Friday, November 1, 2013

Standardized Synoptic Cancer Pathology Reports: Why bother?


Sara Lankshear PhDJohn Srigley MDThomas McGowan MDMarta Yurcan MHScCarol Sawka MD
From the Cancer Information Program (Dr Lankshear and Ms Yurcan), the Programs of Laboratory Medicine (Dr Srigley) and Oncology (Dr McGowan), Trillium Health Partners, Mississauga, Ontario Canada, and Clinical Programs and Quality Initiatives (Dr Sawka).
Context.—Cancer Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time.
Objective.—To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process.
Design.—A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments.
Results.—A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r = 0.750, P < .001) and ease of finding information for clinical decision making (r = 0.663, P < .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t169 = 3.044, P = .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion.
Conclusion.—This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.

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