RE: [Histonet] RE: Embedding process improvement and competencyassessment
How disgusting to hear about cheating. I recall that someone was supposed to sign off as a witness that the applicant had done the work themselves. I spent months acquiring tissue, processing, embedding, cutting and staining a set of blocks and slides and was rewarded with a high score for the effort. It was something I could be proud of. As I recall we had to submit 25 or so slides back then only some of which were graded and the grading was really strict (but did vary with the grader). Joe Galbraith HTL (and also MT by the way) University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Thursday, August 25, 2011 12:14 PM To: 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I
RE: [Histonet] RE: Embedding process improvement andcompetencyassessment
Thank you Joe!! Nancy Heath, HT(ASCP) -Original Message- From: Galbraith, Joe [mailto:joseph-galbra...@uiowa.edu] Sent: Thursday, August 25, 2011 2:07 PM To: Bea DeBrosse-Serra; 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement andcompetencyassessment How disgusting to hear about cheating. I recall that someone was supposed to sign off as a witness that the applicant had done the work themselves. I spent months acquiring tissue, processing, embedding, cutting and staining a set of blocks and slides and was rewarded with a high score for the effort. It was something I could be proud of. As I recall we had to submit 25 or so slides back then only some of which were graded and the grading was really strict (but did vary with the grader). Joe Galbraith HTL (and also MT by the way) University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Thursday, August 25, 2011 12:14 PM To: 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight
Re: [Histonet] RE: Embedding process improvement and competencyassessment
Ditto Joe! I did it twice! Once for HT, then again for HTL!!! Paula K. Pierce, HTL(ASCP)HT President Excalibur Pathology, Inc. 8901 S. Santa Fe Oklahoma City, OK 73139 405-759-3953 Lab 405-759-7513 Fax www.excaliburpathology.com From: Galbraith, Joe joseph-galbra...@uiowa.edu To: Bea DeBrosse-Serra bdebrosse-se...@isisph.com; Jennifer MacDonald jmacdon...@mtsac.edu; Heath, Nancy L. nhe...@lifespan.org Cc: Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley sdatt...@stormontvail.org Sent: Thu, August 25, 2011 1:07:26 PM Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment How disgusting to hear about cheating. I recall that someone was supposed to sign off as a witness that the applicant had done the work themselves. I spent months acquiring tissue, processing, embedding, cutting and staining a set of blocks and slides and was rewarded with a high score for the effort. It was something I could be proud of. As I recall we had to submit 25 or so slides back then only some of which were graded and the grading was really strict (but did vary with the grader). Joe Galbraith HTL (and also MT by the way) University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Thursday, August 25, 2011 12:14 PM To: 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the
RE: [Histonet] RE: Embedding process improvementand competencyassessment
Man did that bring back some memories. Bill and I worked together in the same Navy lab and he is correct if a block was embedded wrong you would get it in either the back of the head or between the shoulders. They stopped throwing them at me the day I throw the block back at the microtomist and hit him in the head. We were a tough crew that saw a lot, did a lot, partied together a lot, but never lost the fact that we were there for patient care and treated all the specimens and bodies as if they came from a love one. When it came time for Bill and I to become the trainers we were brutal in how to embed, section and all other aspects of histology, I mean we only wanted perfection. Tom Podawiltz HT (ASCP) Histology Section Head/Laboratory Safety Officer. LRGHealthcare Laconia, NH 03246 603-524-3211 ext: 3220 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of O'Donnell, Bill Sent: Thursday, August 25, 2011 1:57 PM To: Heath, Nancy L.; Jennifer MacDonald Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvementand competencyassessment Just to throw a somewhat funny situation into the mix. I learned my embedding skills in the Navy. The basic method for learning all tasks was 1. explain it, 2. demonstrate it, 3. do it. Each microtomist was responsible for taking a good look at the block before cutting it. If the embedding was not spot-on, the block was always returned for reembedding. The method of return was to throw it at the back of my head. They rarely missed. Very quickly, I got tired of being hit in the head and my embedding improved. Can't do that kind of stuff now, even in the military. Who knew that histology used to be a contact sport? We've gotten so soft! As to the other situation, as a histology supervisor, I was over cytology in one of the labs I worked at. I doubt that I was much of a manager to them as I knew next to nothing about their work. However, I took the time to learn some aspects, and then just pretty much left them alone. (It was a mutual respect, they pretty much left me alone too.) They did a fine job of making me look good. I trusted them, and they didn't do anything to betray that trust. Because of that, I would simply sign-off on the occasional request. Evals were pretty easy as I simply interviewed the pathologists, checked attendance and moved on. That being said, I wouldn't want to have to do it again. They deserved better, but we made it work, since it wasn't going to change. Have a great day! William (Bill) O'Donnell, HT (ASCP) QIHC Senior Histologist Good Samaritan Hospital 10 East 31st Street Kearney, NE 68847 Check out my podcast at DeaconCast.Net SERENITY is not freedom from the storm, but peace amid the storm. Cultivate it in PRAYER! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Heath, Nancy L. Sent: Thursday, August 25, 2011 11:39 AM To: Jennifer MacDonald Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio,Shelley Subject: RE: [Histonet] RE: Embedding process improvementand competencyassessment Regardless of wether there were 8 blocks or eighteen blocks taking the practical taught me to be precise with all of the hands on aspects of Histology. Shame on the older techs from the practical days of not keeping on top of their game with embedding. My comment was geared more towards the newbies coming out of histo schools who can pass the exam with flying colors but sit them in front of an embedding center or microtome and they are all thumbs! As far as a manager, I myself would rather have someone who has experience with histology over seeing my work. Just once again the lack of respect of having the HT/HTL behind your name. From: Jennifer MacDonald [mailto:jmacdon...@mtsac.edu] Sent: Thursday, August 25, 2011 10:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley; Podawiltz, Thomas Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org,
[Histonet] Re: Embedding process improvement...
Back to the question at hand, You will need to engage the pathologists to provide information as to the correct way to embed the skin specimens. If you have a dermatopathologist in your practice, that person will need to provide the information about how he/she dissects it, what he/she wants, and why. I have attended a continuing education lecture locally by a dermatopathologist and he showed HE slides of incomplete and improperly embedded skin samples. He could not render a proper diagnosis due to this histologist's inability to give him the correct view of the samples. How would you feel if that was your biopsy and someone embedded it with complete disregard? I would like to think that mistakes happen due to a misunderstanding and nothing more sinister. There was a time back in the day that we each had a grossing room rotation and watched how the pathologists did their grossing. I suspect in these busy labs and busy times, that happens less and less. Having the paper trail of the process and/or quality improvement can hopefully demonstrate competency. But the expectation alone can not provide that. The key is education. Teach us how it needs to be done correctly. Show us the results of our work. Have it evaluated and give constructive feedback. Everybody wins in this scenario. Teri Johnson, HT(ASCP)QIHC Head, Histology and Electron Microscopy Stowers Institute for Medical Research Kansas City, MO ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Re: Embedding process improvement...
Starting with the gross dissection manual, pathologist input is excellent. I always assume that education is key! Thanks for points, good comment to this discussion Sent from my Verizon Wireless BlackBerry -Original Message- From: Johnson Teri t...@stowers.org Date: Thu, 25 Aug 2011 18:42:40 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: Embedding process improvement... Back to the question at hand, You will need to engage the pathologists to provide information as to the correct way to embed the skin specimens. If you have a dermatopathologist in your practice, that person will need to provide the information about how he/she dissects it, what he/she wants, and why. I have attended a continuing education lecture locally by a dermatopathologist and he showed HE slides of incomplete and improperly embedded skin samples. He could not render a proper diagnosis due to this histologist's inability to give him the correct view of the samples. How would you feel if that was your biopsy and someone embedded it with complete disregard? I would like to think that mistakes happen due to a misunderstanding and nothing more sinister. There was a time back in the day that we each had a grossing room rotation and watched how the pathologists did their grossing. I suspect in these busy labs and busy times, that happens less and less. Having the paper trail of the process and/or quality improvement can hopefully demonstrate competency. But the expectation alone can not provide that. The key is education. Teach us how it needs to be done correctly. Show us the results of our work. Have it evaluated and give constructive feedback. Everybody wins in this scenario. Teri Johnson, HT(ASCP)QIHC Head, Histology and Electron Microscopy Stowers Institute for Medical Research Kansas City, MO ___ 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
AW: [Histonet] RE: Embedding process improvement andcompetencyassessment
Lucky me. Being a MT in Austria I've learned also histotechniqe during education. ;) So no discussions like this. But in reality people working in histologic or chemical labs are of different species. I think managing and technical supervising are different skills. In small teams both is in close contact and a manager without histotech-knowledge has a hard life - and the coworkers also. Gudrun ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] MSDS binders
Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, HT ASCP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] MSDS binders
Not certain about CLIA, but CAP only requires immediate available access to the MSDS's by any personal using chemicals. I interpret that as digital copies ok, as long as everyone has access. I have passed three inspections with digital MSDS only. Will Chappell Sent from my iPhone On Aug 25, 2011, at 11:58 AM, Jill Cox jco...@yahoo.com wrote: Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, 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
Re: AW: [Histonet] RE: Embedding process improvementandcompetencyassessment
Thank you for clarifying the essential element at hand. I have learned to appreciate the different skill sets indeed. Lucky you for having training in all. Joelle Sent from my Verizon Wireless BlackBerry -Original Message- From: Gudrun Lang gu.l...@gmx.at Date: Thu, 25 Aug 2011 18:53:09 To: histonet@lists.utsouthwestern.edu Subject: AW: [Histonet] RE: Embedding process improvement andcompetencyassessment Lucky me. Being a MT in Austria I've learned also histotechniqe during education. ;) So no discussions like this. But in reality people working in histologic or chemical labs are of different species. I think managing and technical supervising are different skills. In small teams both is in close contact and a manager without histotech-knowledge has a hard life - and the coworkers also. Gudrun ___ 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
Re: [Histonet] MSDS binders
In practicality you would turn to your online version first. What happens if the computer system/network is down. Seems like it would be prudent to have a hard copy available. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst University of Washington Medical Center Dept of Pathology Room BB220 1959 NE Pacific Seattle, WA 98195 vic...@pathology.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. On 8/25/2011 12:08 PM, William wrote: Not certain about CLIA, but CAP only requires immediate available access to the MSDS's by any personal using chemicals. I interpret that as digital copies ok, as long as everyone has access. I have passed three inspections with digital MSDS only. Will Chappell Sent from my iPhone On Aug 25, 2011, at 11:58 AM, Jill Coxjco...@yahoo.com wrote: Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, 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
[Histonet] soaking instruments
Histo Folks- please share what you are using to soak instruments and wipe down counters. What we were using is no longer available. Marcia Funk Histology Laboratory Mercy Medical Center North Iowa Mason City, IA, 50401 641-428-7907 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Returning to Histology-Another Idea Won't Work
I thought it might be good to study and try for the HTL (already have school for HT and am certified) but it looks like the time limits prohibit me from trying this, since I did it so long ago. Anyone else have any ideas? I'd gladly buy the books and study. Cannot get into a lab here in NC without current experience. The closest school is in western NC, about 5 hours away. I didn't see anything near me in Raleigh. I was going to purchase the textbooks but now I see this won't work either: Histotechnologist, HTL(ASCP) Application Fee: $210 To be eligible for this examination category, an applicant must satisfy the requirements of at least one of the following routes: Route 1: Baccalaureate degree from a regionally accredited college/university with a combination of 30 semester hours (45 quarter hours) of biology and chemistry AND successful completion of a NAACLS accredited Histotechnician or Histotechnology program within the last 5 years; OR Route 2: Baccalaureate degree from a regionally accredited college/university with a combination of 30 semester hours (45 quarter hours) of biology and chemistry AND one year full time acceptable experience in a histopathology (clinical, veterinary, industry or research) laboratory in the U.S., Canada or an accredited laboratory* within the last ten years. *laboratory accredited by a CMS approved accreditation organization (i.e., AABB, CAP, COLA, DNV, The Joint Commission, etc.) Clinical Laboratory Experience To fulfill the experience requirement for the Histotechnologist examination, you must have experience, within the last ten years, in the following areas: Fixation Microtomy Processing Staining Any ideas? I have posted this before, but I keep on trying! Paula ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] MSDS binders
There must be some way for the Fire Department to be able to access MSDS. As Victor rightly points out, if your computer system is down, that option no longer exists. It is not only prudent, it is mandatory for the Fire Service to be able to look up any chemical within your facility. If you cannot satisfy your local fire daprtment, they will close you down quicker than CAP or CLIA ever could. Ronnie Houston Anatomic Pathology Manager Nationwide Children's Hospital Columbus OH 43205 (614) 722 5450 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Victor Tobias Sent: Thursday, August 25, 2011 3:16 PM To: William Cc: Histonet@Lists. Edu Subject: Re: [Histonet] MSDS binders In practicality you would turn to your online version first. What happens if the computer system/network is down. Seems like it would be prudent to have a hard copy available. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst University of Washington Medical Center Dept of Pathology Room BB220 1959 NE Pacific Seattle, WA 98195 vic...@pathology.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. On 8/25/2011 12:08 PM, William wrote: Not certain about CLIA, but CAP only requires immediate available access to the MSDS's by any personal using chemicals. I interpret that as digital copies ok, as long as everyone has access. I have passed three inspections with digital MSDS only. Will Chappell Sent from my iPhone On Aug 25, 2011, at 11:58 AM, Jill Coxjco...@yahoo.com wrote: Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, 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 - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that any review, use, disclosure, distribution, copying, printing, or action taken in reliance on the contents of this e-mail is strictly prohibited. If you have received this communication in error, please notify us immediately by reply e-mail and destroy all copies of the original message. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] MSDS binders
Our Fire Marshalls even require we have a big red sign pointing to where the hard copies are located. They don't need to hunt for it in case of an event. Shirley From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald [ronald.hous...@nationwidechildrens.org] Sent: Thursday, August 25, 2011 3:31 PM To: 'Victor Tobias'; William Cc: Histonet@Lists. Edu Subject: RE: [Histonet] MSDS binders There must be some way for the Fire Department to be able to access MSDS. As Victor rightly points out, if your computer system is down, that option no longer exists. It is not only prudent, it is mandatory for the Fire Service to be able to look up any chemical within your facility. If you cannot satisfy your local fire daprtment, they will close you down quicker than CAP or CLIA ever could. Ronnie Houston Anatomic Pathology Manager Nationwide Children's Hospital Columbus OH 43205 (614) 722 5450 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Victor Tobias Sent: Thursday, August 25, 2011 3:16 PM To: William Cc: Histonet@Lists. Edu Subject: Re: [Histonet] MSDS binders In practicality you would turn to your online version first. What happens if the computer system/network is down. Seems like it would be prudent to have a hard copy available. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst University of Washington Medical Center Dept of Pathology Room BB220 1959 NE Pacific Seattle, WA 98195 vic...@pathology.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. On 8/25/2011 12:08 PM, William wrote: Not certain about CLIA, but CAP only requires immediate available access to the MSDS's by any personal using chemicals. I interpret that as digital copies ok, as long as everyone has access. I have passed three inspections with digital MSDS only. Will Chappell Sent from my iPhone On Aug 25, 2011, at 11:58 AM, Jill Coxjco...@yahoo.com wrote: Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, 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 - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that any review, use, disclosure, distribution, copying, printing, or action taken in reliance on the contents of this e-mail is strictly prohibited. If you have received this communication in error, please notify us immediately by reply e-mail and destroy all copies of the original message. Thank you. ___ 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
RE: [Histonet] AMPHYL
We also use Lysol I.C. Caula Gill(HT)ASCP -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A Sent: Thursday, August 25, 2011 2:07 PM To: barbara.cr...@lpnt.net; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] AMPHYL We use Lysol I. C.; haven't be able to get Amphyl for years. Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory DB1-223 VAH 600 Highland Ave. Madison, WI 53792 (608)265-6596 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of barbara.cr...@lpnt.net Sent: Thursday, August 25, 2011 12:56 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] AMPHYL My materials management department told me that AMPHYL has been discontinued. Ventana recommends that we clean/decontaminate the Benchmark and the Ultras with AMPHYL. Has anyone else ran across this? Has AMPHYL really been discontinued? Is there a substitute we can use. Thanks everyone! ANTOINETTE CRILL ANATOMIC PATHOLOGY EXT 5451 ___ 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
[Histonet] Rewording of MSDS binders question
We do have hard copy of our MSDS, my question was mainly if we are able to use same binder type as our procedure manuals for our MSDS or does it have to be in a special color binder like bright bold yellow/black? Jill Cox, HT ASCP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Embedding process improvementandcompetencyassessment
Tom, (and all those following this thread) And we got that ;) perfection. (Warning, long rant ahead... Rene's might have been longer, but he spread it out over a number of posts) (Hi Rene, I enjoyed your rant.) My biggest barrier in assimilating into the civilian workforce was that perfection wasn't required or even at times expected. I still can't get my head around that. Because of what was expected of me by my unit, 30 years later, my embedding is tight w nice, neat rows, cutting is neat and aligned and staining is crisp. (However, I will not win any speed contest) My point in this is not to blow my horn. Most of you out there turn out the same or better quality. My point is this, when supervisors and peers stop striving for perfection then there will always be a need for skills assessments and re-training. There will be little or no perfection. Over the last thirty years of training and supervising, I have always tried to instill the idea that we are dealing with a person's tissue. Wrapped up in that is a lot of anxiety and stress that the patient is having. The first thing a new trainee or tech had to do when they came to me (in the civilian world)was spend a week shadowing phlebotomy so that they got the chance to see some of the faces behind the samples. But in the last ten years or so, there has been too much emphasis on speed as a standard of performance, and in general, there has been a growing attitude that perfection isn't possible. (many factors to blame, I suppose) I once worked for a very demanding pathologist and because of his expectations, the whole crew put out near perfection. Pathologists that are OK with what they get, so long as they can make a diagnosis, are a huge part of that problem. But as supervisors, we only get what we expect of people and strive for and example ourselves. (The rest of the rant is anecdotal and not very interesting, but since I took the time to write it, here it is...) This was also the period (Navy)when I had to do that monster practical for the HT. Back then, it was not 7 or 8 slides, but many more with a large number of special stains as well. I knew if it passed the guys in our lab, it should be no problem passing the practical. The guy who took the test at the same time I did, picked his tissues on Wednesday, embedded them on Thursday cut cut and stained them on Saturday and mailed them on Monday. He had no concern at all that his work wouldn't be good enough. He passed the practical with a very respectable percentile. I think that helps to bolster the idea that an expectation that is demanded and fostered is one that can be confidently met. If people cheated. Then people cheated. There will always be that element. To discard that requirement (the practical) because of the cheat factor was a silly (remember, this is my rantnot yours) excuse that I have heard from some people who were part of the decision. What was lost was the incredable effort that was needed to do that practical and the experience of being able to produce registry quality slides. That is not cheating themselves, but robbing every pathologist and patient that followed until that person started to produce quality work. (Rany over, thanks to those who hung out til the end I hope it was worth it) I hope every one has a great weekend, as I am off on Friday and will be having a great weekend myself. Shalom - Bill -Original Message- From: Podawiltz, Thomas [mailto:tpodawi...@lrgh.org] Sent: Thursday, August 25, 2011 1:21 PM To: O'Donnell, Bill; Heath, Nancy L.; Jennifer MacDonald Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvementandcompetencyassessment Man did that bring back some memories. Bill and I worked together in the same Navy lab and he is correct if a block was embedded wrong you would get it in either the back of the head or between the shoulders. They stopped throwing them at me the day I throw the block back at the microtomist and hit him in the head. We were a tough crew that saw a lot, did a lot, partied together a lot, but never lost the fact that we were there for patient care and treated all the specimens and bodies as if they came from a love one. When it came time for Bill and I to become the trainers we were brutal in how to embed, section and all other aspects of histology, I mean we only wanted perfection. Tom Podawiltz HT (ASCP) Histology Section Head/Laboratory Safety Officer. LRGHealthcare Laconia, NH 03246 603-524-3211 ext: 3220 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of O'Donnell, Bill Sent: Thursday, August 25, 2011 1:57 PM To: Heath, Nancy L.; Jennifer MacDonald Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvementand
Re: [Histonet] MSDS binders
I would say if your computer system is down, then your electricity is probably out so I would hightail it out of there. Or ask yourself, why am I working with hazardous chemicals in the dark? Our EHS allows digital MSDS as well, but they say you could always call them if necessary. So maybe that's also what you would do if you computer system was down. Emily A great book should leave you with many experiences, and slightly exhausted. You should live several lives while reading it. -William Styron On Thu, Aug 25, 2011 at 3:40 PM, Shirley A. Powell powell...@mercer.eduwrote: Our Fire Marshalls even require we have a big red sign pointing to where the hard copies are located. They don't need to hunt for it in case of an event. Shirley From: histonet-boun...@lists.utsouthwestern.edu [ histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald [ ronald.hous...@nationwidechildrens.org] Sent: Thursday, August 25, 2011 3:31 PM To: 'Victor Tobias'; William Cc: Histonet@Lists. Edu Subject: RE: [Histonet] MSDS binders There must be some way for the Fire Department to be able to access MSDS. As Victor rightly points out, if your computer system is down, that option no longer exists. It is not only prudent, it is mandatory for the Fire Service to be able to look up any chemical within your facility. If you cannot satisfy your local fire daprtment, they will close you down quicker than CAP or CLIA ever could. Ronnie Houston Anatomic Pathology Manager Nationwide Children's Hospital Columbus OH 43205 (614) 722 5450 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Victor Tobias Sent: Thursday, August 25, 2011 3:16 PM To: William Cc: Histonet@Lists. Edu Subject: Re: [Histonet] MSDS binders In practicality you would turn to your online version first. What happens if the computer system/network is down. Seems like it would be prudent to have a hard copy available. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst University of Washington Medical Center Dept of Pathology Room BB220 1959 NE Pacific Seattle, WA 98195 vic...@pathology.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. On 8/25/2011 12:08 PM, William wrote: Not certain about CLIA, but CAP only requires immediate available access to the MSDS's by any personal using chemicals. I interpret that as digital copies ok, as long as everyone has access. I have passed three inspections with digital MSDS only. Will Chappell Sent from my iPhone On Aug 25, 2011, at 11:58 AM, Jill Coxjco...@yahoo.com wrote: Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, 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 - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that any review, use, disclosure, distribution, copying, printing, or action taken in reliance on the contents of this e-mail is strictly prohibited. If you have received this communication in error, please notify us immediately by reply e-mail and destroy all copies of the original message. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
Re: [Histonet] MSDS binders
Actually now that I think about it, it would be faster to have a digital system, as you could search the MSDS file with the find option to get exactly what you needed. Also the most updated copies would be online always and you could google for them. And you would haven't to remember the actual chemical name for things like TESPA. Emily A great book should leave you with many experiences, and slightly exhausted. You should live several lives while reading it. -William Styron On Thu, Aug 25, 2011 at 5:16 PM, Emily Sours talulahg...@gmail.com wrote: I would say if your computer system is down, then your electricity is probably out so I would hightail it out of there. Or ask yourself, why am I working with hazardous chemicals in the dark? Our EHS allows digital MSDS as well, but they say you could always call them if necessary. So maybe that's also what you would do if you computer system was down. Emily A great book should leave you with many experiences, and slightly exhausted. You should live several lives while reading it. -William Styron On Thu, Aug 25, 2011 at 3:40 PM, Shirley A. Powell powell...@mercer.eduwrote: Our Fire Marshalls even require we have a big red sign pointing to where the hard copies are located. They don't need to hunt for it in case of an event. Shirley From: histonet-boun...@lists.utsouthwestern.edu [ histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald [ ronald.hous...@nationwidechildrens.org] Sent: Thursday, August 25, 2011 3:31 PM To: 'Victor Tobias'; William Cc: Histonet@Lists. Edu Subject: RE: [Histonet] MSDS binders There must be some way for the Fire Department to be able to access MSDS. As Victor rightly points out, if your computer system is down, that option no longer exists. It is not only prudent, it is mandatory for the Fire Service to be able to look up any chemical within your facility. If you cannot satisfy your local fire daprtment, they will close you down quicker than CAP or CLIA ever could. Ronnie Houston Anatomic Pathology Manager Nationwide Children's Hospital Columbus OH 43205 (614) 722 5450 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Victor Tobias Sent: Thursday, August 25, 2011 3:16 PM To: William Cc: Histonet@Lists. Edu Subject: Re: [Histonet] MSDS binders In practicality you would turn to your online version first. What happens if the computer system/network is down. Seems like it would be prudent to have a hard copy available. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst University of Washington Medical Center Dept of Pathology Room BB220 1959 NE Pacific Seattle, WA 98195 vic...@pathology.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. On 8/25/2011 12:08 PM, William wrote: Not certain about CLIA, but CAP only requires immediate available access to the MSDS's by any personal using chemicals. I interpret that as digital copies ok, as long as everyone has access. I have passed three inspections with digital MSDS only. Will Chappell Sent from my iPhone On Aug 25, 2011, at 11:58 AM, Jill Coxjco...@yahoo.com wrote: Hello Histonetters, Does anyone know if there is a rule as to MSDS binders having to be in yellow and black bold lettering? Do we even still need to have hard copy if we have access to msds.com on desk top? I am in Ca and will be CLIA licensed.. Thank you in advance!! Jill Cox, 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 - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you
RE: [Histonet] AMPHYL
Linda, Where do you get your Lysol IC? Rae Staskiewicz -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A Sent: Thursday, August 25, 2011 1:07 PM To: barbara.cr...@lpnt.net; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] AMPHYL We use Lysol I. C.; haven't be able to get Amphyl for years. Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory DB1-223 VAH 600 Highland Ave. Madison, WI 53792 (608)265-6596 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of barbara.cr...@lpnt.net Sent: Thursday, August 25, 2011 12:56 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] AMPHYL My materials management department told me that AMPHYL has been discontinued. Ventana recommends that we clean/decontaminate the Benchmark and the Ultras with AMPHYL. Has anyone else ran across this? Has AMPHYL really been discontinued? Is there a substitute we can use. Thanks everyone! ANTOINETTE CRILL ANATOMIC PATHOLOGY EXT 5451 ___ 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
RE: [Histonet] AMPHYL
We get ours from Lab Safety Supply. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rae Staskiewicz Sent: Thursday, August 25, 2011 2:54 PM To: 'Sebree Linda A'; barbara.cr...@lpnt.net; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] AMPHYL Linda, Where do you get your Lysol IC? Rae Staskiewicz -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A Sent: Thursday, August 25, 2011 1:07 PM To: barbara.cr...@lpnt.net; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] AMPHYL We use Lysol I. C.; haven't be able to get Amphyl for years. Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory DB1-223 VAH 600 Highland Ave. Madison, WI 53792 (608)265-6596 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of barbara.cr...@lpnt.net Sent: Thursday, August 25, 2011 12:56 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] AMPHYL My materials management department told me that AMPHYL has been discontinued. Ventana recommends that we clean/decontaminate the Benchmark and the Ultras with AMPHYL. Has anyone else ran across this? Has AMPHYL really been discontinued? Is there a substitute we can use. Thanks everyone! ANTOINETTE CRILL ANATOMIC PATHOLOGY EXT 5451 ___ 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Diane Tokugawa/CA/KAIPERM is out of the office.
I will be out of the office starting 08/25/2011 and will not return until 08/29/2011. Note: For Cytology issues, please call Molly at 8-421-5487, Eric at 8-421-5405, Barbara at 8-421-5033, or Wanda 8-421-5426 For Histology issues, please call Mario at 8-421-4961, general histology lab 8-421- 5408 or Wanda at 8-421-5426. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] RE: New CAP question
Greetings all, I contacted CAP just before my on-site inspection last year. I was told that all validation studies had to be on file until the antibody/ special stain/ or equipment was no longer used. Sad to say. Now, I understand for 2012, CAP has added another lab specific checklist. My understanding is that some of the General Checklist questions will now be department specific. It's like a subset of the General Checklist. I was told by a co-worker, I haven't seen anything in print yet, but come on people. A General department checklist from the General checklist. Then why have a General Checklist? Let's keep adding checklists because we can? This is what happens when a monopoly is formed. I'm going to start my own inspection company. I'm going to start from the toes and work my way up. JTT - Original Message - From: Carol Bryant cb...@lexclin.com To: 'Vickroy, Jim' vickroy@mhsil.com; histonet@lists.utsouthwestern.edu Sent: Thursday, August 25, 2011 11:09 AM Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please call the sender immediately at (859)258-4000 and delete all copies of this message and any attachment. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___ 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] zebrafish
Hi all We would like to prepare cryosections of adult zebrafish (3 - 6 months old). Fixation is not allowed. Is anyone of you familiar with the preparation of cryosections (including fish bones, and spinal cord)? I assume that especially the spinal cord will cause problems. Joost Bruijntjes TNO-Triskelion Zeist The Netherlands TNO.NLhttp://www.tno.nl/ Joost Bruijntjes T +31 88 866 17 38 F +31 30 694 49 86 E joost.bruijnt...@tno.triskelion.nlmailto:joost.bruijnt...@tno.triskelion.nl Disclaimerhttp://www.tno.nl/tno/email/ ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Embedding process improvement and competency assessment
Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure that the embedding unit is wipe down between each case as are the forceps, this will avoid tissue floaters. 5. Never open more than one cassette at a time. 6. Verify that the piece count on the work sheet matches what is in the cassette when it is opened. 7. Never hound the staff about speed, accuracy is more important, speed comes with experience. If its embedded wrong, it will be cut wrong and this will effect diagnosis. 8. What do you do for QA on the slides?I have a work sheet that the Pathologist fills out each day about the slides, which is the end product of embedding. I hope my tips help you and feel free to contact me if you need anything. Tom Podawiltz, HT (ASCP) Histology Section Head/Laboratory Safety Officer LRGHealthcare 603-524-3211 ext: 3220 NEED A DOCTOR? Stormont-Vail's Health Connections can help you find a doctor accepting new patients. Call (785) 354-5225. ** The information transmitted in this e-mail and in any replies and forwards are for the sole use of the above individual(s) or entities and may contain proprietary, privileged and/or highly confidential information. Any unauthorized dissemination, review, distribution or copying of these communications is strictly prohibited. If this e-mail has been transmitted to you in error, please notify and return the original message to the sender immediately at the above listed address. Thank you for your cooperation. ** ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Embedding process improvement and competency assessment
This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Thursday, August 25, 2011 9:31 AM To: histonet@lists.utsouthwestern.edu; ShelleyD'Attilio Subject: [Histonet] Embedding process improvement and competency assessment Shelley: I fully understand your position and I am sure that you sometimes may have felt as a stranger in histology. I also understand that you have been able to do things that had benefit the histology work flow.. My general point is that I think that promotions, in all fields of the medical laboratory, should come from within as a reward for a good job. It is the same thing as if somebody from outside the ranks of the Chemical Laboratory is promoted to run it. The same thing has happen in your case when you became the manager for histology coming from outside histology. You have pointed out to a key component of this whole equation: the salary differences and, more deep than that even, is the fact that histotechs are looked down from many members of the medical lab. There is still the perception, encouraged by many a pathologist, that even a monkey can make a tissue section. The fact that histology is 80% still manual compared with the chemical lab that is almost 90% automated, projects an image that histology is a less than technical activity, when it is not. This missperception and some disdain the histotechs are perceived, is the core cause why the promotions in histology usualy do not come from its ranks. And it is also why when that happens, like in your case, you find yourself at a miss about how those tasks wordy of a monkey are done. I hope that now you understand why my first rant. This is my second rant. Under separate cover I am sending you the competencies you need. René J. --- On Wed, 8/24/11, D'Attilio, Shelley sdatt...@stormontvail.org wrote: From: D'Attilio, Shelley sdatt...@stormontvail.org Subject: RE: [Histonet] Embedding process improvement and competency assessment To: Rene J Buesa rjbu...@yahoo.com, histonet@lists.utsouthwestern.edu Date: Wednesday, August 24, 2011, 5:14 PM Rene', I agree with many of the points you make about a non-histotech managing a histology laboratory, especially since the decision could be seen to devalue the special training and knowledge of a histotech. Every bit of knowledge I have gained along the way has been hard-fought, to say the least, and I'm quite sure that I have made mistakes. My experience in the clinical lab did give me an outside perspective on our procedures and processes in our Histology lab. In my tenure, I have introduced slide and cassette labelers that are interfaced with our AP information system and rapid tissue processing technology. In addition, I am a great proponent of specimen tracking systems, particularly as a way to improve patient safety. I hope to implement a tracking system in the next 2-3 years. So while I struggle with the many things that I do not know, I am proud of the changes I championed in our laboratory. I think the original idea for my position (and I'm not the first to have this position) was as an administrative manager--budget, new equipment, personnel matters, etc. with the histotechs themselves functioning as a self-directed team for technical matters. Because our volumes have grown and the technology become more complex, I was able to justify the addition of a bench-level supervisor. And I agree with you that medical technologists/clinical laboratory scientists could make excellent histotechs. It is a shame that in many labs the rate of pay for the two positions is not equivalent. It is very generous to offer your embedding competencies, and I humbly accept. Regards, -Original Message- From: Rene J Buesa [mailto:rjbu...@yahoo.com] Sent: Wednesday, August 24, 2011 2:18 PM To: histonet@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: [Histonet] Embedding process improvement and competency assessment Shelley: Please do not miss-understand what I am going to write you but I still find extremely difficult to wrap my mind around the fact that somebody without practical knowledge of histology can become a manager of a histology laboratory. You will have a very hard time going about your tasks and you will probably make some judgment mistakes. I have proposed many times that medical technologists are the answer to the shortage of histotechs, but because I think MT can be trained and add to their theoretical knowledge of the lab the skills to become good histotecha. Your question is an example of the difficulties you are encountering because one of the responsibilities of the histology manager is to develop and write the competencies for each task based on his/her
RE: [Histonet] RE: Embedding process improvement and competencyassessment
This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure that the embedding unit is wipe down between each case as are the forceps, this will avoid tissue floaters. 5. Never open more than one cassette at a time. 6. Verify that the piece count on the work sheet matches what is in the cassette when it is opened. 7. Never hound the staff about speed, accuracy is more important, speed comes with experience. If its embedded wrong, it will be cut wrong and this will effect diagnosis. 8. What do you do for QA on the slides?I have a work sheet that the Pathologist fills out each day about the slides, which is the end product of embedding. I hope my tips help you and feel free to contact me if you need anything. Tom Podawiltz, HT (ASCP) Histology Section Head/Laboratory Safety Officer LRGHealthcare 603-524-3211 ext: 3220 NEED A DOCTOR? Stormont-Vail's Health Connections can help you find a doctor accepting new patients. Call (785) 354-5225. ** The information transmitted in this e-mail and in any replies and forwards are for the sole use of the above individual(s) or entities and may contain proprietary, privileged and/or highly confidential information. Any unauthorized dissemination, review, distribution or copying of these communications is strictly prohibited. If this e-mail has been transmitted to you in error, please notify and return the original message to the sender immediately at the above listed address. Thank
Re: [Histonet] instructions for steaming slides
We use a black and decker rice steamer fairly routinely. It has the ability to steam for a total of 75 minutes, although it takes a good 15 of them to get up to temperature. I like it becasue the temperature is nice and even and it is very easy to do. 1. add water to the bottom of the steamer and turn it on (I turn the dial all the way to 75 minutes) 2. preheate the HIER solution in the microwave (90-120 seconds for a tissue-tek staining bucket is fine) 3. add slides to the solution and place into the top compartment of the steamer 4. steam for desired time (in tests that I did many years ago, most antibodies required a minimum of 45 minutes in the steamer) 5. you can check the temperature of your retrieval solution, it should be about 100C 6. once done, remove, cool, rinse in water and proceed with your staining Good luck! Kim Kim Merriam, MA, HT(ASCP)QIHC Cambridge, MA From: Kant, H.J.G. van de (Henk) h.j.g.vandek...@uu.nl To: 'histonet@lists.utsouthwestern.edu' histonet@lists.utsouthwestern.edu Sent: Thursday, August 25, 2011 1:49 AM Subject: [Histonet] instructions for steaming slides Dear All, Can somebody help me with instructions (protocol) for steaming slides in a domestic ricecooker or vegetable steamer. Head induced antigen retrieval method is with sodium citrate 0.01 M pH 6.0. Kind regards, Henk van de Kant | Utrecht University | Faculty of Science | Department of Pharmaceutical Sciences | Division of Pharmacology David de Wied building (room 2.21) | Universiteitsweg 99 | 3584 CG Utrecht | The Netherlands ___ 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] Re: Embedding process improvement and competency assessment
Dear Shelly, I would work for you without reserve. I have managed both cytometry and Electron Microscopy successfully, and I cannot do either technique. However, I understand enough about it to make sound decisions and empower my people enough that it works well. It is possible to do well if done properly. The hardest part is proving yourself to those who have preconceived notions as to your worth and suitability because you are not an HT. Best wishes, Teri Johnson, HT(ASCP)QIHC Head, Histology and Electron Microscopy Stowers Institute for Medical Research Kansas City, MO ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Re: Embedding process improvement and competency assessment
Well said. Johnson, Teri t...@stowers.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:39 AM To Histonet histonet@lists.utsouthwestern.edu cc Subject [Histonet] Re: Embedding process improvement and competency assessment Dear Shelly, I would work for you without reserve. I have managed both cytometry and Electron Microscopy successfully, and I cannot do either technique. However, I understand enough about it to make sound decisions and empower my people enough that it works well. It is possible to do well if done properly. The hardest part is proving yourself to those who have preconceived notions as to your worth and suitability because you are not an HT. Best wishes, Teri Johnson, HT(ASCP)QIHC Head, Histology and Electron Microscopy Stowers Institute for Medical Research Kansas City, MO ___ 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] Cowpox frozen sections
I don't normally do frozens on tissue that has some pathogen but have been asked to cut slides on mouse tissue that has been infected with cowpox. I can take that precautions while doing the frozens but what can I use to disinfect the cryostat after the project is complete? Andi Grantham___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Embedding process improvement and competencyassessment
I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure that the embedding unit is wipe down between each case as are the forceps, this will avoid tissue floaters. 5. Never open more than one cassette at a time. 6. Verify that the piece count on the work sheet matches what is in the cassette when it is opened. 7. Never hound the staff about speed, accuracy is more important, speed comes with experience. If its embedded wrong, it will be cut wrong and this will effect diagnosis. 8. What do you do for QA on the slides?I have a work sheet that the Pathologist fills out each day about the slides, which is the end product of embedding. I hope my tips help you and feel free to contact me if you need anything. Tom Podawiltz, HT (ASCP) Histology Section Head/Laboratory
[Histonet] New CAP question
One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: New CAP question
Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please call the sender immediately at (859)258-4000 and delete all copies of this message and any attachment. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] embedding
I have produced a very detailed guide for my techs. A little long, it is about 8 pages including diagrams pertaining mostly to derms. I would be glad to forward to anyone interested. I would also like to share a book. I met the author and she autographed my book at a North Carolina meeting many, many years ago. It is Pearls, Preventatives and Anecdotes in Histologic Technic, by Billy Swisher. I have found it very useful over the years and I always have my trainees read it. One of her statements is an everyday quote in my lab. The finished cassette should almost give the appearance of already been faced off when it is removed from the mold. Orientation is most important, but if the block does not have the faced off appearance, it will be re-embeded until it does! Sure makes cutting a breeze and the Docs love our slides! Kelly Kelly D. Boyd, BS, HTL (ASCP) Lab Manager Harris Histology Services 2025 Eastgate Dr. Ste. F Greenville, NC 27858 www.harrishisto.com Tele (252)-830-6866 (800)-284-0672 Cell (252)-943-9527 Fax (252)-830-0032 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: New CAP question
I hope you're correct. James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 -Original Message- From: Martha Ward [mailto:mw...@wakehealth.edu] Sent: Thursday, August 25, 2011 11:30 AM To: Carol Bryant; Vickroy, Jim; histonet@lists.utsouthwestern.edu Subject: RE: New CAP question We too have been performing ER and PR for at least 15 years, participate in CAP proficiency testing and, when we switched staining platforms a few years ago, validated the new antibody we switched to. I have interpreted the standard as necessary if you are introducing ER/PR in your lab. In my opinion you would not have to go back and revalidate something you did years ago just to have something to show at inspection time. We had our CAP inspection this summer and a similar question pertains to the HER2 assay, which we have also been doing for many years, and that is what I told our inspector, which seemed to satisfy them. Martha Ward, MT (ASCP) QIHC Manager, Molecular Diagnostics Lab Dept. of Pathology Wake Forest Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Thursday, August 25, 2011 12:10 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please call the sender immediately at (859)258-4000 and delete all copies of this message and any attachment. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___ 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
RE: [Histonet] RE: Embedding process improvement and competencyassessment
Regardless of wether there were 8 blocks or eighteen blocks taking the practical taught me to be precise with all of the hands on aspects of Histology. Shame on the older techs from the practical days of not keeping on top of their game with embedding. My comment was geared more towards the newbies coming out of histo schools who can pass the exam with flying colors but sit them in front of an embedding center or microtome and they are all thumbs! As far as a manager, I myself would rather have someone who has experience with histology over seeing my work. Just once again the lack of respect of having the HT/HTL behind your name. From: Jennifer MacDonald [mailto:jmacdon...@mtsac.edu] Sent: Thursday, August 25, 2011 10:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley; Podawiltz, Thomas Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction,
RE: [Histonet] RE: New CAP question
I think it may depend on the inspector. We had something similar happen in Cytology during inspection. They had no validation records for their Thin Prep processing, which they had been doing for years. They were required to validate and provide documentation to CAP. Laurie Colbert -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 9:31 AM To: Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question I hope you're correct. James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 -Original Message- From: Martha Ward [mailto:mw...@wakehealth.edu] Sent: Thursday, August 25, 2011 11:30 AM To: Carol Bryant; Vickroy, Jim; histonet@lists.utsouthwestern.edu Subject: RE: New CAP question We too have been performing ER and PR for at least 15 years, participate in CAP proficiency testing and, when we switched staining platforms a few years ago, validated the new antibody we switched to. I have interpreted the standard as necessary if you are introducing ER/PR in your lab. In my opinion you would not have to go back and revalidate something you did years ago just to have something to show at inspection time. We had our CAP inspection this summer and a similar question pertains to the HER2 assay, which we have also been doing for many years, and that is what I told our inspector, which seemed to satisfy them. Martha Ward, MT (ASCP) QIHC Manager, Molecular Diagnostics Lab Dept. of Pathology Wake Forest Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Thursday, August 25, 2011 12:10 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please call the sender immediately at (859)258-4000 and delete all copies of this message and any attachment. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
RE: [Histonet] RE: Embedding process improvement and competencyassessment
That is unfortunate that people will resort to dishonesty, only cheating themselves in my humble opinion... According to NAACLS, since the discontinuation of the practical component of the HT exam( per Zoe) it is the responsibility of the program directors to require practical blocks and slides in HT training programs. Couldn't a histology supervisor or lead person create a similar process in their lab, if they wished to do so, for those who did not complete a formal program? Maybe something like a technincal proficiency from their procedures and competency standard that includes demonstration of manual execution and technical quality and mastery ? I also think this plays in with quality control documentation and assessment, ( which could be considered as a MGMT function) i.e. documenting versus execution of theory understanding and technical task(s) . Personally, I know that I have always included this technical execution in the proficiency any time that I have been involved or responsible for assessment, training and evaluation, since there is theory and practical execution to be considered...but once the method and means are in place, it should be applicable in many situations with persons at different places in their learning, experience and training, in my opinion. I have seen this applied in several histology labs successfully, and included with the QMS and procedures. I know that having a histologist involved in this development process, could be crucial, as already pointed out in this discussion thread, but I think given the shortage of trained people, with the right attitude many high level managing activities could be supported or performed by an otherwise trained administrator . Joelle Weaver MAOM, BA, (HTL) ASCP To: nhe...@lifespan.org From: jmacdon...@mtsac.edu Date: Thu, 25 Aug 2011 07:57:46 -0700 Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment CC: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu; sdatt...@stormontvail.org I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of
RE: [Histonet] RE: New CAP question
I might be wrong here but I thought that each time that you brought in new testing, you had to validate it at that time, then had to keep those records for the life of the test, plus a couple of years. Tom Podawiltz HT (ASCP) Histology Section Head/Laboratory Safety Officer. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert Sent: Thursday, August 25, 2011 12:46 PM To: Vickroy, Jim; Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New CAP question I think it may depend on the inspector. We had something similar happen in Cytology during inspection. They had no validation records for their Thin Prep processing, which they had been doing for years. They were required to validate and provide documentation to CAP. Laurie Colbert -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 9:31 AM To: Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question I hope you're correct. James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 -Original Message- From: Martha Ward [mailto:mw...@wakehealth.edu] Sent: Thursday, August 25, 2011 11:30 AM To: Carol Bryant; Vickroy, Jim; histonet@lists.utsouthwestern.edu Subject: RE: New CAP question We too have been performing ER and PR for at least 15 years, participate in CAP proficiency testing and, when we switched staining platforms a few years ago, validated the new antibody we switched to. I have interpreted the standard as necessary if you are introducing ER/PR in your lab. In my opinion you would not have to go back and revalidate something you did years ago just to have something to show at inspection time. We had our CAP inspection this summer and a similar question pertains to the HER2 assay, which we have also been doing for many years, and that is what I told our inspector, which seemed to satisfy them. Martha Ward, MT (ASCP) QIHC Manager, Molecular Diagnostics Lab Dept. of Pathology Wake Forest Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Thursday, August 25, 2011 12:10 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended
RE: [Histonet] RE: Embedding process improvement and competencyassessment
I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure that the
RE: [Histonet] RE: Embedding process improvement and competencyassessment
This point is well taken- I agree that our experience and knowledge often goes unrecognized. In my humble opinion , it takes all components, theory knowledge, extended practice and forthcoming technical mastery... some of this can come with academic study, some comes with actual doing . No doubt we are not there yet in having the best system for training new people coming in, it has been an ongoing industry challenge. Some managers seem to understand the components needed, some do not. Certainly helps to be a histologist in any case, for any type of management of this lab section. Do to our lack of recognition in some markets I guess, we often have MT people as supervisors and managers, they bring some things to the table, but lack some insights it seems. But what I am suggesting that we can try to do, is to get those willing and already in those positions, to an understanding for what is particularly needed for histology. Some MT managers I have had have in the past, have been pretty good and are open to this, some unfortunately have demonstrated the dissappointing attitude that anyone can do histology...and seem to try to fill the need with any warm body. In my experience, with few exceptions, I have never seen the warm body method of filling staffing needs work out very well. Joelle Joelle Weaver MAOM, BA, (HTL) ASCP Date: Thu, 25 Aug 2011 12:39:16 -0400 From: nhe...@lifespan.org To: jmacdon...@mtsac.edu Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment CC: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu; sdatt...@stormontvail.org Regardless of wether there were 8 blocks or eighteen blocks taking the practical taught me to be precise with all of the hands on aspects of Histology. Shame on the older techs from the practical days of not keeping on top of their game with embedding. My comment was geared more towards the newbies coming out of histo schools who can pass the exam with flying colors but sit them in front of an embedding center or microtome and they are all thumbs! As far as a manager, I myself would rather have someone who has experience with histology over seeing my work. Just once again the lack of respect of having the HT/HTL behind your name. From: Jennifer MacDonald [mailto:jmacdon...@mtsac.edu] Sent: Thursday, August 25, 2011 10:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley; Podawiltz, Thomas Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form.
RE: [Histonet] embedding
I also like this reference- I like the quote. Quality embedding is key to me to the ultimate production for high quality, and sometimes discounted and overlooked in that regard. Joelle Weaver MAOM, BA, (HTL) ASCP Date: Thu, 25 Aug 2011 09:29:17 -0700 From: kdboydhi...@yahoo.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] embedding I have produced a very detailed guide for my techs. A little long, it is about 8 pages including diagrams pertaining mostly to derms. I would be glad to forward to anyone interested. I would also like to share a book. I met the author and she autographed my book at a North Carolina meeting many, many years ago. It is Pearls, Preventatives and Anecdotes in Histologic Technic, by Billy Swisher. I have found it very useful over the years and I always have my trainees read it. One of her statements is an everyday quote in my lab. The finished cassette should almost give the appearance of already been faced off when it is removed from the mold. Orientation is most important, but if the block does not have the faced off appearance, it will be re-embeded until it does! Sure makes cutting a breeze and the Docs love our slides! Kelly Kelly D. Boyd, BS, HTL (ASCP) Lab Manager Harris Histology Services 2025 Eastgate Dr. Ste. F Greenville, NC 27858 www.harrishisto.com Tele (252)-830-6866 (800)-284-0672 Cell (252)-943-9527 Fax (252)-830-0032 ___ 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
RE: [Histonet] RE: New CAP question
Yes, but I don't think this has always been the case, or at least it hasn't been strictly enforced. With all of the new specific CAP guidelines regarding validation, it is not only a requirement now, but the expectations/requirements are more clearly spelled out. When I started here in 2000, we had a Ventana ES IHC stainer and had no validation records. When we received a new IHC stainer in 2001, we validated but the records we kept were very insufficient. When we upgraded again this year, we followed the CAP checklist requirements (and I took several validation classes at NSH last year), and the process was very extensive and time-consuming - but I have lots and lots of documentation to show the inspectors. Laurie -Original Message- From: Podawiltz, Thomas [mailto:tpodawi...@lrgh.org] Sent: Thursday, August 25, 2011 10:05 AM To: Laurie Colbert; Vickroy, Jim; Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New CAP question I might be wrong here but I thought that each time that you brought in new testing, you had to validate it at that time, then had to keep those records for the life of the test, plus a couple of years. Tom Podawiltz HT (ASCP) Histology Section Head/Laboratory Safety Officer. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert Sent: Thursday, August 25, 2011 12:46 PM To: Vickroy, Jim; Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New CAP question I think it may depend on the inspector. We had something similar happen in Cytology during inspection. They had no validation records for their Thin Prep processing, which they had been doing for years. They were required to validate and provide documentation to CAP. Laurie Colbert -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 9:31 AM To: Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question I hope you're correct. James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 -Original Message- From: Martha Ward [mailto:mw...@wakehealth.edu] Sent: Thursday, August 25, 2011 11:30 AM To: Carol Bryant; Vickroy, Jim; histonet@lists.utsouthwestern.edu Subject: RE: New CAP question We too have been performing ER and PR for at least 15 years, participate in CAP proficiency testing and, when we switched staining platforms a few years ago, validated the new antibody we switched to. I have interpreted the standard as necessary if you are introducing ER/PR in your lab. In my opinion you would not have to go back and revalidate something you did years ago just to have something to show at inspection time. We had our CAP inspection this summer and a similar question pertains to the HER2 assay, which we have also been doing for many years, and that is what I told our inspector, which seemed to satisfy them. Martha Ward, MT (ASCP) QIHC Manager, Molecular Diagnostics Lab Dept. of Pathology Wake Forest Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Thursday, August 25, 2011 12:10 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand
Re: [Histonet] RE: New CAP question
It is my understanding that one should also revalidate when you switch antibodies, detection kits or instruments/methodology. As far as validating against another source, you should validate against someone doing the same methology, same antibody, and same detection kit. Thanks Debbie Siena HT(ASCP)QIHC Technical Manager | StatLab Medical Products 407 Interchange St. | McKinney, TX 75071 Direct: 972-436-1010 x229 | Fax: 972-436-1369 dsi...@statlab.com | www.statlab.com - Original Message - From: Podawiltz, Thomas [mailto:tpodawi...@lrgh.org] Sent: Thursday, August 25, 2011 12:04 PM To: Laurie Colbert laurie.colb...@huntingtonhospital.com; Vickroy, Jim vickroy@mhsil.com; Martha Ward mw...@wakehealth.edu; Carol Bryant cb...@lexclin.com; histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New CAP question I might be wrong here but I thought that each time that you brought in new testing, you had to validate it at that time, then had to keep those records for the life of the test, plus a couple of years. Tom Podawiltz HT (ASCP) Histology Section Head/Laboratory Safety Officer. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert Sent: Thursday, August 25, 2011 12:46 PM To: Vickroy, Jim; Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New CAP question I think it may depend on the inspector. We had something similar happen in Cytology during inspection. They had no validation records for their Thin Prep processing, which they had been doing for years. They were required to validate and provide documentation to CAP. Laurie Colbert -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 9:31 AM To: Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question I hope you're correct. James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 -Original Message- From: Martha Ward [mailto:mw...@wakehealth.edu] Sent: Thursday, August 25, 2011 11:30 AM To: Carol Bryant; Vickroy, Jim; histonet@lists.utsouthwestern.edu Subject: RE: New CAP question We too have been performing ER and PR for at least 15 years, participate in CAP proficiency testing and, when we switched staining platforms a few years ago, validated the new antibody we switched to. I have interpreted the standard as necessary if you are introducing ER/PR in your lab. In my opinion you would not have to go back and revalidate something you did years ago just to have something to show at inspection time. We had our CAP inspection this summer and a similar question pertains to the HER2 assay, which we have also been doing for many years, and that is what I told our inspector, which seemed to satisfy them. Martha Ward, MT (ASCP) QIHC Manager, Molecular Diagnostics Lab Dept. of Pathology Wake Forest Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Thursday, August 25, 2011 12:10 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy
RE: [Histonet] embedding
I would love to have a copy of your embedding guidelines. Becky Garrison Pathology Supervisor Shands Jacksonville Jacksonville, FL 32209 904-244-6237, phone 904-244-4290, fax 904-393-3194, pager -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kelly Boyd Sent: Thursday, August 25, 2011 12:29 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] embedding I have produced a very detailed guide for my techs. A little long, it is about 8 pages including diagrams pertaining mostly to derms. I would be glad to forward to anyone interested. I would also like to share a book. I met the author and she autographed my book at a North Carolina meeting many, many years ago. It is Pearls, Preventatives and Anecdotes in Histologic Technic, by Billy Swisher. I have found it very useful over the years and I always have my trainees read it. One of her statements is an everyday quote in my lab. The finished cassette should almost give the appearance of already been faced off when it is removed from the mold. Orientation is most important, but if the block does not have the faced off appearance, it will be re-embeded until it does! Sure makes cutting a breeze and the Docs love our slides! Kelly Kelly D. Boyd, BS, HTL (ASCP) Lab Manager Harris Histology Services 2025 Eastgate Dr. Ste. F Greenville, NC 27858 www.harrishisto.com Tele (252)-830-6866 (800)-284-0672 Cell (252)-943-9527 Fax (252)-830-0032 ___ 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] AMPHYL
My materials management department told me that AMPHYL has been discontinued. Ventana recommends that we clean/decontaminate the Benchmark and the Ultras with AMPHYL. Has anyone else ran across this? Has AMPHYL really been discontinued? Is there a substitute we can use. Thanks everyone! ANTOINETTE CRILL ANATOMIC PATHOLOGY EXT 5451 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Embedding process improvementand competencyassessment
Just to throw a somewhat funny situation into the mix. I learned my embedding skills in the Navy. The basic method for learning all tasks was 1. explain it, 2. demonstrate it, 3. do it. Each microtomist was responsible for taking a good look at the block before cutting it. If the embedding was not spot-on, the block was always returned for reembedding. The method of return was to throw it at the back of my head. They rarely missed. Very quickly, I got tired of being hit in the head and my embedding improved. Can't do that kind of stuff now, even in the military. Who knew that histology used to be a contact sport? We've gotten so soft! As to the other situation, as a histology supervisor, I was over cytology in one of the labs I worked at. I doubt that I was much of a manager to them as I knew next to nothing about their work. However, I took the time to learn some aspects, and then just pretty much left them alone. (It was a mutual respect, they pretty much left me alone too.) They did a fine job of making me look good. I trusted them, and they didn't do anything to betray that trust. Because of that, I would simply sign-off on the occasional request. Evals were pretty easy as I simply interviewed the pathologists, checked attendance and moved on. That being said, I wouldn't want to have to do it again. They deserved better, but we made it work, since it wasn't going to change. Have a great day! William (Bill) O'Donnell, HT (ASCP) QIHC Senior Histologist Good Samaritan Hospital 10 East 31st Street Kearney, NE 68847 Check out my podcast at DeaconCast.Net SERENITY is not freedom from the storm, but peace amid the storm. Cultivate it in PRAYER! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Heath, Nancy L. Sent: Thursday, August 25, 2011 11:39 AM To: Jennifer MacDonald Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio,Shelley Subject: RE: [Histonet] RE: Embedding process improvementand competencyassessment Regardless of wether there were 8 blocks or eighteen blocks taking the practical taught me to be precise with all of the hands on aspects of Histology. Shame on the older techs from the practical days of not keeping on top of their game with embedding. My comment was geared more towards the newbies coming out of histo schools who can pass the exam with flying colors but sit them in front of an embedding center or microtome and they are all thumbs! As far as a manager, I myself would rather have someone who has experience with histology over seeing my work. Just once again the lack of respect of having the HT/HTL behind your name. From: Jennifer MacDonald [mailto:jmacdon...@mtsac.edu] Sent: Thursday, August 25, 2011 10:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley; Podawiltz, Thomas Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in
RE: [Histonet] RE: New CAP question
All: It is my understanding that you should retain validation records for any testing that is still being done regardless of how long ago that validation may have occurred. In general, you need to be able to show how you traced and compared the current test to some previously validated test and that requirement does not have an expiration date to my knowledge. If the switch occurred so long ago that there was no validation requirement at the time of the switch then some inspectors may let you off the hook but I suspect that the intent here is that you would still need to be able to document that you have validated the test somehow, perhaps by redoing it today. FDA approved prognostic markers are often scrutinized more carefully than other testing. Documentation for testing that has been discontinued can eventually be discarded after a lengthy waiting period. There is indeed variation between interpretations depending on your inspector with some being very rigid and others much less so. Joe Galbraith University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert Sent: Thursday, August 25, 2011 11:46 AM To: Vickroy, Jim; Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: New CAP question I think it may depend on the inspector. We had something similar happen in Cytology during inspection. They had no validation records for their Thin Prep processing, which they had been doing for years. They were required to validate and provide documentation to CAP. Laurie Colbert -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 9:31 AM To: Martha Ward; Carol Bryant; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question I hope you're correct. James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 -Original Message- From: Martha Ward [mailto:mw...@wakehealth.edu] Sent: Thursday, August 25, 2011 11:30 AM To: Carol Bryant; Vickroy, Jim; histonet@lists.utsouthwestern.edu Subject: RE: New CAP question We too have been performing ER and PR for at least 15 years, participate in CAP proficiency testing and, when we switched staining platforms a few years ago, validated the new antibody we switched to. I have interpreted the standard as necessary if you are introducing ER/PR in your lab. In my opinion you would not have to go back and revalidate something you did years ago just to have something to show at inspection time. We had our CAP inspection this summer and a similar question pertains to the HER2 assay, which we have also been doing for many years, and that is what I told our inspector, which seemed to satisfy them. Martha Ward, MT (ASCP) QIHC Manager, Molecular Diagnostics Lab Dept. of Pathology Wake Forest Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Thursday, August 25, 2011 12:10 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: New CAP question Please respond to all. I would like the information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, Jim Sent: Thursday, August 25, 2011 12:01 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] New CAP question One of the new CAP questions is ANP.22976 ER/PgR validation. If the laboratory performs immunohistochemistry for estrogen receptor and/or progesterone receptor as a prognostic/predictive marker on breast carcinoma, the laboratory has documented appropriate validation for the assays. In the note it says should include a minimum of 40 cases and validation should be performed by comparing the laboratory's results with another assay that has been appropriately validated. We have been doing ER/PR's for over ten years. Originally we compared our ER/PR testing with the old immunology method that used frozen breast tissue. We also compared our ER/PR results with another hospital. Problem is that this has been over ten years and we do not keep quality control records that long. Am I missing something? I know we use the FDA approved protocol from Ventana on our Ventana Benchmark XT. Should we do another validation study using Ventana or another hospital that is using the FDA approved method? Anybody understand what CAP is wanting and how to accomplish this? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including
RE: [Histonet] AMPHYL
We use Lysol I. C.; haven't be able to get Amphyl for years. Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory DB1-223 VAH 600 Highland Ave. Madison, WI 53792 (608)265-6596 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of barbara.cr...@lpnt.net Sent: Thursday, August 25, 2011 12:56 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] AMPHYL My materials management department told me that AMPHYL has been discontinued. Ventana recommends that we clean/decontaminate the Benchmark and the Ultras with AMPHYL. Has anyone else ran across this? Has AMPHYL really been discontinued? Is there a substitute we can use. Thanks everyone! ANTOINETTE CRILL ANATOMIC PATHOLOGY EXT 5451 ___ 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
