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Medical City Fort Worth
dermatopathology, quality improvement
Dermatology | Pathology | Quality Improvement | Skin and Connective Tissue Diseases
Introduction: Dermatopathology requisition forms (RFs) are a critical communication tool between dermatologists and dermatopathologists. Including detailed information on RFs improves the diagnostic accuracy of the consulting dermatopathologist. However, the diameter of the biopsied lesion is often omitted on RFs. This study aimed to increase the rate of reporting lesion diameters on RFs from an academic outpatient dermatology clinic to greater than 65% through education, reinforcement, and evaluation. Methods: This quality improvement project retrospectively and prospectively analyzed the inclusion rate of lesion diameters on dermatopathology RFs from a single institution. In Phase 1, data was collected from all skin biopsies performed between July 1, 2021 and February 4, 2022, and the presence or absence of lesion diameters on RFs was recorded. A single intervention was conducted on February 4, 2022 to educate the authors on societal guidelines for reporting lesion diameters on RFs. Phase 2 evaluated short-term efficacy through data collection and analysis of RFs for biopsies obtained from February 5, 2022 to June 14, 2022. Long-term efficacy will be assessed through data collection and analysis of RFs for biopsies obtained from January 1, 2023 to June 30, 2023. Results: During Phase 1, 839 skin biopsies were performed, with 594 biopsies meeting the criteria for analysis. 49 samples included lesion diameters, resulting in a final reporting rate of 8.25%. In Phase 2, after the intervention, there was a statistically significant reporting rate increase to 49.71% (85/171) in the intervention group (chi-squared test, p < 0.001). The intervention group had a statistically significant increase in reporting rate compared to the control group not receiving the intervention (1.73%, 5/289, chi-squared test, p < 0.001). Long-term efficacy results from Phase 3 are yet to be reported. Conclusion: The intervention in this study successfully increased the rate of reporting lesion diameters on RFs from an academic outpatient dermatology clinic, demonstrating the importance of education and reinforcement in improving quality. Further studies will determine the long-term efficacy of the intervention.
HCA Healthcare Graduate Medical Education
Wong, Christopher M.; Lim, Henry; Scheufele, Christian; Nguyen, Daniel A.; Hermann, Ashleigh E.; Carletti, Michael; and Weis, Stephen, "Lesion Size Inclusion on Dermatopathology Requisition Forms: a Quality Improvement Project" (2023). North Texas Research Forum 2023. 35.