Understanding Referral Sources and Patient Satisfaction: A Path to Improving Patient Care in Interventional Cytology

Summary: Introduction: Cytopathologist-performed fine needle aspiration biopsy (FNA-B) offers advantages including higher sample adequacy and triage for ancillary testing. Therefore, expansion of FNA-Bs is thought to improve patient quality of care. While few studies have formally measured patient satisfaction in interventional cytopathology clinics (ICC), those that have reflect high patient satisfaction. This study presents patient satisfaction data and clinical features of an ICC at a public safety net hospital over 9 months. Materials and Methods: Between July 2021-March 2022, an 11-question survey was verbally administered to patients at conclusion of a visit at an ICC. Survey questions gathered demographic data and patient satisfaction of the clinic. Satisfaction was rated on a 5-point Likert scale. Clinical data related to the patient's referral and subsequent management were obtained from the electronic health record. Results: 76 patient visits were analyzed with the most common patient identifying as Hispanic (29%), cisgender female (59%) at an average 49.9 years old. An interpreter was required in 34% of visits. The average wait time was 19.5 minutes (Table 1). Most FNA-Bs were performed by ultrasound (82%) with an average of 3.2 passes made, an average of 4.2 smears generated, and material gathered for cell blocks (88% of visits), flow cytometry (18% of visits), and culture (14% of visits) (Table 2). Most referrals were from Family Medicine (71%) and lymph nodes were most commonly biopsied (30%) (Figure 1). Over 90% of respondents indicated they could find the clinic, received an explanation of the biopsy, were treated with respect, felt listened to, and understood how to get results (Table 3). Conclusions: This clinic serves a diverse and underserved population of patients, involving an interpreter one-third of the time, and still maintains a high patient satisfaction level. Similar ICC clinics looking to increase patient referrals should focus on primary care clinics especially when needing assessment of lymph nodes.