Re: [Histonet] frozen section/histo duties
It's a little tricky and usually brings in CLIA's definition of high complexity testing personnel and then the nuanced definition of testing. As strange as it seems, most of what we do in histology is not actually testing until a pathologist reads it out and reviews it. The way I read it, the only things in pathology that are actually high complexity testing that aren't performed exclusively by pathologists are grossing (ANP.11610) and QCing special stain/ISH/IHC slides (ANP.21395). This can put some labs in a position where, even though a grandfathered histotech may be very capable at QCing stains and fully certified, he or she may not be able to do the QC for regulatory purposes. Furthermore, the requirements to sit for the exam could be met without being CLIA high complexity testing compliant, so we are still pumping out new histotechs in this loophole. I doubt it was intended that way, but there it is. Other high complexity tasks include report review (ANP.29590), digital image analysis (ANP.23038), and circulating tumor cell analysis (ANP.29630) but those aren't an issue for our lab because we either don't do them or because our pathologists obviously do report review. More directly to your point, I don't see anything in the requirements about histotechs doing or not doing frozens. I also don't see anything about requiring histotechs to be certified at all for any reason other than your laboratory's preference. In fact, you can have non-certified staff that have the high complexity testing education who are able to perform routine histology tasks that certified (particularly grandfathered) histotechs aren't allowed to do. Hopefully someone with more knowledge will chime in because I'm sure I have a lot to learn about the ins and outs of this. Andrew Dilts HTL(ASCP) Histo Supervisor, Laboratory Services Phone: (417) 269-5021 andrew.di...@coxhealth.com www.coxhealth.com -Original Message- From: Nancy Schmitt Sent: Monday, August 24, 2020 3:12 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] frozen section/histo duties Hello and Happy Monday- Would you please share what your processes are for: 1. HT's cutting frozen under direct supervision of pathologist - do you do this? * Now HT has changed and requires Associates degree - but previous would be grandfathered in - correct? 2. Non- certified staff working in histology with supervision - anything they DON"T do? CAP is our guideline and I am reading - want to make sure I am not overthinking this but not missing anything. Thoughts appreciated, Nancy Schmitt HT, MLT(ASCP) Pathology Support Services Manager CoxHealth – ranked one of Missouri's Best Hospitals by U.S. News & World Report COXHEALTH CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intendedrecipient(s) and may contain confidential and privileged information protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] MMR IHC validaton
You've likely been sending MMR out regularly for some time now. Look at your send out logs to find cases that you have known results for and validate against those. In our case, lost expression was rare enough on some of the markers that we had to write an exception and do less than the full validation, but there is an exception for that very reason. Your Roche Field Application Specialist may be able to advise you on a protocol to use as a starting point for validation. Good luck! Andrew Dilts HTL(ASCP) Histo Supervisor, Laboratory Services Phone: (417) 269-5021 andrew.di...@coxhealth.com www.coxhealth.com -Original Message- From: Waitts, Celeste Sent: Wednesday, August 5, 2020 10:23 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] MMR IHC validaton HI, WHAT is everyone's opinion on the best way to validate the Roche MMR IHC panel. Cost, time, ease? Any help? Thank you Celeste Waitts Histology Supervisor Centrastate Medical Center CoxHealth – ranked one of Missouri's Best Hospitals by U.S. News & World Report COXHEALTH CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intendedrecipient(s) and may contain confidential and privileged information protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Tissue Adherence Issue
We find that the amount of time slides spend baking in the oven prior to deparaffinization on our Benchmark Ultras tends to make a difference. Harder tissue like brain and bone can even benefit from 2 hours at 58*C. Andrew Dilts HTL(ASCP) Histo Supervisor, Laboratory Services Phone: (417) 269-5021 andrew.di...@coxhealth.com www.coxhealth.com -Original Message- From: Knutson, Deanne Sent: Wednesday, July 17, 2019 9:22 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] Tissue Adherence Issue Fellow Histonetters - I would appreciate your feedback on an intermittent issue that has shown up in our lab. All of a sudden, we are having difficulty with tissue specimens falling off of our slides on the IHC stains and special stains sporadically. About a year ago, we switched instruments on the IHC bench from the Leica BOND to the ROCHE ULTRA, and we use the Ventana NexES special stainer. No adherence issues with all of the validation slides that were run. We have tried various types of slides recently as well, and the issue still prevails. Would any of you mind telling me your slide workflow - type of slide used, gelatin or not used in flotation bath, how long slides are cooked, etc for your IHC slides, for your special stains slides, and even for your H slides. I would welcome your suggestions and feedback. Thank you so much!!! Deanne Knutson Supervisor Anatomic Pathology [X] "Let All Be Received as Christ." This email may include confidential and privileged information. If this is not intended for your use, please destroy immediately and contact the sender of the message. This email and attachments contain information that may be confidential or privileged. If you are not the intended recipient, notify the sender at once and delete this message completely from your information system. Further use, disclosure, or copying of information contained in this email is not authorized, and any such action should not be construed as a waiver of privilege or other confidentiality protections. CoxHealth – ranked one of Missouri's Best Hospitals by U.S. News & World Report COXHEALTH CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intendedrecipient(s) and may contain confidential and privileged information protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
