One Procedure - One Report: Implementing a Quality Improvement Project for Bronchoscopy-Guided Samples Streamlines Pathology Reporting

Summary: Introduction: A single pulmonary bronchoscopy procedure often involves concurrent cytopathology and histology sampling that, previously at our institution, was reviewed by different pathologists and reported separately among multiple reports. Consolidating these multiple reports from the same procedure into a single, integrated pathology report is a concept explored in recent literature (1). This approach aims to simplify the health record and aids in identifying the optimal paraffin block for ancillary and molecular testing (Figure 1). We report our early experience at an academic medical center in implementing this quality initiative. Materials and Methods: In January 2024, our department began integrating surgical pathology and cytology reports for pulmonary specimens. All samples from one procedure (both cytology and histology) were reviewed by the same cytopathologist, resulting in one integrated report (Figure 2). The integrated reports generated between January 12, 2024, and April 18, 2024, were reviewed by using the Cerner Powerchart. The number of reports and the number of specimen parts per integrated report were collected. Results: 63 integrated reports were generated, combining 184 reports [Mean: 2.9 (2-4)] and 432 specimens [Mean: 6.7 (3-13)] (Table 1). Conclusions: Our Pathology Department adopted integrated reports for pulmonary specimens as a standard practice to improve the quality of reporting without affecting the turnaround time. The integrated report initiative received positive feedback from the clinical team, who noted enhanced clarity and conciseness. This approach facilitated a comprehensive understanding of findings from the same procedure, crucial for avoiding confusion, especially in cases of discrepancies between different types of samples from the procedure. Reference: (1) Ly A, Balassanian R, Alperstein S, et al. One procedure-one report: the Re-Imagine Cytopathology Task Force position paper on small tissue biopsy triage in anatomic pathology. J Am Soc Cytopathol. 2023;12(6):395-406. doi:10.1016/j.jasc.2023.04.007