Communication patterns among surgical pathologists: a retrospective review of ideal strategies in a tertiary care setting.

Abstract

Timely communication of significant surgical pathology results is essential for patient safety, yet quantitative data on how pathologists select result recipients, especially in urgent settings, are limited. We examined real-world communication patterns, focusing on STAT vs routine orders. We retrospectively reviewed pathologist-initiated notifications of significant surgical pathology results at a tertiary academic medical center (January to July 2024). In 324 events, we recorded recipient/provider characteristics, care team involvement, urgency status, procedural setting, and turnaround time (TAT). Events were compared by ordering provider (OP) vs alternate provider (AP) contact and by STAT vs routine designation using χ2 tests. Most notifications were sent to OPs (67%), with 33% sent to APs. Alternate provider contact was more frequent for STAT cases, biopsies, and shorter TATs (all P < .05). Contacted OPs were more often subspecialty trained (P < .001) and on the care team (P = .001). Ordering providers were more likely to be contacted directly when they were attending physicians and subspecialty trained; radiology was the predominant AP specialty (62%), while obstetrics and gynecology and gastroenterology were most common among OPs. STAT cases showed faster TATs, outpatient settings, and more frequent notification of nonordering but subspecialty-trained clinicians (all P < .05). Recipient role did not differ by urgency. Pathologists adjust communication based on urgency, prioritizing rapid notification to qualified clinicians when needed. Flexible recipient selection may support timely clinical action and inform institutional communication policies.