[Histonet] RE: Ventana discontinuing INFORM HPV product line
Thanks for the information, Angela. I'm sure we will be having a similar conversation with our account rep as well. Regards, Shelley 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
[Histonet] Ventana discontinuing INFORM HPV product line
Hi all, We have just been informed that Ventana is discontinuing the INFORM HPV Family 6 ASR and the Family 16 Probe ASR. I believe that Ventana is the only company that offers this kind of product. We don't have any experience in our laboratory developing and testing our own cocktails. Can someone offer some words of wisdom or perhaps a procedure? At this point, I don't really know where to start other than to find out the probes included in the Family 16 ASR and to buy some dispensers for the BenchMark XT and Ultra. Ventana cannot help us due to FDA regulations regarding laboratory developed tests (I think). Thanks, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] RE: Gastro prices
Hi all, Lin asked about charges for HE slides, unstained slides, etc. for gastric biopsy. Lin, I just want to caution you about asking for this information on an open forum such as this. I'm not up on all the legal issues, but I think you want to avoid any suspicion of price fixing. A source of information might be the reference lab with whom you already do busines. And of course, take into consideration the amount of reimbursement for the test. Thanks, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] RE: Histonet Digest, Vol 106, Issue 15
Hi all, The Histonet is a great tool for learning and collaboration. It's utility, however, is decreased when one must plow through multiple copies of the same post to find a shiny new nugget of information. Before you hit Reply and then Send, take a few seconds to delete all the stuff under your reply. Everyone who receives the digest form of the Histonet listserv will thank you! This is especially important if you are replying after receiving a digest. Thanks, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] Evaluation of interobserver variability among pathologists
Hi all, Could you please share how your laboratory evaluates interobserver variability among the pathologists per CAP checklist item ANP.22970 (Annual Result Comparison)? I would like to evaluate if my procedure is adequate of if there is more that I should be doing. Does the checklist item imply that we compare the results by individual pathologist to the published benchmarks? Or does it mean that we compare the scoring of each pathologist on the same set of cases? Or something else? Thanks, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas P.S. Hi Scott! Thanks again for the great inspection yesterday. 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
[Histonet] RE: Histonet Digest, Vol 98, Issue 29
Hi all, Madeleine asked the group to share policies with her. Madeleine, I would advise you to sit down with your medical director and tell him or her exactly what is going on in the lab. It is frankly almost unbelievable to me that your medical director did not know about the state of the procedures. He or she needs to get you some help NOW. I also advise you to finish a couple of simple procedures to document your serious intent and request an extension from CAP. A schedule of how you will finish your procedures will help CAP grant your extension. 1. Maintenance procedures for equipment are specific for the equipment you are using. Check the website of your equipment manufacturer. Many manufacturers provide their procedures online in an editable format. Look for CLSI procedure or something like that. Download the procedure and customize it for your own lab. The account rep for your big equipment might be another source of information. In addition to a procedure, you need a checklist or other form to document that the maintenance was performed. 2. The explanations in the CAP checklist are excellent resources for writing procedures. Often the Principle/Purpose section of your procedure can be lifted directly from the CAP checklist. Download your lab's customized checklist from www.cap.org. 3. Ask your IHC instrument account rep if the company can send a technical specialist to help you with optimization and validation of your stains so that you can have extra time to work on procedures. I will send some procedures to you directly to get you started. I hope that you find them helpful. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] RE: New lab desperation
Hi all, Phillip asked about where to start building a new pathology lab. I would start by hiring a registered histotechnologist with both bench and management experience and pay him or her very well. This employee would then be able to advise you about what space and equipment will be needed. In addition, I would recommend that you start with an excellent specimen tracking system and information system that utilizes bar coding for positive patient identification. From that, you can choose the best instrumentation that works with the tracking system. Good luck! It's exciting to think about building a lab from scratch. Don't forget to look for a building with good parking for your couriers as well as windows for your employees. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] RE: Histology lab assistant
Hi all, Matt asked about the duties of a non-certified Histology aide. We have had this position for about 4 years and I consider it absolutely vital to the running of the lab. We originally started with a half-time assistant working in the afternoons (the time with the busiest call volume). This summer, I was able to increase the hours and make the position full time, working 0830-1700. The assistant's responsibilities are as follows: * Filing slides and paperwork * Morning slide distribution to pathologists (match slides to reports, last check of number of parts submitted) * Answering the phone (a big boon to histotech productivity!) * Coordinates send-out testing--pulls slides and block and takes to pathologist, fill out paperwork, package, etc. * Moves slides from the stainer to the automatic coverslipper * Some non-technical tasks related to our weekly Tumor board preparation * Back-up gross room assistant for patient registration, specimen accessioning, and assist with gross exam * Compilation of some CAP-required statistics (e.g. frozen section turnaround times) * Reviewing bills and handling reference lab reports Eventually, this position may also be assigned minor daily maintenance on the slide labeler and HE stainer and alcohol recycling. Giving these tasks to an assistant, especially answering the phone and managing sendouts, allows our histotechs to focus on their core competencies as well as other technical responsibilites such as regular procedure review and other items related to our CAP accreditation. Our professional staff is a mixture of HT(ASCP) and HTL(ASCP), with a few folks who are trained or in training. These people have the necessary education to sit for the certification exam following their training period and they are expected to pass the exam as a condition of their continued employment. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] RE: Recommendations for a slide and cassette labeler system
Hi all, Sheila asked for recommendations for a slide and cassette labeler system. We use the Leica IPS and IPC printers and we are very happy with their reliability and performance. I believe they are larger than other printers but well worth the real estate, in my opinion. Our printers are interfaced to our A/P LIS (WinSurge), but we also have the ability to print slides and cassettes as needed through the printing software. Be advised that our installation required that each printer be connected to its own PC and I needed to purchase two interfaces from WinSurge, so it wasn't an inexpensive project by any means. I think the Leica labelers are suitable for a high-volume laboratory, but may be overkill for a lab with smaller volumes. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] Thanks!
Hi all, I wanted to thank all of you who responded to my question about my xylene-sensitive employee and purchase of an air filter system. I got tons of terrific information and enjoyed the discussion about xylene substitutes. Those who responded gave me a lot to think about and raised some questions for me to have answered. It's wonderful to have access to all of you experts on the listserv! Thank you for your generosity. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] Xylene sensitivity
Hi all, I have a new employee who is developing a scratchy, painful throat and some difficulty breathing when exposed to xylene (for instance, when the cover is raised on the coverslipper). This is her first job in a lab of any sort. We are investigating all the usual culprits--air handling system, hoods, allergies or virus unrelated to histology, etc. Right now she is wearing a PAPR to work, which is obviously not a long-term solution. Ultimately, I think we will conclude that this employee has a sensitivity to xylene and possibly other chemicals in the histology lab, as other employees are not complaining about symptoms related to chemicals. Does anyone have any experience with activated charcoal air cleaners? I am looking at a portable unit that sits on casters and provides 4 air exchanges per hour. It's not cheap at $1000, but well worth it if it will provide relief for this employee and allow her to continue her employment. Our lab is approximately 800-1000 sq. ft in size with 8 foot ceilings. We have 1 standard bio-hood for processing cytology fluids and 2 wall-mounted air suckers above our processors. I am open to any suggestions. Thanks, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] RE: xylene sensitivity
Kathryn, Thanks for the advice. I will evaluate the installation of a hood. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas -Original Message- From: Stoll, Kathryn [mailto:kst...@mcw.edu] Sent: Tuesday, September 27, 2011 12:33 PM To: D'Attilio, Shelley Subject: xylene sensitivity Shelley, I also have the same xylene sensitivity. In a previous job we coverslipped by hand. I wore a N95 respirator mask when I was doing coverslipping. We eventually moved to a new building and the coverslipping was done under a hood. If you could get a hood over the coverslipper or keep it closed that really helps. (The same can be said for the stainer) - It takes cooperation from the other people you work with to comply. I would also suggest to have this person cutting as far away from the xylene sources as possible. Definitely the less exposure the better. That seems to work the best for me. But keep a fair balance between all duties and have them wear a mask as needed. It is better than coughing all day and night. Good Luck. Kathryn Stoll, HT(ASCP) Depatment of Pathology Medical College of Wisconsin 9200 W Wisconsin Ave Milwaukee WI 53226 414.805.1525 kst...@mcw.edu 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] Xylene sensitivity
Hi Sarah, Thanks so much for the information. We do have a small fume extractor next to our formalin containers in the Gross Room. This might be worth a try for the coverslipper anyway. I believe that the piece of equipment I am thinking of buying while we evaluate xylene replacements is a larger version of that type of device, so it might work quite well. Thanks for taking the time to respond, Shelley -Original Message- From: Sarah Holmes [mailto:sa...@kidneybiopsy.com] Sent: Tuesday, September 27, 2011 12:22 PM To: D'Attilio, Shelley Subject: Re: [Histonet] Xylene sensitivity Not fully understanding your setup, we have had great success with inexpensive local fume extractors, like welders use, at our grossing and coverslipping sites. We still hand coverslip in front of a container of xylene (holding roughly 400ml) and we set the fume extractor right behind it to divert all fumes thru the charcoal filter. The fan competes so strongly with airflow that xylene (formalin) fumes are never in the breathing zone of the worker, and they are run thru an activated charcoal filter which we change every 3 months. Available at technitool.com, item number 272SO350 is the extractor, 272SO352 are filters. Hope this helps! Sarah Holmes Laboratory Manager Laboratory for Kidney Pathology, Inc. 1916 Patterson St, Suite 501 Nashville, TN 37203 615-321-5729 - Original Message - From: D'Attilio, Shelley sdatt...@stormontvail.org To: Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu Sent: Tuesday, September 27, 2011 8:27 AM Subject: [Histonet] Xylene sensitivity Hi all, I have a new employee who is developing a scratchy, painful throat and some difficulty breathing when exposed to xylene (for instance, when the cover is raised on the coverslipper). This is her first job in a lab of any sort. We are investigating all the usual culprits--air handling system, hoods, allergies or virus unrelated to histology, etc. Right now she is wearing a PAPR to work, which is obviously not a long-term solution. Ultimately, I think we will conclude that this employee has a sensitivity to xylene and possibly other chemicals in the histology lab, as other employees are not complaining about symptoms related to chemicals. Does anyone have any experience with activated charcoal air cleaners? I am looking at a portable unit that sits on casters and provides 4 air exchanges per hour. It's not cheap at $1000, but well worth it if it will provide relief for this employee and allow her to continue her employment. Our lab is approximately 800-1000 sq. ft in size with 8 foot ceilings. We have 1 standard bio-hood for processing cytology fluids and 2 wall-mounted air suckers above our processors. I am open to any suggestions. Thanks, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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 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
[Histonet] RE: Xylene sensitivity
Hi Tom, Yes, our Employee Health Safety department is involved with this problem. Our lab is negative pressure, but do not know the air exchange rate. I will definitely ask that to be checked. We monitor employees annually and had a full environmental assessment 2-3 years ago prior to installation of a new air handling system for the histology lab. The coverslipper and stainer are not in a hood. The Leica HE Auto Stainer is under two large air suckers that are installed in the walls (along with our Peloris and two old Shandon tissue processors), and the coverslipper is on a bench. Manual coverslipping is rarely performed, but we do have a standard chemical/bio hood for that if required. A broken belt was discovered on the air handling system yesterday and was repaired. Hopefully this will help a little bit. Regards, Shelley 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] Xylene sensitivity
Hi Jan, Thanks for the advice on xylene substitutes. Your symptoms mirror those of my affected employee and I'm glad to hear that you found relief using another product. I'm anxious to fix this situation as quickly as possible. This employee is ready to make a career of Histology and I would like to see that happen if I can. Regards, Shelley 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] Xylene sensitivity
Rene', Thanks for the quick response to my question. The two articles that you sent were very interesting and I have forwarded them to my department histotech supervisor for her evaluation. It is apparent from your comments on the listserv that you have a strong commitment to safety. You have given me much to think about and some new things to try. I may still try the filter/hood option during evaluation of xylene-free options. Regards, Shelley 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
[Histonet] RE: Histonet Digest, Vol 93, Issue 46
Hi all, Pam speaks to the real reason we have shortages: The lack of educational and degree-track programs at colleges and universities across the United States. As for me, I would love to hire a shiny new HT with no practical experience. We can give him or her that experience in our lab. We have done it many times before. What is difficult is to find people with a professional mind-set who have taken it upon themselves to get the necessary education and who see Histology as a career and not something you do while you are waiting to get into med-,vet- or nursing school. Encouraging professionalism is a priority. My hospital has what we call a professional ladder. It was developed in conjunction with our campaign to become a Magnet hospital under the American Nurses Credentialing Center. A program for recognition of professional nurses was developed (called the Professional Nurse Contribution Ladder). It offers the ability to be recognized and rewarded at 3 different levels of accomplishment based on their clinical practice, continuing education, service to the community, etc. Our administration offered the same program to other professional classes in our healthcare system: laboratorian, pharmacists, respiratory therapists, etc. The laboratory launched our Professional Laboratory Contribution Ladder shortly after nursing went live with their program. Lab professionals holding certification can apply every two years for one of 3 levels offered, with each level being more difficult than the one before. I'm proud to say that histotechs that have their HT or HTL certification have been included in that program from the very beginning. Histotechs are also given funding for educational events on equal footing with all other professionals in our lab. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[Histonet] Embedding competency and med techs running a Histo lab
Hi all, Thanks so much for the advice I received following my request for help on our embedding competency improvement project. I enjoyed the lively discussion that followed about non-histotechs managing a Histology lab and I appreciated all the kind comments and words of encouragement both on and off the listserv board. Regards, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
[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
[Histonet] Embedding process improvement and competency assessment
Hi all, I'm looking on ways to assess competency on embedding skills. I am a medical technologist managing histotechnologists, so I don't actually know how to embed anything. Luckily, I have been able to promote a registered histotech to a front-line supervisor position in the lab and improving our techs' embedding skills, particularly on skins, is a process improvement project for the coming year. I would love some tips on how you assess competency on this important skill. Is direct observation the only way, or do you use other techniques in conjunction with direct observation? Any good resources out there that has lots of photos of actual specimens? Any ideas for measuring improvement? Thanks in advance for your help, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
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 experience. Since you do not have such experience your only solution will be to rely on others and if your select the wrong one, you will end with soft competencies that will adversely affect the overall work flow of the lab. Excuse for this rant. Now, if you want, I can send you the embedding competencies I developed for my lab. René J. --- On Wed, 8/24/11, D'Attilio, Shelley sdatt...@stormontvail.org wrote: From: D'Attilio, Shelley sdatt...@stormontvail.org Subject: [Histonet] Embedding process improvement and competency assessment To: histonet@lists.utsouthwestern.edu Date: Wednesday, August 24, 2011, 1:55 PM Hi all, I'm looking on ways to assess competency on embedding skills. I am a medical technologist managing histotechnologists, so I don't actually know how to embed anything. Luckily, I have been able to promote a registered histotech to a front-line supervisor position in the lab and improving our techs' embedding skills, particularly on skins, is a process improvement project for the coming year. I would love some tips on how you assess competency on this important skill. Is direct observation the only way, or do you use other techniques in conjunction with direct observation? Any good resources out there that has lots of photos of actual specimens? Any ideas for measuring improvement? Thanks in advance for your help, Shelley D'Attilio MT(ASCP) Manager, Chemistry, Cytology and Histology Dept. of Pathology and Laboratory Medicine Stormont-Vail HealthCare Topeka, Kansas 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
