[Histonet] RE: Ventana Ultra CD10
For Ventana CD10, (SP67), we use the extended CC1 (92 minutes), antibody for 36 minutes and amplify on the Ultra. 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 O'neil, Beth Sent: Thursday, February 26, 2015 4:22 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Ventana Ultra CD10 We are in the last stages of contract negotiations for purchasing two Ventana Benchmark Ultras. During this time period we have been optimizing our current inventory of approximately 110 antibodies and validating before our current instrumentation is removed within the next two weeks. My Ventana application specialist is unable to successfully optimize CD10 (Ventana clone SP67) on the Ventana Benchmark Ultra. He had me send slides to their applications/troubleshooting lab but they told us they won't start working on it until next week and then it would take about a week for them to try and optimize it. We are in an urgent rush to get this antibody optimized and validated within the next two weeks since it is heavily requested by our Hemepaths. Would anyone be willing to share their Ultra protocols with me? Has anyone had similar experiences with Ventana being unsuccessful and having to send their slides to their applications lab for work up? Thank you for your help. Beth Ann O'Neil, MT(ASCP)SC, HTL, QIHC one...@wvuhealthcare.commailto:one...@wvuhealthcare.com Histology Supervisor, Technical Specialist Lab: 304 - 293 - 6014 Office: 304 - 293 - 7629 - Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: breast tissue and radioactive seeds
If this is the I-125 seed localization procedure for breast casses: our Radiology dept here does this and I can tell you what we do here. 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 robin.r...@hcahealthcare.com Sent: Wednesday, January 14, 2015 10:40 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] breast tissue and radioactive seeds Hi Everyone, After 5 years of being in the private sector I am now back in the wonderful environment of a hospital setting as the Histology supervisor. We are going to be starting a new procedure here called Conversion to Radioactive Seed Localized Breast Surgery and I have been asked to come to this meeting. As I have been strictly in Dermatology for the past few years I am not familiar with this process. I have dealt with the prostate radioactive seeds before but not sure if this will involve the Histology lab in the form of surgical tissue or not. I would like to be as informed as possible before the meeting which is next week, so I came to the source I value the most. Can anyone share any information with me? Thanks so much, Kaye ___ 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: Slide Consults
We do not cover the referring institution label. Will place our label on front if there is clear area; if not, our label is placed on the back of the slide, at the frosted end. 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 O'Donnell, Lynn M. Sent: Thursday, March 20, 2014 8:13 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Slide Consults I am ok with them putting the label on the front as long as it does not obscure our label. Especially since our label contains bar codes we use for tracking and storage. __ Lynn M. O'Donnell, CT (ASCP), MHA Technical Specialist, Cytology Danbury Hospital 203-739-6704 Email: lynn.o'donn...@wchn.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bitting, Angela K. Sent: Wednesday, March 19, 2014 17:16 To: Amber McKenzie; Histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Slide Consults I think it's pretty standard that outside institutions put their accession ID on the front of the consult slides. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Amber McKenzie Sent: Wednesday, March 19, 2014 5:05 PM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Slide Consults Would it be rude to ask other hospitals that review my slides to NOT WRITE their accession number on the front of my slides, but instead put their accession number on the back of my slides? Sometimes, I get slides back that have stickers on the front under my accession number or they'll hand write their accession number under mine. I feel like I should scribble out the other institution number so that it doesn't confuse any of us refilling slides. What are your thoughts? Would anyone like to share their slide send out form? Thanks! ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet IMPORTANT WARNING: The information in this message (and the documents attached to it, if any) is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorized. If you are not the intended recipient, any disclosure, copying, distribution or any action taken, or omitted to be taken, in reliance on it is prohibited and may be unlawful. If you have received this message in error, please delete all electronic copies of this message (and the documents attached to it, if any), destroy any hard copies you may have created and notify me immediately by replying to this email. Thank you. Geisinger Health System utilizes an encryption process to safeguard Protected Health Information and other confidential data contained in external e-mail messages. If email is encrypted, the recipient will receive an e-mail instructing them to sign on to the Geisinger Health System Secure E-mail Message Center to retrieve the encrypted e-mail. ___ 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] Tracking OR specimens
Realize this is a late response I can pull a Specimen report through Centricity (the OR computer system). The OR staff enters each specimen as it is collected (for pathology, cultures for micro, frozens, touch preps) into Centricity as part of their documentation for the case. The report I pull extracts this data. I run each day after 12 noon for the previous day. We only instituted this in April. Gives great feedback and lets me check that the specimen is received in Pathology but that the pathology accession staff accurately records each specimen. We also get the OR schedule but not all cases on schedule generate a specimen and some cases expected to have pathology specimen don't and other cases not expected to generate a specimen do .. so the Specimen Report is the most specific way to track what was intended to go to Pathology. Unfortunately, we are converting hospital wide to EPIC and so far, EPIC OR documentation does not have a comparable function. Orders will then be placed not in an OR module but in the same place that all other orders are placed and our Order Interface does not give specific specimen sites. If there are EPIC users / EPIC vendors that have a solution, I would really like to hear from you. If you use Centricity and want more specifics, will be glad to give more information on our set up. 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 WILLIAM DESALVO Sent: Monday, March 18, 2013 11:25 AM To: Michelle Lamphere; histonet Subject: RE: [Histonet] Tracking OR specimens We use the OR schedule and have a log at Surgical Pathology that the person delivering specimens places a patient label w/ the number of specimens delivered and they sign off. This has helped many times when OR believes they have delivered all the specimens. We use both the log and OR schedule to reconcile cases and contact OR is a case has not been delivered by end of day. William DeSalvo, BS HTL(ASCP) Production Manager-Anatomic Pathology Chair, NSH Quality Management Committee Owner/Consultant, Collaborative Advantage Consulting From: michelle.lamph...@childrens.com To: histonet@lists.utsouthwestern.edu Date: Mon, 18 Mar 2013 13:14:04 + Subject: [Histonet] Tracking OR specimens Are there any histology labs that actively participate in auditing the Operating Room on a daily basis to make sure that histology receives all of the specimens that the OR should have submitted? If so, how do you do this? Or should the OR be solely responsible for making sure that they specimens make it to histology? Michelle M Lamphere, HT (ASCP) Senior Tech, Histology Children's Medical Center 1935 Medical District Drive Dallas, TX 75235 Office :214-456-2798 Histology: 214-456-2318 Fax: 214-456-0779 Please consider the environment before printing this e-mail This e-mail, facsimile, or letter and any files or attachments transmitted with it contains information that is confidential and privileged. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please notify Children's Medical Center Dallas immediately at 214-456- or via e-mail at priv...@childrens.com. Children's Medical Center Dallas and its affiliates hereby claim all applicable privileges related to this information. Please consider the environment before printing this e-mail. This e-mail, facsimile, or letter and any files or attachments transmitted with it contains information that is confidential and privileged. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please notify Children's Medical Center Dallas immediately at 214-456- or via e-mail at priv...@childrens.com. Children's Medical Center Dallas and its affiliates hereby claim all applicable privileges related to this information. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
[Histonet] RE: Pathology IS
Is there an EPIC/Beaker Pathology product?? Thought they had Lab module only. Our hospital LIS is EPIC. Hear that we will be going to the Lab product in the future. Would really like some input on them. 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 Lori Harris Sent: Tuesday, January 08, 2013 1:59 PM To: Margiotta-Watz, Michele; 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] RE: Pathology IS Don't choose EPIC/Beaker. It's a disaster. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Margiotta-Watz, Michele Sent: Tuesday, January 08, 2013 8:12 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] Pathology IS Hi All, We will be looking to change our pathology information system very soon. We currently use PowerPath/Tamtron. Any info regarding other systems out there that you might recommend would be greatly appreciated! Thanks, Michele Histology Supervisor BMHMC 631-654-7192 DISCLAIMER: This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to which they are addressed. This communication may contain material protected by the attorney-client privilege. If you are not the intended recipient or the person responsible for delivering the e-mail to the intended recipient, be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail is strictly prohibited. If you have received this e-mail in error, please immediately notify the sender via return e-mail or call Brookhaven Memorial Hospital Medical Center at (631) 654-7282. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] (no subject)
I am forwarding this response from a fellow worker, D Kaylor (The techs here have consistently good results when freezing fresh muscles for enzyme histochemistry. The small holes are freeze artifact. Usually they occur when the muscle is not frozen fast enough. We use methyl butane floating in a liquid nitrogen bath. Either way, the temp is critical. It needs to be at least -155 degrees C. The muscle must be submerged and held under for about 45 seconds to one minute. Do not start or dip the muscle. Once started it must be held submerged. We have never had any issues with humidity. Are the muscle bx swimming in saline? We have better results when they are submitted on saline moistened gauze. We use positively charged slides to pick up our sections. We have some wrinkles but that is due to the sectioning of frozen tissue not the type of slide. 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 Miha Tesar Sent: Saturday, October 15, 2011 4:47 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] (no subject) Hi! I am working in Institute of Phatology Slovenia EU. Recently I have problems with muscle biopsy. There are a lots of artefact that I can not explain, like little holes in the tissue after the tissue is being frozen. We are using the isopentan and the liquid nitrogen for the freezing. Can enyone give me some ideas haw to avoid this artefact. How important is humidity in laboratory for the good results? The next problem is that after I put the tissue on the microscope slides after coloring the GTK all the tissue gets wrinkeld. Iam using the poly L lisin microscope slides or the Immuno microscope slides. Thx in advance! Best regards Miha from SLO ___ 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] 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
RE: [Histonet] Slide Volume Inquiry
There is an article on histology workload in the current issue of: Arch Pathol Lab Med Vol 135, June 2011 Just placed on my desk today; I have only glanced at it. It may have some information helpful to you. 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 Tonia Richmond Sent: Wednesday, June 01, 2011 5:29 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Slide Volume Inquiry I'm trying to determine the annual volume of glass slides produced globally for a project I'm working on. I'm having no luck finding any information. Any suggestions would be greatly appreciated!! All the best, Tj Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Position - Muscle Enzyme Histochem Tech
What state? 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 Barone, Carol Sent: Wednesday, November 10, 2010 11:01 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Position - Muscle Enzyme Histochem Tech Hello Histonetters: We presently have a position available for a HT/HTL (certified, or eligible) in our clinical muscle enzyme histochemistry lab (within the Department of Biomedical Research). We request 3 yrs experience minimum in EHC... and skills for manual IF, as well. If you meet these requirements and have interest, please contact cbar...@nemours.org. We are looking for 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
[Histonet] closure of EM lab
We are closing our EM service and have the following equipment to surplus: Philips CM 100 Electron Microscope w/ Haskris Water chiller and Jun Air Compressor. Ted Pella Nitrogen Burst Negative Developing Tank Durst Laborator S-45 EM Enlarger w/ lens for 35 mm, 3 x 4 and 2.25 x 2.25 sheet film Dessicator w/ Vacuum Pump BEEM Negative Dryer Oven Penetron Rotary Shaker Sorvall GKM Glass Knife Maker We have a Leica UC6 ultramicrotome that may be surplused; may be able to trade for current model, good rotary microtome. Most of the equipment was purchased in the late 78 / 79 and has been carefully cared for and maintained. The Philips CM 100 was installed in 11/95 and has been under continuous service with FEI / Philips. The Leica microtome is only 2 / 3 years old. Our hospital follows the surplus guidelines established by the Shands Healthcare System. I am trying to get the word out to other EM users and will gladly put you in contact with our surplus co-ordinator. Or work with you to see the equipment which is still set up within our department. Please pass on to others that may have an interest. Becky Garrison Pathology Supervisor Shands Jacksonville Jacksonville, FL 32209 904-244-6237, phone 904-244-4290, fax 904-393-3194, pager ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] questions
We receive the placentas fresh (they are refrigerated in LD before transport to Pathology); add lots of formalin (use 163 oz containers) and let fix overnight. Early next morning, placenta is grossed and cassettes sit in formalin til end of day. This formalin is changed at least once so that bloody formalin is replaced with fresh. Placed on processor at end of second day after receipt. When we had LD add formalin, there was never enough formalin added and the placentas sat unfixed at room temperature for long periods of time. This procedure works better for us. Yes, we can not meet the CAP guideline for 2 day TAT but do end up with a consistently better quality product for this tissue type. (Placentas make up a small portion of overall workload, so overall TAT is not affected). Prior to this procedure, placentas made up a disproportionate amount of reprocessed blocks. 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 Webb, Dorothy L Sent: Tuesday, March 30, 2010 3:04 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] questions We have been having problems with underprocessed placental membrane, some of which are cut fairly thick, but am seeing it on more than just the thich samples. Does anyone out there in histoland have a special process for placentas or any helpful hints? I do know that many times the placentas sit without formalin in LD for hours before they bring them to histo and add formalin and this seems to me it could be a factor, even though we have them sitting in formalin for a few hours before processing. Also, does anyone do the high-iron diamine stain for intestinal mucin staining? Do you do it with an Alcian Blue-PAS stain? Thank you ahead of time for any and all responses!! Dorothy Webb, HT (ASCP) Regions Histology Lab This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient or the individual responsible for delivering the e-mail to the intended recipient, please be advised that you have received this e-mail in error and that any use, dissemination, forwarding, printing, or copying of this e-mail is strictly prohibited. If you have received this e-mail in error, please immediately notify the HealthPartners Support Center by telephone at (952) 967-6600. You will be reimbursed for reasonable costs incurred in notifying us. HealthPartners R001.0 ___ 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] Hello fellow Histo's , 2 questions for you
Here, we have either a pathologist or histotech take a cart with dissecting microscope to the kidney biopsy in Radiology and give the nephrologist who performs the procedure immediate feed back on whether the biopsy contains sufficient glomeruli. 95% of the time, the techs attend and the pathologist backs up when no tech is available. (This applies to native kidney biopsies only; transplant kidney biopsies are brought immediately to Pathology Gross Room by nephrology fellow or resident.) It is interesting that we have never charged for this 'immediate evaluation' service, neither technical nor professional. Are others who perform this service charging, and if so, what CPT code / modifier is used? We do not do frozens off site. Becky Garrison Pathology Supervisor Shands Jacksonville 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 kim.dona...@bhcpns.org Sent: Thursday, December 24, 2009 10:04 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Hello fellow Histo's , 2 questions for you First of all I hope all of you are enjoying your Holiday. And I expect that many of you are not at work like me, but when you get a chance if you could help me out by answering these two questions I would be very grateful. :-) 1) In your lab when you receive renal biopsy's fresh. Who finds the Glomeruli using a microscope? A pathologist or a Histologist? 2) Also, if you have frozen sections off site, do you always send a Histologist to assist the Pathologist? Thanks for your help in advance Many Blessing to each of you! Kim Donadio Pathology Supervisor Baptist Hospital 1000 W Moreno St. Pensacola FL 32501 Phone (850) 469-7718 Fax (850) 434-4996 - All electronic data transmissions originating from or sent to Baptist Health Care Corporation (BHC) are subject to monitoring. This message along with any attached data, are the confidential and proprietary communications of BHC and are intended to be received only by the individual or individuals to whom the message has been addressed. If the reader of this message is not the intended recipient, please take notice that any use, copying, printing, forwarding or distribution of this message, in any form, is strictly prohibited and may violate State or Federal Law. If you have received this transmission in error, please delete or destroy all copies of this message. For questions, contact the BHC Privacy Officer at (850) 434-4472. Rev.10/07. ___ 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: tracking turnaround time of intraoperativeconsultations
Sorry I did not respond yesterday. The reason we just started measuring order to sign out for frozens was also prompted by preparation for our next JCAHO inspection. However, there is this distinction. The Joint Commission does not define a frozen as a critical test. The designation of critical test is left up to the individual institution. However, once your institution defines the frozen as a critical test, (indicated somewhere in a policy), you must conform to JCAHO guidelines for critical tests. And apparently this is the buzz with JCAHO watchers right now. Here we designate the IntraOp consultations for frozens (not gross only or Touch prep) and IntraOp PTH (Clinical test) as a critical tests and have started tracking order to sign out. Order time is the time the surgeon indicates 'send this to pathology' not when pathology receives the specimen. We are somewhat in uncharted waters as there is no national standard that defines target time from order to sign out. We set a 40 minute time (20-OR to Path and 20-path to completed frozen). I campaigned against a 30 minute total time (15 each) because we do have some frozens that do take over 15 minutes and this was an absolute value (unlike the CAP goal of 90% within 20 minutes). Our approach is to monitor, evaluate the data we retrieve. There will certainly be adjustments made to target time and how and what we monitor. The data collection raises more questions: how do you come up with meaningful data for multiple specimens on a single case; multiple frozens (different patients) received together or before we are finished with the first patient's frozen). This is one of those ideas that sounds good in theory but presents some challenges in execution. But it is a valid process to monitor as we periodically have surgeons complain of the time they are waiting for frozen results. This is really a joint quality management review which involves multiple departments (OR and Pathology) and how we make it better for the patient. Becky Garrison Pathology Supervisor Shands Jacksonville Jacksonville, FL 32209 904-244-6237 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Della Speranza, Vinnie Sent: Wednesday, June 24, 2009 5:15 PM To: 'Robert Richmond'; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Re: tracking turnaround time of intraoperativeconsultations Thanks Dr. Richmond. CAP's turnaround time requirement for frozen sections is unchanged. My question was prompted by the fact that we have an individual internal to our organization pushing for measuring turnaround from time of order to time result is issued, which muddies the water, at least for us as we do not have electronic ordering from the OR. This is prompted by JCAHO's requirement that turnaround time for critical tests be measured (Frozen section is considered a critical test by this organization) As far as I know, there is no national standard to be met if one measures turnaround from time of order, so the data then is up to the institution's interpretation for what is acceptable. One of the respondents indicated that they consider the time the sample gets to pathology as the time the test was ordered. Of those who responded to my query, one lab has electronic order entry and is just beginning to track both the in lab turnaround time and the time from order to result. Vinnie Della Speranza Manager for Anatomic Pathology Services Medical University of South Carolina 165 Ashley Avenue Suite 309 Charleston, South Carolina 29425 Tel: (843) 792-6353 Fax: (843) 792-8974 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Robert Richmond Sent: Wednesday, June 24, 2009 1:29 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: tracking turnaround time of intraoperative consultations Vinnie Della Speranza, Manager for Anatomic Pathology Services Medical University of South Carolina Charleston SC asks about tracking turnaround time of frozen sections (note that not every intraoperative consultation requires a frozen section). The few services I've worked on that attempted to track turnaround time timed them from time of receipt in the laboratory (using a time stamp for that) to telephoning the report (the pathologist had to write down the time on the hand-scribbled report). The prescribed maximum turnaround was 20 minutes, which is pretty easy to meet. Cases with multiple frozen sections were not timed. Has there been some change in the CAP requirements for recording turnaround time of frozen sections in the last three years? Bob Richmond Samurai Pathologist Knoxville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] tracking turnaround time of intraoperative consultations
We have just started tracking from order to sign out for frozen sections. (In addition, frozens are tracked from receipt in pathology to sign out using the CAP guidelines). The trouble with the electronic order (in our institution) is that the OR may place the pathology order in hospital computer system early in the surgery so that the order time that prints on the requisition is substantially different than the actual collect time. We have resolved this by having the OR staff write the actual collect time on the requisition and initial it. This collect time is also noted in the OR documentation notes for the surgery. When OR forgets to note collect time manually on the requisition (and they do), I call back and have them look up and verify the collect time. This was started with the cooperation and support of the OR administration. For the pathology accession staff, this means they can not use the order time that crosses the interface to the LIS (lab computer system) but must enter the handwritten time as noted on the requisition. We have set a goal of 40 minutes from frozen order to sign out. This may be lowered to 30 - 35 minutes depending on how our data looks over several months. Our pathology dept. is located on the first floor and the OR on second floor of same building. As for noting collect times for multiple specimens, same case: We have always required the OR to generate a requisition for each container. The collect time is written on each requisition. This is no different than writing the collect date/time and initials that nursing/phlebotomy does for each tube of blood drawn hospitalwide. Would be interested in hearing from others on how this is handled. Becky Garrison Pathology supervisor Shands Jacksonville Jacksonville, FL 32209 904-24-6237 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Della Speranza, Vinnie Sent: Tuesday, June 23, 2009 4:02 PM To: histonet Subject: [Histonet] tracking turnaround time of intraoperative consultations CAP utilizes the term intraoperative consultation to describe the utilization of frozen (cryo) sections to provide a rapid diagnosis back to a surgeon in the operating room. The CAP checklist requires a turnaround time of 20 minutes for single specimen submitted for intraoperative consultation. My understanding is that the turnaround time is measured from the time the sample is received in the laboratory until the time the report is issued to the surgeon. Is anyone tracking or measuring turnaround time from the time the consult is ordered in/by the Operating Room until the time the result is issued? If so, would you share how you are able to determine the time the test was ordered and to what extent you have elicited the cooperation of Operating Room personnel. We receive many complex surgical cases and our intraoperative consults frequently consist of multiple surgical samples from the same patient arriving in the lab at the same time. Our head and neck cases, for example, consist of 6-8 biopsies that are sent to pathology at the same time. In this example, we have no knowledge of which biopsies was excised first or last and because the surgeon chooses to allow multiple samples to accumulate before sending them all off to the lab, it's clear that the true pre-analytical time will not be the same for each sample. If you are tracking turnaround from the time of order to the time of result reporting, how are you determining what is an acceptable turnaround time? CAP's standard is the only national standard I am aware of for frozen section turnaround times. Vinnie Della Speranza Manager for Anatomic Pathology Services Medical University of South Carolina 165 Ashley Avenue Suite 309 Charleston, South Carolina 29425 Tel: (843) 792-6353 Fax: (843) 792-8974 ___ 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] Rolling sections
Are you freezing muscle? If so, for our muscle biopsies we use OCT to adhere the base of the tissue to a piece of cork (which is frozen in the isopentane); the tissue is not surrounded by OCT. The tissue section is guided onto the blade holder with a brush and then picked up on the slide. All our other tissues are frozen surrounded by OCT. Becky Garrison Shands Jacksonville 904-244-6237 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Dearolf, Jennifer Sent: Tuesday, April 28, 2009 6:52 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Rolling sections Greetings, Histonetters! First, I wanted to thank all of you that responded to my e-mail a few years back about freezing small pieces of muscle tissue. We have found a method that works for us, and if anyone is interested, I would be happy to share. It still involves the wonderfully explosive isopentane, but it allows us to freeze fetal guinea pig muscle without artifact. I am writing today to ask a question about cutting frozen sections with a cryostat. We are having problems with the sections rolling once they come off the knife and before we can get them on a slide. We have a Microm 505E cryostat, and we cut our OCT mounted specimens at around -25 degrees C. We use Accuedge high profile blades, cut sections between 8 and 12 microns thick, and use a brush to pull the sections off. But, when we remove the brush, the sections roll up. Sometimes, they just arc up and other times they completely roll into a jellyroll. I have tried putting 70% EtOH in a beaker in the cryostat. This method was suggested to us by a vendor, but it doesn't seem to work consistently. We can also flatten the sections with a brush, but unless we are really quick, the sections roll up before we can get them on the slide. It makes it difficult to get serial sections. Any advice would be appreciated. Thanks again for all your help so far. Sincerely, Jenn Jennifer Dearolf, Ph.D. Associate Professor Biology Department Hendrix College 1600 Washington Ave. Conway, AR 72032 (501) 450-4530 (office) ___ 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] Frozen section
We require our OR to submit a separate requisition with each container. The specimen site is listed on each requisition. This applies to all specimens (not just frozens). In addition, frozens (and other intra operative consultations such as gross only or touch prep) must also have a frozen section form for each container. The frozen section form has patient ID, clinical history and specimen site fields completed by the OR and a diagnosis field which is completed and signed by the pathologist. Original goes to patient chart; copy stays in Pathology. When a specimen is submitted for frozen, all 3 must have matching information: container, requisition and frozen section form. If discrepant, OR must fix immediately before the frozen is signed out. Any later specimen, even on same patient, must have a separate requisition and (if applicable) a frozen form. It is the responsibility of the OR to accurately identify the specimen site. Becky Garrison Pathology Supervisor Shands Jacksonville Jacksonville, FL 32209 904-244-6237 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Gary Sent: Wednesday, March 25, 2009 10:43 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen section We need to make a change in the way we presently account for our frozen section while doing them. Presently we receive the requisition with the first specimen, then pathology is responsible to account for any subsequent specimens. The problem is that the subsequent specimens are typically labeled poorly, and we are trying very hard to conform to the CAP guidelines. So ... when the specimens are not labeled in detail, it requires follow up calls to gain the proper information. I would like to know how other facilities are handling multiple frozen sections. Thanks Gary ___ 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
