title: Dermatopathologists' concerns and challenges with clinical information in the skin biopsy requisition form: a mixed-methods study.
abstract: BACKGROUND
  Communication failures between clinicians and dermatopathologists are prevalent. Our primary objective was to characterize the concerns and challenges of dermatopathologists posed by incomplete or inaccurate clinical information in the skin biopsy requisition form.
  
  
  METHODS
  An explanatory sequential, mixed-methods study design comprised of a survey sent to 1103 members of the American Society of Dermatopathology (ASDP), followed by two focus group sessions.
  
  
  RESULTS
  A total of 54% (598/1103) of dermatopathologists completed the questionnaire. Most dermatopathologists (80%; 436/548) viewed their roles to be providers of histopathological diagnosis and a report that is clinically meaningful. Paper or electronic requisition forms were the most common communication method (85%; 458/541) and were associated with the highest rates of dissatisfaction in 36% (193/537) of respondents. Inadequacy of specimens emerged as an important factor influencing judgment of the quality of provided clinical information. 44.7% (261/584) of dermatopathologists spent 30 minutes or more on average every day searching for relevant clinical information to assist with their histopathologic interpretation.
  
  
  CONCLUSIONS
  ASDP dermatopathologists expressed significant dissatisfaction with the quality of clinical information in the requisition form and the time spent gathering information necessary for accurate, timely and clinically meaningful diagnosis. These findings have implications for the quality, safety and efficiency of dermatologic care.
authors.affiliation: Department of Dermatology and Department of Laboratory Medicine and Pathology, Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Nneka I
authors.initials: NI
authors.lastname: Comfere
authors.affiliation: Department of Dermatology and Department of Laboratory Medicine and Pathology, Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Margot S
authors.initials: MS
authors.lastname: Peters
authors.affiliation: Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jenkins
authors.affiliation: Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors.forename: Kandace
authors.initials: K
authors.lastname: Lackore
authors.affiliation: Health Sciences Research-Epidemiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Yost
authors.affiliation: Division of General Internal Medicine, Biomedical Ethics Research Unit and Knowledge & Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Tilburt
mesh_terms: D001706:Biopsy / Q000379:methods; D000068598:Data Accuracy; D003880:Dermatology / Q000379:methods*; D057286:Electronic Health Records / Q000458:organization & administration; D005260:Female; D017144:Focus Groups / Q000379:methods; D005568:Forms and Records Control / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010336:Pathology / Q000379:methods*; D010465:Perception; D012017:Referral and Consultation; D012867:Skin / Q000473:pathology*; D013048:Specimen Handling / Q000941:ethics; D011795:Surveys and Questionnaires
keywords: dermatologist; dermatology; dermatopathology