Ed. Adickes et Kl. Sims, ENHANCING AUTOPSY PERFORMANCE AND REPORTING - A SYSTEM FOR A 5-DAY COMPLETION-TIME, Archives of pathology and laboratory medicine, 120(3), 1996, pp. 249-253
Citations number
10
Categorie Soggetti
Pathology,"Medical Laboratory Technology","Medicine, Research & Experimental
Objective.-To develop a system for enhancing the performance and repor
ting of autopsies in an effective and clinically useful manner. Design
.-Twelve steps were defined as essential for the completion of the aut
opsy. Each step of the process was evaluated for usefulness and effect
iveness. Setting.-Autopsies performed in a university hospital from 19
92 through 1994. Participants.-Pathology residents and staff, clinicia
ns, and clinical team house staff. Intervention.-Participants followed
the 12-step process, with emphasis on involving the clinical team in
the interview, prosection, and final rounds. The final rounds conferen
ce was designated a working conference, where the perfused-fixed brain
was cut, histologic sections of the case were submitted, and the prov
isional diagnosis was written with the clinicians. A next-day microsco
pic slide review session was scheduled to ''sign out'' the case. Estab
lishing a philosophy of status equal to all other department functions
facilitated implementation. Main Outcome Measure.-All autopsies perfo
rmed for a period of 3 years (2 retrospective and 1 prospective) were
included. Results.-The completion time for the autopsy was reduced fro
m a mean of 57 days (range 7 to 174) in 1992 to 4.8 days (range 1 to 1
6) in 1994. Conclusion.-The autopsy completion time was reduced, incre
asing its usefulness for teaching and quality assurance. Relationships
with the clinical staff were enhanced with consultation-style final r
eports. Enthusiasm for, and satisfaction with, the new process was exp
ressed by clinicians, pathology staff, residents, and technical suppor
t staff.