Avoiding Medical Errors in Cutaneous Site Identification

Abstract

Site identification remains a challenge for dermatologists and is a leading cause of medical errors in this field. Patients are often unreliable in their ability to identify biopsy sites; therefore, practitioners must take a proactive role to ensure that medical errors do not occur. This article provides a thorough description and evaluation of current site identification techniques used in dermatology with the aim to improve quality of care and reduce medical errors.

Photographic Confirmation of Biopsy Sites Saves Lives

“…It is suggested that the providers obtain 2 images, one that is far enough to include landmarks, and one that is close enough to clearly differentiate the targeted lesion from others. 10 Although high-resolution digital cameras are preferred, mobile phones also can be used if they provide quality images. As phones with built-in cameras are ubiquitous, they offer a quick and easy method of photographic documentation.…”

“…St John and colleagues also presented the possibility of having patients keep pictures of the lesion on their phones, as this removes potential privacy concerns and facilitates easy transportation of information between HCPs. 10 If it is discovered that a photograph was not taken at the time of biopsy, our practice contacts the patient and asks them to photograph and circle the biopsy site using their mobile phone or camera and bring it to the surgery appointment. We propose a VA protocol for photographic documentation of biopsy sites (Table ).…”

“…If a HCP is uncomfortable or unable to use photography to document lesions, alternative strategies for documenting lesions exist, including diagrams, anatomic landmarks, ultraviolet (UV) fluorescent tattoos, and patient identification of lesions. 10 In the diagram method, a HCP marks the lesion location on a diagram of the body preferably with a short description of the lesion's location and/or characteristics. 11 The diagram should be uploaded into the EHR.…”

Artificial Intelligence in Cutaneous Oncology

“…Therefore, it is first necessary to establish whether or not a biopsy is required through a visual inspection performed by an experienced dermatologist. Furthermore, dermatologist needs a device that can detect changes over time in skin lesions and record the lesions in detail so that wrong-site surgery does not occur ( 2 , 3 ).…”

A smartphone application to improve the precision of biopsy site identification: A proof-of-concept study

“…2,3 Every biopsy should include accurate anatomic descriptors of the biopsy site in the pathology request form that accompanies the biopsy. 4 Biopsy sites are permanently recorded in the subsequent pathology report. These reports rely on text descriptions of the anatomic site provided by the dermatology care provider, and it is imperative they use correct anatomical language.…”