Intraoperative Consultation Rounds: A Pathologist Educational and Quality Assurance Initiative
Jesse Babwah, Simon Raphael, Corwyn Rowsell. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
Background: Intradepartmental rounds are an important means of pathologist education, quality assurance and promoting professional interaction. In a subspecialized department, traditional models where pathologists share difficult or interesting cases may be of less utility and interest than in non-subspecialized departments. The Department of Anatomic Pathology at Sunnybrook Health Sciences Centre is subspecialized, but the area where all pathologists practices overlap is intraoperative consultation (IOC). We therefore decided to abandon our traditional interesting case rounds in favour of a model which focussed on IOC.
Design: IOC rounds commenced in September 2011 after a planning process involving the departmental executive committee and accreditation from the Royal College of Physicians and Surgeons of Canada. Rounds occurred weekly, and were limited to staff pathologists. Cases which had had IOC performed were selected by the Director of Surgical Pathology and slides were distributed 2-3 days in advance. The pathologist who performed IOC functioned as the presenter of the case, while the pathologist who signed out the final report was the discussant. Presentations focussed on various aspects of IOC, including history, gross findings, microscopic interpretation, and communication with surgeons.
Results: On average, 11 pathologists attended the rounds weekly. A range of 2 to 6 cases were presented per session. Evaluation forms were distributed at each rounds; 93% of responses were that the majority of cases were relevant to practice, and 100% indicated that the format was conducive to open discussion. Comments were positive, and highlighted openness and educational value. In a one year evaluation, all respondents indicated that the rounds provided new ideas for practice and enhanced their knowledge. 64% identified a practice issue which needed improvement. 82% indicated gynecologic pathology as the area where they would most likely ask for assistance of a colleague in IOC.
Conclusions: IOC rounds provided a non-threatening environment for discussion of challenges in IOC. Strong interest was maintained throughout the first year as evidenced by engagement and attendance. These rounds served as a springboard for developing policies improving intraoperative consultation practice and confronting systemic difficulties in providing this service in our hospital. We plan to measure effects on diagnostic discrepancy in IOC in the future to see the effects our efforts have had on patient outcome.
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 60, Tuesday Morning