title: Beware The smerf: suboptimally made electronic request form.
abstract: OBJECTIVE
  To assess the impact of use of Electronic Request Forms (ERFs) on the amount of clinical information accompanying placentas for histopathology in a tertiary public hospital.
  
  
  BACKGROUND
  In 2009 Mater Pathology Services introduced a 'tick box' dedicated placental request form (DPRF) which significantly increased the amount of clinical information provided with placentas sent for histopathology. In 2011 ERFs were introduced across the campus, replacing the DPRF.
  
  
  METHODS
  Histopathology request forms from sequential accessions of placentas were evaluated for number of pieces of clinically relevant information, defined as data that would change specimen handling or information that was used for clinicopathological correlation. ERF were compared to two control groups from different years: consecutive DPRF from 2009 and consecutive accessions using standard blank pathology request forms from 2006. Each request form was assessed by at least two authors.
  
  
  RESULTS
  Use of the ERF significantly decreased the number of items of useful clinical information provided, compared to the DPRF (mean of 2.6 vs 1.3 items, p = 0.0004). Provision of relevant clinical information declined to the level seen prior to the introduction of the DPRF.
  
  
  CONCLUSIONS
  ERFs may improve quality by reducing error, but also change clinician behaviour, resulting in provision of fewer items of useful clinical information to guide specimen handling, pathology reporting and clinicopathological correlation.
authors.affiliation: Anatomical Pathology, Mater Pathology Services, South Brisbane.
authors.forename: Rachel
authors.initials: R
authors.lastname: Maywald
authors.affiliation: Anatomical Pathology, Royal Brisbane and Women's Hospital, formerly of Mater Pathology Services, South Brisbane.
authors.forename: Mark
authors.initials: M
authors.lastname: Bettington
authors.affiliation: Anatomical Pathology, Sullivan and Nicolaides Pathology, formerly of Mater Pathology Services, Brisbane, Queensland, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Lehane
authors.affiliation: Anatomical Pathology, Mater Pathology Services, South Brisbane.
authors.forename: Jane
authors.initials: J
authors.lastname: Armes
authors.affiliation: Anatomical Pathology, Mater Pathology Services, South Brisbane.
authors.forename: Rohan
authors.initials: R
authors.lastname: Lourie