Thanks Tim, these references are VERY helpful.
Joelle Weaver MAOM, HTL (ASCP) QIHC
> From: timothy.mor...@ucsfmedctr.org
> To: lcolb...@pathmdlabs.com; histonet@lists.utsouthwestern.edu
> Date: Tue, 14 Oct 2014 17:57:46 +0000
> CC:
> Subject: [Histonet] RE: Labeling Errors
>
> Laurie,
>
> The question to ask is, what is ACHIEVABLE with the technology you have in
> place? The term is ALRA or ALRP...As Low as Reasonably Achievable, or
> Possible.
>
> For instance, when we hand-wrote slide labels, and used offline cassette
> printers we accepted that we would have a rather high rate of human errors.
> Same with hand-applying labels after staining.
>
> With barcoding, printing cassettes directly from the LIS, printing and
> applying labels at the microtome our error rate is down by an order
> magnitude, but occasional errors still occur due to humans "shortcutting"
> the system, or faults in the system itself (ie, not flagging duplicate labels
> scanned). None of those errors are acceptable but we still need to figure out
> how to design the system to prevent them.
>
> The papers below give numbers to this problem. The patient ID error without
> automation came out to 4+ per 1000 specimens.
>
> The general error rate was/is:
> 1/100 with all hand-written workflow
> 1/1000 with LIS printing of cassettes and labels, but human-applied
> 1/10,000 with barcoding and single piece workflow throughout the system and
> interfaces to instruments (stainers)
>
> Makary MA et al. Surgical specimen identification errors.... Surgery 2007
> Apr;141(4):450-5
> Nakhleh RE, et al. Amended reports ... Q-probes study of 1,667,547
> accessioned cases ... Arch Pathol Lab Med. 1998 Apr;122(4):303-9
> Resar RK. Making noncatastrophic health care processes more reliable...
> Health Serv Res. 2006; 41:1677-1689.
>
>
>
> Tim Morken
> Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies
> UC San Francisco Medical Center
> San Francisco, CA
>
> CONFIDENTIALITY NOTICE: This email message, including any attachments, is for
> the sole use of the intended recipient(s) and may contain confidential,
> proprietary, and/or privileged information protected by law. If you are not
> the intended recipient, you may not use, copy, or distribute this email
> message or its attachments. If you believe you have received this email
> message in error, please contact the sender by reply email and destroy all
> copies of the original message.
>
> -----Original Message-----
> From: histonet-boun...@lists.utsouthwestern.edu
> [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert
> Sent: Tuesday, October 14, 2014 10:21 AM
> To: Histonet Post (histonet@lists.utsouthwestern.edu)
> Subject: [Histonet] Labeling Errors
>
> Is there a national average or benchmark for "acceptable" labeling errors in
> Histology?
>
> Laurie Colbert HT (ASCP)
> _______________________________________________
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>
> _______________________________________________
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
_______________________________________________
Histonet mailing list
Histonet@lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet
