Template Reporting of Colorectal Carcinoma Resections: 5-Year Follow-Up Shows a Stable, High Adherence Rate to the Implemented Guideline.
Bettina Casati, Roger Bjugn. Akershus University Hospital, Lørenskog, Norway; Oslo University Hospital, Norway
Background: Several professional pathology organizations have published guidelines to ensure adequate quality of histopathology cancer reports. Template (or synoptic) reporting have been found to be superior in ensuring that key parameters are reported. Studies in clinical medicine have, however, shown that adherence rates to guidelines may return to baseline levels after cessation of the specific implementation strategies. In 2005, a nationwide system for electronic template reporting of colorectal carcinoma resections was introduced in Norway. The present study was undertaken to evaluate the long-term adherence to the use of this template in a routine pathology department.
Design: All histopathology reports on colorectal carcinoma resections for a 5-year period (April 1, 2005 to March 31, 2010) were identified by a systematic search in the full electronic pathology software package being used by the laboratory. The reports were then evaluated with respect to the use of the electronic template. In order to evaluate a possible time-change in adherence to the use of the template, the reports were grouped into five consecutive 1-year periods.
Results: 1186 colorectal resection specimens were identified. The electronic template had been used in 1089 cases (91.8%). The adherence rates in the five consecutive 1-year periods were 93.3, 91.7, 87.1, 94.1, and 92.8 percent, respectively.
Conclusions: Our study shows a high, consistent rate of adherence to the use of the electronic template. The template was implemented in 2005 based on a joint decision among the consultants after just one group discussion. Apart from a quality-survey 18 months after the introduction of the template, no other interventions had been undertaken. Among factors influencing the implementation of such a guideline (characteristics of the guidelines; the implementation strategies; the professionals; the patients; or the environment), we believe the characteristic of the template (experienced simplicity and efficiency in use) and the environment (common decision among consultants and supportive “peers”) were the factors ensuring the high adherence rate despite a very simple implementation strategy.
Category: Quality Assurance
Monday, February 28, 2011 1:00 PM
Poster Session II # 223, Monday Afternoon