname: Nehal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008875:Middle Aged; D015580:Mohs Surgery; D010781:Photography / Q000379:methods*; D010865:Pilot Projects; D011300:Preoperative Care; D011446:Prospective Studies; D058996:Quality Improvement; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult