I am the sole histologist in a gastroenterology laboratory situated in a GI 
clinic. Complying with the 24-hour grossing review by the pathologist is a 
challenge because my slides travel by courier across town to the pathologist to 
read. I receive specimens throughout the day and perform grossing in the early 
AM then again at 11 AM.  My pathologist signs copies of the requisition that I 
fax over that contains the gross and sends them back to me.  On a daily basis 
this works just fine. Fridays and holidays are a pickle but we manage.
My question is the intent of the 24-hour review. The inspector cannot tell me 
why this was put in place, what the pathologist is supposed to do with this 
information and/or how to tell if it is accurate because he does not receive 
the slides until the following day which would be outside of the 24-hour review 
rule.
Can anyone tell the intent of the rule? How does this rule improve patient 
care? Even in a hospital laboratory, once a biopsy is grossed and placed in a 
cassette, how on earth does looking at the written gross of how big the 
specimen is or what color it is impact further actions that can take place?  
What remedial action does CLIA expect?

Thanks for your input, Gastro Gal



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