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Develop a Policy for Timely Diagnoses Communication to Facilitate Prompt Treatment

March 26, 2021

A list of urgent diagnoses and significant, unexpected diagnoses is an important aspect of diagnoses reporting policy. However, there is considerable disagreement about which diagnoses should be included in those lists.1 The most relevant guideline, the “Consensus Statement on Effective Communication…” from CAP/ADASP,* does not define either urgent diagnosis or significant, unexpected diagnosis. Instead, it recommends that pathology departments develop their own lists of urgent diagnoses and provide examples of significant, unexpected diagnoses.2

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Filed under: Business of Medicine, Patient Care

Failure to Communicate a Positive Biopsy Leads to Delayed Cancer Diagnosis

March 26, 2021

A diagnosis of cancer does not always need to be directly communicated. However, special care must be used to ensure receipt of the diagnosis by the clinician in the best position to coordinate or provide treatment to the patient. The following case highlights the importance of creating a “paper trail” that proves pathology diagnoses were sent to the intended clinicians.

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Filed under: Case Study, Patient Care

Failure to Communicate a Significant Diagnosis Change Leads to Worsened Prognosis

March 26, 2021

With the complexity of today’s healthcare environment, a pathologist may need to take a more active role in coordinating diagnosis communication than what may have been standard in the recent past. In the following case, the patient was never informed of a final diagnosis of malignancy after being informed the preliminary diagnosis was benign. Consider how the pathologists could have changed the outcome in this case.

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Filed under: Case Study, Patient Care

Failure to Directly Communicate Unexpected Cancer Finding Leads to Delayed Treatment

March 26, 2021

It is a good idea to copy primary care physicians or physicians coordinating the patient’s care on pathology reports in addition to the physician who has obtained the specimen. A clinician who performs a biopsy and sends the sample to a pathologist may not otherwise be involved in the patient's care. If the pathology report is only sent to the clinician who performed the biopsy, an actionable diagnosis may never get to a physician who is in the best position to initiate or coordinate treatment.

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Filed under: Patient Care

Prioritizing Urgent Diagnosis List Over Medical Judgment Leads to Patient Death

March 26, 2021

In the following case, the pathologist’s finding was not listed on the urgent or unexpected diagnoses lists so she did not directly contact the ordering physician to report her findings. However, a number of experts in the malpractice suit that followed believed the pathologist should have done so. Consider how the outcome could have been different if the pathologist had used her medical judgment and focused on patient safety.

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Filed under: Patient Care

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