Measuring the Clinical Impact of Pathologist Reviews of Blood and Body Fluid Smears

Abstract

Abstract Context.—Despite the widespread practice of pathologist review of blood and body fluid smears, little is known about its impact on improving patient care. Objective.—To assess the clinical usefulness of pathologist review of blood and body fluid smears. Design.—Survey study. Pathology residents contacted the ordering physician after pathologist reviews were reported to assess their clinical impact. Results.—Ninety-six pathologist reviews met criteria for study inclusion, and 64 ordering physicians were successfully contacted during the 2-month study period. Of the 64 cases, 19 reviews (30%) had been seen by the physician within 24 to 48 hours after the report was issued and 33 (51%) had not been seen; in 4 (6%) instances, physicians did not remember whether they had seen the review. Eight reviews (13%) were considered urgent enough to warrant immediate communication by the pathologist. Of the 27 reviews that were seen or directly communicated, 23 (85%) contributed to clinical diagnosis and/or patient management. Conclusions.—This study demonstrates the contribution of pathologist reviews of blood and body fluids to clinical diagnosis and patient management. The results also highlight the problem of a lack of physician awareness of clinical pathology results.