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Guideline on Effective Communication of Urgent Diagnoses Posted to
AHRQ National Guidelines Clearinghouse

Developed jointly by the Association of Directors of Anatomic and Surgical Pathology (ADASP) and the College of American Pathologists (CAP), the full title of this new guideline is “Consensus statement on effective communication of urgent diagnoses and significant, unexpected diagnoses in surgical pathology and cytopathology.”  The objective of the guideline is to promote effective communication of urgent and significant, unexpected diagnoses in surgical pathology and cytology.


Urgent Diagnosis: A medical condition that, in most cases, should be addressed as soon as possible.Significant, Unexpected Diagnosis: A medical condition that is clinically unusual or unforeseen and should be addressed at some point in the patient's course.

Among the major recommendations are the following:

  • Each institution should create its own policy regarding Urgent Diagnoses and Significant, Unexpected Diagnoses in Anatomic Pathology. This policy should be separate from critical result or panic value policies in clinical pathology with the expectation of a different time frame for communication.

  • Pathology departments should determine specific urgent diagnoses in collaboration with the clinical staff.

  • Determination of a significant, unexpected diagnosis is heavily dependent on the pathologist's judgment as a physician. By their nature, significant, unexpected diagnoses cannot always be anticipated.

  •  Pathologists should communicate urgent diagnoses as soon as possible because it may directly affect patient care, but each institution should establish a reasonable time frame. The consensus statement authors recommend no longer than the same day on which the diagnosis is made..

  • Pathologists should communicate verbally and directly with physicians, but other satisfactory methods of communication may be established and validated by each institution.

  • Pathologists should document the communication. Documentation should include the person with whom the case was discussed, the time and date, and when appropriate, the means of communication

You can view the full document by clicking on the title above or by going to the AHRQ site at: