Re: [Histonet] OJT Histotechs/Training
Research is a different world than clinical. That's not fun. Can you pursue your degree if you haven't already and then do a 1 year under a clinical pathologist? It took me awhile to my clinical hours since I working full time in pharmacy and in histology school fulltime, but it was worth it. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 18 May 2015 11:59:59 -0700 Subject: Re: [Histonet] OJT Histotechs/Training From: lld...@gmail.com To: joellewea...@hotmail.com CC: jmacdon...@mtsac.edu; tnma...@mdanderson.org; histonet@lists.utsouthwestern.edu I have a different perspective on this issue. I have been in histology for over 20 years. I worked at UC Davis in Vet. Histopath for several years. I was a histology Core facility manager and started up the facility from scratch at UC Davis Health system while running a Core Confocal microscope facility there. BUT I was in research, I wasn't in a Pathology lab and I don't qualify for the HT or HTL so I can't get work in the industry. Talk about a conundrum! Loralei On Sun, May 17, 2015 at 3:38 AM, Joelle Weaver joellewea...@hotmail.com wrote: I will speak to my laboratory director about this. I know the situation first hand from my previous experience! Joelle Weaver MAOM, HTL (ASCP) QIHC To: tnma...@mdanderson.org From: jmacdon...@mtsac.edu Date: Sat, 16 May 2015 20:02:34 -0700 Subject: Re: [Histonet] OJT Histotechs/Training CC: histonet@lists.utsouthwestern.edu This is an issue with our program as well. We have a difficult time finding clinical sites for our students. Many people want to hire trained individuals, but don't want to invest any time in the training. Our students receive a great deal of hands-on time in the student laboratory, but need real life experience. Jennifer MacDonald Mt. San Antonio College From: Mayer,Toysha N tnma...@mdanderson.org To: 'histonet@lists.utsouthwestern.edu' histonet@lists.utsouthwestern.edu Date: 05/14/2015 01:48 PM Subject:Re: [Histonet] OJT Histotechs/Training One good way to find techs is to offer to become a clinical affiliate for a program. Most programs struggle with attracting students and providing them with clinical affiliates to fine tune their skills. It may not matter that the school is not located near you, the student may have family nearby to stay with. We are always looking for long distance affiliates, that way we can attract an out-of-state student and not saturate the local area. I have students who want to relocate to different areas and just for a change and this helps them do so. We also get calls from applicants who don't mind moving to us for 9-10 months, as long as they can go home when they finish. If the program is agreeable to this, the specifics can be worked out, such as what skills are entry level and the length of the time the student is at your facility. Ours is called an Internship and the student is at the facility for 12 weeks. They come in knowing basic embedding, cutting, routine staining, specials, and have performed a minimum of three IHC stains. Two are manual and one automated. Some programs keep the students in house for some time before they leave for internship, while others leave the technical training to the clinics. It all depends on what is available. This would be a low cost way to see if you like a person, can train them and are willing to teach. Some students are looking to relocate just before graduation, so a move for an internship is a consideration. Many times it is the expectations of the trainer that are not aligned with the skill level of entry-level techs and that can cause problems. This way the person can come in with an assessment of the skill level and the OJT phase can begin. If the affiliate chooses to hire the student, great. If not, then no harm. At least you get to say that you tried and did not have to waste money doing so. It is not a source of free labor, but a way of accurately assessing a person's fit for your needs. Many allied health programs (not just histo) are doing this and it helps to showcase different labs and programs. Just my two cents. Sincerely, Toysha N. Mayer, D.H.Sc., MBA, HT (ASCP) Instructor/Education Coordinator Program in Histotechnology School of Health Professions UT M.D. Anderson Cancer Center 713.563-3481 Message: 1 Date: Thu, 14 May 2015 17:07:06 + From: Morken, Timothy timothy.mor...@ucsf.edu To: Pam Marcum mucra...@comcast.net, Lisa Roy ro...@labcorp.com Cc: Histonet histonet@lists.utsouthwestern.edu, Michael Dessoye mjdess...@commonwealthhealth.net Subject: Re: [Histonet] OJT Histotechs/Training Message-ID: 761e2b5697f795489c8710bcc72141ff36831...@ex07.net.ucsf.edu Content-Type: text/plain; charset=utf-8 I think there is some actor from the CSI series that has
Re: [Histonet] OJT Histotechs/Training
I will speak to my laboratory director about this. I know the situation first hand from my previous experience! Joelle Weaver MAOM, HTL (ASCP) QIHC To: tnma...@mdanderson.org From: jmacdon...@mtsac.edu Date: Sat, 16 May 2015 20:02:34 -0700 Subject: Re: [Histonet] OJT Histotechs/Training CC: histonet@lists.utsouthwestern.edu This is an issue with our program as well. We have a difficult time finding clinical sites for our students. Many people want to hire trained individuals, but don't want to invest any time in the training. Our students receive a great deal of hands-on time in the student laboratory, but need real life experience. Jennifer MacDonald Mt. San Antonio College From: Mayer,Toysha N tnma...@mdanderson.org To: 'histonet@lists.utsouthwestern.edu' histonet@lists.utsouthwestern.edu Date: 05/14/2015 01:48 PM Subject:Re: [Histonet] OJT Histotechs/Training One good way to find techs is to offer to become a clinical affiliate for a program. Most programs struggle with attracting students and providing them with clinical affiliates to fine tune their skills. It may not matter that the school is not located near you, the student may have family nearby to stay with. We are always looking for long distance affiliates, that way we can attract an out-of-state student and not saturate the local area. I have students who want to relocate to different areas and just for a change and this helps them do so. We also get calls from applicants who don't mind moving to us for 9-10 months, as long as they can go home when they finish. If the program is agreeable to this, the specifics can be worked out, such as what skills are entry level and the length of the time the student is at your facility. Ours is called an Internship and the student is at the facility for 12 weeks. They come in knowing basic embedding, cutting, routine staining, specials, and have performed a minimum of three IHC stains. Two are manual and one automated. Some programs keep the students in house for some time before they leave for internship, while others leave the technical training to the clinics. It all depends on what is available. This would be a low cost way to see if you like a person, can train them and are willing to teach. Some students are looking to relocate just before graduation, so a move for an internship is a consideration. Many times it is the expectations of the trainer that are not aligned with the skill level of entry-level techs and that can cause problems. This way the person can come in with an assessment of the skill level and the OJT phase can begin. If the affiliate chooses to hire the student, great. If not, then no harm. At least you get to say that you tried and did not have to waste money doing so. It is not a source of free labor, but a way of accurately assessing a person's fit for your needs. Many allied health programs (not just histo) are doing this and it helps to showcase different labs and programs. Just my two cents. Sincerely, Toysha N. Mayer, D.H.Sc., MBA, HT (ASCP) Instructor/Education Coordinator Program in Histotechnology School of Health Professions UT M.D. Anderson Cancer Center 713.563-3481 Message: 1 Date: Thu, 14 May 2015 17:07:06 + From: Morken, Timothy timothy.mor...@ucsf.edu To: Pam Marcum mucra...@comcast.net, Lisa Roy ro...@labcorp.com Cc: Histonet histonet@lists.utsouthwestern.edu, Michael Dessoye mjdess...@commonwealthhealth.net Subject: Re: [Histonet] OJT Histotechs/Training Message-ID: 761e2b5697f795489c8710bcc72141ff36831...@ex07.net.ucsf.edu Content-Type: text/plain; charset=utf-8 I think there is some actor from the CSI series that has done some of this work promoting lab techs... Tim Morken -Original Message- From: Pam Marcum [mailto:mucra...@comcast.net] Sent: Thursday, May 14, 2015 9:18 AM To: Lisa Roy Cc: Histonet; Michael Dessoye Subject: Re: [Histonet] OJT Histotechs/Training I understand and agree with everything being said and feel we do need more education in getting your registry, as Histology is changing and growing.??We need to be prepared to grow with it, much as we did when IHC first came into Histology and many thought it would go to the MTs.?? ? The one thing that has not changed in the 50 years I have done Histology is the fact that no one outside of AP knows what a Histologist is or what we do.? (I'm tried of being asked Oh what kind of history is that?)? Until we change that and get more information about the field and advantages we will still be in the straights we are in now.? No one joining because so few people even know what we do or that there is an opportunity here.? If you don't know what Histology is why would you even look at the field.? I know about and have done school visits, career days etc
Re: [Histonet] OJT Histotechs/Training
We have discussed this on the histonet many times... Most professions, and most if not all healthcare professions, require degrees and/or certification for entry. This is how the public, other medical professions ,and even HR-who do not know the technical- assess for our capacity to provide care and judge the skill level needed of the profession as they are looking in. We all know that this isn't always perhaps the best method to assess or measure some aspects of this profession, but this is what they work from. There are good and bad examples of both OJT and educated, formally trained histology professionals. However, education is more than learning facts, it helps develop many other facets of the person that are viewed as valuable to organizations. That is why it is used as a screening tool. Please try to value the broader perspective. Technical proficiency itself is probably not going to be enough as the future unfolds. Though it may seem unfair if you have worked for a very long time and learned a great deal through experienc e, the bottom line is that for some employers, some environments and outside groups- education, credentials and professionalism are the primary criteria they use to evaluate, and they pay and recognize accordingly. Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsf.edu To: histonet@lists.utsouthwestern.edu Date: Thu, 14 May 2015 17:28:15 + Subject: Re: [Histonet] OJT Histotechs/Training Mike, yes, the vast majority of histotechs have been, are, and will be OJT (me included). The people who take on training these people have a responsibility to do the best they can. Most techs end up learning whatever their lab does and so have limited knowledge. I studied a full year for the HT and passed fine, and later the HTL. In our small lab at the time we had a broad array of testing in histology (specials, muscle histochem, immunochem, electron microscopy), but I found out my true lack of knowledge when I went to Saudi Arabia and worked with techs from other countries where they had comprehensive bachelors-level programs required for ALL lab techs. Those from the US, all certificated, where vastly under-educated compared to techs from other countries. It was a bit embarrassing! Luckily we have online courses and degrees available now - not available in the 1980's when I started. That is a tremendous advantage to those who are willing to take advantage of it. Other than that it will be up to the lab management to be sure the OJT tech gets the basic instruction according to the requirements of the ASCP exam. That is the bare bones knowledge necessary to function. Even then the experience in the lab is key to whether the knowledge is just regurgitated or practiced. Lab management has a responsibility to be sure good lab practices are ingrained during training. It is a big job. As an aside, there are some people out there trying to break into histology but do not work in a histo lab, or work in a lab that does not support their desire to get certificated (which is practically criminal in my view). I talked to a person recently who is working in a histo lab but is trying to find a lab to do special stains they do not do in the lab they are working in. Their lab will not buy them the reagents necessary and actually told this person that they will not help them get certificated because they feel the person will move on to get better pay elsewhere. I agree with another thought expressed that finding a person excited about getting into histology can lead to a good tech. I had a person just show up cold one day saying he really wanted to work in the histo lab - he had learned some histology in a research lab and did not realize it could be a full time profession until he stumbled on our lab one day. He had a good background but we had no histo jobs open, but we happened to have a new grossing lab aid job opening and he managed to get that job. The expectation is that he will eventually work his way into histology. He's happy to have his foot in the door, and we are happy to have an enthusiastic person with a plan for advancement. Tim Morken Pathology Site Manager, Parnassus Supervisor, Electron Microscopy/Neuromuscular Special Studies Department of Pathology UC San Francisco Medical Center -Original Message- From: Dessoye, Michael [mailto:mjdess...@commonwealthhealth.net] Sent: Thursday, May 14, 2015 4:44 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] OJT Histotechs/Training Hello Histonet, I'm curious how people are dealing with on-the-job-trained histotechs. Many people are seeing a shortage in techs, and in my opinion OJT will become more common than it already is. Does anyone have an 'official' training program? Requirements to pass the exam? Qualifications to be able to be trained on-the-job? I'd
Re: [Histonet] OJT Histotechs/Training
I know it is hard Hazel. I have a hard time finding well qualified people myself. OJT only works now if you already have a degree. If we can't raise the pay and the recognition we will have some difficulty recruiting those people too. I know the situation well, as I used to be the sole educator person in an HT program. It closed due to lack of enrollment and funding. I have trained people the best way that I knew how both formally and informally. I have driven in my car to multiple states,written articles, gone to conferences, schools, colleges and trade shows, and did my personal best to present topics and sell' our profession. Admittedly, sometimes it feels like it doesn't matter or change anything. But we have to keep trying and pushing for our group, its best interests, its public recognition, its compensation. There will be no budging from anyone else I'm afraid. Change often moves like a glacier, but it does move! Joelle Weaver MAOM, HTL (ASCP) QIHC From: hor...@archildrens.org To: joellewea...@hotmail.com; timothy.mor...@ucsf.edu; histonet@lists.utsouthwestern.edu Date: Thu, 14 May 2015 14:46:40 -0500 Subject: RE: [Histonet] OJT Histotechs/Training Joelle I agree with you. But the problem is, no one knows we exist. OJT is the only route for some/if not most positions to be filled. We would all love to have a choice of educated ASCP registered techs to choose from. I have an open position and no applicants. Hazel Horn, HTL/HT (ASCP) Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital 1 Children's Way | Slot 820| Little Rock, AR 72202 501.364.4240 direct | 501.364.1241 fax hor...@archildrens.org archildrens.org -Original Message- From: Joelle Weaver [mailto:joellewea...@hotmail.com] Sent: Thursday, May 14, 2015 2:35 PM To: Morken, Timothy; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] OJT Histotechs/Training We have discussed this on the histonet many times... Most professions, and most if not all healthcare professions, require degrees and/or certification for entry. This is how the public, other medical professions ,and even HR-who do not know the technical- assess for our capacity to provide care and judge the skill level needed of the profession as they are looking in. We all know that this isn't always perhaps the best method to assess or measure some aspects of this profession, but this is what they work from. There are good and bad examples of both OJT and educated, formally trained histology professionals. However, education is more than learning facts, it helps develop many other facets of the person that are viewed as valuable to organizations. That is why it is used as a screening tool. Please try to value the broader perspective. Technical proficiency itself is probably not going to be enough as the future unfolds. Though it may seem unfair if you have worked for a very long time and learned a great deal through experie nce, the bottom line is that for some employers, some environments and outside groups- education, credentials and professionalism are the primary criteria they use to evaluate, and they pay and recognize accordingly. Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsf.edu To: histonet@lists.utsouthwestern.edu Date: Thu, 14 May 2015 17:28:15 + Subject: Re: [Histonet] OJT Histotechs/Training Mike, yes, the vast majority of histotechs have been, are, and will be OJT (me included). The people who take on training these people have a responsibility to do the best they can. Most techs end up learning whatever their lab does and so have limited knowledge. I studied a full year for the HT and passed fine, and later the HTL. In our small lab at the time we had a broad array of testing in histology (specials, muscle histochem, immunochem, electron microscopy), but I found out my true lack of knowledge when I went to Saudi Arabia and worked with techs from other countries where they had comprehensive bachelors-level programs required for ALL lab techs. Those from the US, all certificated, where vastly under-educated compared to techs from other countries. It was a bit embarrassing! Luckily we have online courses and degrees available now - not available in the 1980's when I started. That is a tremendous advantage to those who are willing to take advantage of it. Other than that it will be up to the lab management to be sure the OJT tech gets the basic instruction according to the requirements of the ASCP exam. That is the bare bones knowledge necessary to function. Even then the experience in the lab is key to whether the knowledge is just regurgitated or practiced. Lab management has a responsibility to be sure good lab practices are ingrained during training. It is a big job. As an aside
Re: [Histonet] OJT Histotechs/Training
Degree/college credit requirements since 2005 for OJT. If they have a degree, you would need to provide/document training under a direction of board certified pathologist. Programs often have a theory ( class room) and practical component that is completed on site at affiliate laboratories. Recommend becoming an affiliate site for program and accepting clinical students who are registry eligible when they complete both portions of the program. Joelle Weaver MAOM, HTL (ASCP) QIHC From: mjdess...@commonwealthhealth.net To: histonet@lists.utsouthwestern.edu Date: Thu, 14 May 2015 11:43:53 + Subject: [Histonet] OJT Histotechs/Training Hello Histonet, I'm curious how people are dealing with on-the-job-trained histotechs. Many people are seeing a shortage in techs, and in my opinion OJT will become more common than it already is. Does anyone have an 'official' training program? Requirements to pass the exam? Qualifications to be able to be trained on-the-job? I'd like to consider having some kind of plan in place when I don't have an HT/HTL applicant but have folks who, if they get the experience, are otherwise qualified to sit for the exam. If anyone has a similar situation or experience to share I would appreciate it! Thanks, Mike Michael J. Dessoye, M.S. | Histology/Toxicology/RIA Supervisor | Wilkes-Barre General Hospital | An Affiliate of Commonwealth Health | mjdess...@commonwealthhealth.netmailto:mjdess...@commonwealthhealth.net | 575 N. River Street | Wilkes Barre, PA 18764 | Tel: 570-552-1432 | Fax: 570-552-1486 -- Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If you are not an intended recipient of this message, please notify the sender immediately and delete the material from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any action in reliance on the information it contains. ___ 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] HE Stainer Question
Personally I love the Prisma for volume and the tape. I know many have bad opinions, but I wish I had both the Prisma and the tape right now! I have never seen any problems with very old ( 15+ year) slides. using the tape. Not saying it can't happen-but have not personally seen it. The tape is easier to get off if you need to versus old glass CS, just use acetone, acetone/xylene, xylene. Comes off in a gel form and slides right off leaving the tissue intact. Joelle Weaver MAOM, HTL (ASCP) QIHC From: ro...@labcorp.com To: pat...@gmail.com; histonet@lists.utsouthwestern.edu Date: Tue, 12 May 2015 12:18:46 + Subject: Re: [Histonet] HE Stainer Question Paula Here are my two cents I currently use a Leica Autostainer XL with attached glass coverslipper. It is consistent in its staining and easy to use. The downfall is if you are a large volume lab or just have large volume days, each staining rack holds 30 slides and only one rack can be stained in each batch. The stainer also only has one on board oven, so the throughput of this machine is fairly low. It is only staining 30 slides at a time, with one holding station for the next set. It will run multiple batches concurrently, but gets to a point where it is all backed up. We sometimes have 2 racks staining, one in the oven, one in the loading dock, and some sitting on top of the stainer until it can go on. On the flip side, the Sakura Prisma is a workhorse. It is very similar to the Leica in the sense that it is linear and very consistent in staining. It has two on board ovens and each basket can hold 20 slides. The difference is that the Sakura can stain 3 racks (60 slides) per batch, with two batches in the oven at the same time. That gives you 120 slide throughput for each batch. This stainer also has an attached coverslipper (Sakura Film), but it is film coverslips. I know, I know.no one likes the film coverslips. One advantage to the film, is that the slides are dry almost immediately and can be filed away the same day. No waiting for 3-4 days for the glass ones to fully cure. I can say that the last lab I worked in had the film coverslips and after 10 years, the slides were still in pristine condition. There are many pathologists that do not like to read film covered slides, but once ours got used to it, they had no problems. Some say the film yellows or comes of f with the tissue still attached. I can say that I never seen this in my past position. It is very dependent on Xylene only during coverslipping. You cannot use a xylene substitute in the coverslip portion and expect to get good results. Hope it helpsgood luck. Lisa -Original Message- From: Paula Sicurello [mailto:pat...@gmail.com] Sent: Monday, May 11, 2015 5:04 PM To: HistoNet Subject: [Histonet] HE Stainer Question Me again... UCSD is in the market for a new HE stainer for our new hospital opening next year. We need a workhorse, not a prima dona, something with a coverslipper built in would be nice. What do you use? Suggestions gratefully accepted-even from you two Keith and Matt ;) Opinions about the good, the bad, and the ugly (as long as it works really well) will be helpful. Thanks oodles! Paula :-) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -This e-mail and any attachments may contain CONFIDENTIAL information, including PROTECTED HEALTH INFORMATION. If you are not the intended recipient, any use or disclosure of this information is STRICTLY PROHIBITED; you are requested to delete this e-mail and any attachments, notify the sender immediately, and notify the LabCorp Privacy Officer at privacyoffi...@labcorp.com or call (877) 23-HIPAA / (877) 234-4722. ___ 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] IHC and oven temperature
John your points do seem to make it seem somewhat counter-intuitive in regards to the temperatures suggested in the literature for high points for each step. Perhaps someone will be able to provide a complete theoretical basis for the differences. It seems though that there wouldn't be much of a directed point or purpose in heating slides dry at such high temperature for very long at that stage in the process. But during AR , we have moist and the eletrolytic conditions, so use of the higher temperature is applied for a more directed and specific effect that benefits us in identifying the particular epitope of interest..any thoughts? Seems like high temp acheives a goal in the second instance, but not much purpose is gained at the higher temperature in the first instance, and potentially damage to some aspects. I'll await further information and discussion from the group. Thanks Joelle Weaver MAOM, HTL (ASCP) QIHC From: jkier...@uwo.ca To: Histonet@lists.utsouthwestern.edu; tony.henw...@health.nsw.gov.au Date: Thu, 30 Apr 2015 18:24:10 -0500 Subject: Re: FW: [Histonet] IHC and oven temperature CC: The statement quoted by Tony from the Dako manual cannot be true because many antigens have to be exposed to water at 100C in order to be immunostained - antigen retrieval. Denaturation of a macromolecule by heat increases the number of exposed epitopes, which typically are short amino acid sequences that bind specifically to the Fab segments of antibody molecules. On the other hand, it is easy to believe that 60C would denature antibody molecules enough to damage their binding sites and impair or prevent immunostaining. According to AWP Vermeer and W Norde (2000), the Fab segments of IgG were denatured when the temperature of a solution slightly exceeded 60C. (The Thermal Stability of Immunoglobulin: Unfolding and Aggregation of a Multi-Domain Protein Biophysical Journal 78: 394–404.) They found that further heating denatured the Fc segment, but the changed molecules became entangled and aggregated before denaturation was complete. Microwave heating is sometimes used to accelerate immunostaining, but control of the temperature is critical. For example: ME Boon E Marani (1991) The major importance of temperature data in publications concerning microwave techniques European Journal of Morphology 29: 181–183. John Kiernan London, Canada = = = On 30/04/15, Tony Henwood (SCHN) tony.henw...@health.nsw.gov.au wrote: Yes, I read the Dako IPX educational guides (5th ed) and on page 32: No processes should raise tissue temperature to higher than 60oC as this will cause severe loss of antigenicity that may not be recoverable Unfortunately there is no evidence given or cited that validates this statement. Even though this could be right (and there are several papers that have looked at this), this statement is scientifically weak and we should not cite this as truth. Now I do recommend the Dako reference series to my students, and I have contributed to one of these texts myself (Microscopic control of routine HE - know your histology) but I request my students to continue to question what they read and confirm the scientific validity of the information. Regards, Tony From: Joelle Weaver [joellewea...@hotmail.com] Sent: Saturday, 25 April 2015 5:51 AM To: Tony Henwood (SCHN); WILLIAM DESALVO; Preiszner, Johanna Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] IHC and oven temperature I remember reading that the preferred temperature was about 60 degrees Celsius. I think that this was in the Dako education guides if I'm not mistaken. If that is the case, the citation for the source is probably in that resource available as pdf from their website. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tony.henw...@health.nsw.gov.au To: wdesalvo@outlook.com; preis...@mail.etsu.edu Date: Fri, 24 Apr 2015 09:43:59 + Subject: RE: [Histonet] IHC and oven temperature CC: histonet@lists.utsouthwestern.edu Hi temp drying shown to be a bad idea: Henwood, A., (2005) “Effect of Slide Drying at 80°C on Immunohistochemistry” J Histotechnol 28(1):45-46. Abstract Prolonged high temperature dry heating has been found to be deleterious to the immunohistochemical demonstration of several antigens in formalin-fixed, paraffin- embedded sections. Paraffin sections were dried at 80°C for 7 h and their immunoreactivity was compared with mirror sections dried for 1 h at 60°C. NCL-5D3, CMV, S100, HMB45, and CEA were quite labile to dry overheating whereas AElAE3, HBsAg, HBcAg, HSVII, EMA, chromogranin, and NSE were found to be quite resistant. It is recommended that coated slides (poly-L-lysine or aminopropyltriethoxysilane) and low-temperature
Re: [Histonet] IHC billing question
Histologists enter all TC IHC billing codes manually as performed before they leave the lab. Joelle Weaver MAOM, HTL (ASCP) QIHC From: garr...@gmail.com Date: Thu, 30 Apr 2015 17:52:25 -0400 To: mpe...@grhs.net Subject: Re: [Histonet] IHC billing question CC: histonet@lists.utsouthwestern.edu; richard.car...@hhchealth.org Your Lis should not have done that. If you are using Copath/Cerner, I think they have automated it now according to their most recent newsletter. Currently, I have to manually change the 88342's to 1's It's somewhat of a pain. But, your Lis should have consulted someone before deleting all codes. Your pathologists should have been on top of it as well imho. Unfortunately, someone has to change. It may be too late to bill too for some. Garrey Sent from my iPhone On Apr 30, 2015, at 5:44 PM, Mike Pence mpe...@grhs.net wrote: We do all of our IHC billing manually. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of WILLIAM DESALVO Sent: Thursday, April 30, 2015 4:43 PM To: Cartun, Richard Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC billing question We have to manually review the IHC billing also and continue to audit. It took billing and IT three months to create the logic to automate billing for a specimen and account for combination of there being the possibility of 88341, 88342 88344 and the proper combinations. Sent from my iPhone On Apr 30, 2015, at 2:34 PM, Cartun, Richard richard.car...@hhchealth.org wrote: Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes for IHC from our CoPath stain dictionary since you couldn't tell whether a Cytokeratin-7 was being performed as an 88341 or as an 88342. Now, as you might have expected, none of the inpatient IHC testing has been accounted for (the outpatient IHC has been billed manually from the pathology report), and they want someone to go back and enter all the CPT codes into the system (hopefully, not me!). Has anyone else encountered this problem? Thanks (I think). Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax 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, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] ANP.23410
Usually I have done weekly , but in rather high usage places. With more strict downtimes and decontamination for TB or other suspected infectious cases. Joelle Weaver MAOM, HTL (ASCP) QIHC From: dknut...@primecare.org To: histonet@lists.utsouthwestern.edu Date: Thu, 30 Apr 2015 14:20:54 -0500 Subject: [Histonet] ANP.23410 Hi fellow Histonetters - I was wondering if I could get some feedback from my peers on how you are dealing with the CAP standard ANP.23410 on Cryostat Decontamination. It states that this is done at defined intervals appropriate for the institution. The place I just inspected was doing a weekly decontaminating, and a more thorough one quarterly. I would like to know how often are other sites taking apart the entire cryostat chamber for decontamination. Thank you so much for sharing your process. Deanne Knutson Supervisor Anatomic Pathology 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. ___ 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: IHC and Oven Temperatures
Thank you. I knew it was discussed in that reference. I guess my memory isn't totally gone! Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Sun, 26 Apr 2015 11:42:04 -0400 From: richardb...@charter.net To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: IHC and Oven Temperatures The specific pages in the Dako Education Guide: Immunohistochemistry Staining Methods, Fifth Edition are: Discussion on page 32 and references on page 33. It's in the Fixation and Processing Chapter and says no part of the process should have temperatures above 60C. Rick Boen, BS, HTL (ASCP) Histology Lab St. Luke's Hospital Duluth, Mn ___ 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: Question on IHC billing
Yes, that is what we do. It is per specimen. First IHC 88342, additional are 88341 Joelle Weaver MAOM, HTL (ASCP) QIHC From: joyce.we...@emoryhealthcare.org To: jvick...@springfieldclinic.com; histonet@lists.utsouthwestern.edu Date: Thu, 23 Apr 2015 20:31:09 + CC: Subject: [Histonet] RE: Question on IHC billing Correct Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Vickroy, James Sent: Thursday, April 23, 2015 4:19 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Question on IHC billing Let me see if I have this straight:If a pathologist orders an Hpylori stain on 2 blocks from the same specimen C1 and C2 we can only bill one 88342. If this correct.Obviously if he ordered addition different IHC stains we could change additional 88341's. Jim Vickroy Histology Manager Springfield Clinic, Main Campus, East Building 1025 South 6th Street Springfield, Illinois 62703 Office: 217-528-7541, Ext. 15121 Email: jvick...@springfieldclinic.commailto:jvick...@springfieldclinic.com This electronic message contains information from Springfield Clinic, LLP that may be confidential, privileged, and/or sensitive. This information is intended for the use of the individual(s) or entity(ies) named above. If you are not the intended recipient, be aware that disclosure, copying, distribution, or action taken on the contents of this information is strictly prohibited. If you have received this electronic message in error, please notify the sender immediately, by electronic mail, so that arrangements may be made for the retrieval of this electronic message. Thank you.___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ 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] IHC and oven temperature
I remember reading that the preffered temperature was about 60 degrees Celsius. I think that this was in the Dako education guides if I'm not mistaken. If that is the case, the citation for the source is probably in that resource available as pdf from their website. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tony.henw...@health.nsw.gov.au To: wdesalvo@outlook.com; preis...@mail.etsu.edu Date: Fri, 24 Apr 2015 09:43:59 + Subject: RE: [Histonet] IHC and oven temperature CC: histonet@lists.utsouthwestern.edu Hi temp drying shown to be a bad idea: Henwood, A., (2005) “Effect of Slide Drying at 80°C on Immunohistochemistry” J Histotechnol 28(1):45-46. Abstract Prolonged high temperature dry heating has been found to be deleterious to the immunohistochemical demonstration of several antigens in formalin-fixed, paraffin- embedded sections. Paraffin sections were dried at 80°C for 7 h and their immunoreactivity was compared with mirror sections dried for 1 h at 60°C. NCL-5D3, CMV, S100, HMB45, and CEA were quite labile to dry overheating whereas AElAE3, HBsAg, HBcAg, HSVII, EMA, chromogranin, and NSE were found to be quite resistant. It is recommended that coated slides (poly-L-lysine or aminopropyltriethoxysilane) and low-temperature drying (60°C) be routinely used for irnmunohistochemistry. From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of WILLIAM DESALVO [wdesalvo@outlook.com] Sent: Tuesday, 21 April 2015 1:56 AM To: Preiszner, Johanna Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] IHC and oven temperature Dry heat compared to wet heat. Do not dry your slides at high heat. You are removing water trapped between slide and paraffin section. Antigen retrieval is an entirely different process. So not try to combine the two processes Sent from my iPhone On Apr 20, 2015, at 8:48 AM, Preiszner, Johanna preis...@mail.etsu.edu wrote: Hi Netters, is there something wrong with this logic: If the tissue needs 95C for HIER, it's ok to dry the slides in an 82C oven. Of course I'll test it before I try it on real specimens, but maybe someone else already knows the answer... Thanks! Hanna Preiszner ETSU/QCOM ___ 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 * This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, please delete it and notify the sender. Views expressed in this message and any attachments are those of the individual sender, and are not necessarily the views of The Sydney Children's Hospitals Network. This note also confirms that this email message has been virus scanned and although no computer viruses were detected, The Sydney Childrens Hospital's Network accepts no liability for any consequential damage resulting from email containing computer viruses. * ___ 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] BS in Histotechnology
Yes, thank you! I hate when this statement is made. It is truly insulting. I have left organizations because the manager or director would say this right in meetings to us histotechs and to others in the meeting. At the moment of that utterance, I knew I was in the wrong place! Cheers. Joelle Weaver MAOM, HTL (ASCP) QIHC From: garr...@gmail.com Date: Tue, 24 Mar 2015 18:33:37 -0400 To: nancy.sted...@buschgardens.com Subject: Re: [Histonet] BS in Histotechnology CC: histonet@lists.utsouthwestern.edu; mtur...@csilaboratories.com; jmacdon...@mtsac.edu; timothy.mor...@ucsf.edu; pamar...@uams.edu I am trying to find (hire) a histotech and will make sure I don't use the words trained monkey in my interviews. . Ha ha. I truly value and appreciate a skilled and motivated histotech. I've had to train myself to cut my own sections in order to understand the process better. It is a great field; it's like art to me.There is no room for monkeys in my book. Garrey Sent from my iPhone On Mar 24, 2015, at 5:22 PM, Stedman, Nancy nancy.sted...@buschgardens.com wrote: As a pathologist I'd like to apologize for all the pathologists who have made comments like this.. forget trained monkeys and dogs, most (all?) pathologists cannot cut slides either, at least not slides they'd want to try to read. I know I can't. -Nancy Stedman -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Turner Sent: Tuesday, March 24, 2015 4:26 PM To: Paula Sicurello; Michael Ann Jones Cc: histonet@lists.utsouthwestern.edu; Timothy Morken; Jennifer MacDonald; Marcum, Pamela A Subject: RE: [Histonet] BS in Histotechnology I once worked with a Pathologist who said she was in a group meeting of other pathologists when one of them blurted out that a trained monkey could cut slides. My pathologist, having had the opportunity to review some cases from the offender's laboratory, promptly replied Yes, and with the quality of your slides it looks like you did just that. She shut down the other pathologist really quickly, and as far as I know, we never received another case to review from him. My pathologist was not about to let that kind of arrogance stand. She was one of the best bosses I ever had! Mark Turner, Ph.D., HT(ASCP)QIHC Manager, Histology/IHC -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello Sent: Tuesday, March 24, 2015 3:47 PM To: Michael Ann Jones Cc: histonet@lists.utsouthwestern.edu; Jennifer MacDonald; Marcum, Pamela A; Timothy Morken Subject: Re: [Histonet] BS in Histotechnology I've had more than one pathologist tell me a monkey could do my job. Though one of them said it with a smile and added a very highly skilled and well trained monkey, he was one of the few who knew better. How many of us monkeys have trained the whining and complaining residents how to do things correctly? Paula On Tue, Mar 24, 2015 at 12:29 PM, Michael Ann Jones mjo...@metropath.com wrote: OMG Pam~ our pathologist said the exact same thing to us when we started our Grossing training. Sheesh. . . Michael Ann On 3/24/15, 11:52 AM, Marcum, Pamela A pamar...@uams.edu wrote: That was nicer than the pathologist who told me years ago, any monkey could be trained to do my job. I basically did not take the job I was interviewing for at the time. At least the next interview went a lot better and I did take the job. Pam -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sanders, Jeanine (CDC/OID/NCEZID) Sent: Tuesday, March 24, 2015 12:30 PM To: Sue; Timothy Morken Cc: histonet@lists.utsouthwestern.edu; Jennifer MacDonald Subject: RE: [Histonet] BS in Histotechnology I agree, BUTas long as many pathologists think you can teach any trained dog how to section histology will never have the recognition those of us that have studied and trained deserve. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sue Sent: Tuesday, March 24, 2015 12:59 PM To: Timothy Morken Cc: histonet@lists.utsouthwestern.edu; Jennifer MacDonald Subject: Re: [Histonet] BS in Histotechnology This is a fight that we continue to have with hospital administration. In my opinion histologists are just as important and needed as MT. Even though there is an increase in automation in pathology the hands on of a histologists is most important. The fact that hospital still consider a lower entry job is the reason there are not more
RE: [Histonet] histology in higher education
Many people do this, and have donated hundreds of hours of their own time. But definately not enough. Good to encourage people to get involved. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Wed, 22 Apr 2015 14:07:18 + From: koelli...@comcast.net To: histonet@lists.utsouthwestern.edu Subject: [Histonet] histology in higher education The following has to do with histology and STEM (science, technology, engineering, math) so if not interested, please ignore. But I believe it can have real meaning to the profession of histology at the NSH, state society and local levels. I am elected to the Board of WSSEF (Washington State Science and Engineering Fair) where I am in educational outreach and also the assistant to the head judge. We recently had our Washington State Fair with 650 kids, grades 1-12 from all over the state. And while there was a lot of engineering and robots and computers there were a few projects having to do with medicine, biotechnology, immunology and pathology with some familiar histology or immunohistochemistry pictures included. At the end of the fair, we awarded almost 1.8 MILLION dollars of scholarships and awards to grades 7-12 students. Not only that, our top winners get an all-expenses paid trip to present at the ISEF (Intel International Fair) with 1,700 students competing from all 50 states and 70 countries. Wherever you are in the US, you have a state fair. I would advocate for some of you so interested at the national, state or local levels to promote histology, by getting involved as mentors for middle and high school students to science fairs; especially those that could lead to histopathology or other related projects that could lead into Intel affiliated fairs resulting in great benefit to the student and a spread of the word of histology into both the STEM world and general population. I've mentored for 15 years. It can be done. Molecular histopathology, personalized diagnostics and therapeutics, advances in immunohistochemistry, current controversies about breast biopsy diagnosis, or other disease with newer classifications, PCR and RTPCR in histology, modern-targeted therapeutics like in melanoma or colo-rectal carcinoma, FISH, digital image analysis software for you computer geeks and on and on; the list is nearly limitless. Especially if you are close to or can contact biotech companies or educational institutions to find co-mentors for grades 7-12 there are histology-related science project possibilities in terms of data collection and the scientific method and project presentation are nearly unlimited now. Be a mentor for or engage a grade 7-12 student, with the help of another mentor or organization, to think about (histology-related) projects for science fairs leading to a state fair and Intel ISEF. Can't think of any better way to promote histology so would hope those at NSH would take note of this. And since the ISEF fair receives projects and groups from 70 countries, I hope any outside the US would also think about the same thing. Ray Koelling HT, HTL, QIHC, STEM educational outreach advocate Lake Forest Park, WA ___ 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] NY State regulations
Probably CLIA related to high complexity testing. IHC is not considered under CLIA ( from 1988), though many people feel otherwise. Grossing is. I think that it is under sub part G or H if I remember correctly. Joelle Weaver MAOM, HTL (ASCP) QIHC From: gmarce...@nj-urology.com To: histonet@lists.utsouthwestern.edu Date: Wed, 22 Apr 2015 10:55:19 -0400 Subject: [Histonet] NY State regulations Hi - I was wondering if anyone knows the regulations regarding the NY State Clinical Laboratory license. I have been a Histotech and have worked in IHC for 20+ years and was required to obtain a NY State Clinical Lab License in 2007. I don't have and associates or bachelor degree and was not required to prior to 2007. I was told on a job interview that if I don't have either of these degrees that I cannot gross any specimens or run IHC. I've never heard this before. Has anyone else ever heard of this??? Thanks - Gail ___ 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] NY State regulations
The FDA categorizes and grades each test based on the complexity of the test method. The FDA lists the category at http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/IVDRegulatoryAssistance/ucm393285.htm on the FDA website. The FDA categorizes test methods into three levels of complexity: Waived complexity, Moderate Complexity, including the subcategory of Provider-Performed Microscopy Procedures (PPMP); and High Complexity.When categorizing a test, the FDA considers the: Amount of interpretation involved; Calibration and quality control requirements of the instruments used; Degree of independent judgment involved; Difficulty of the calculations involved; Examinations and procedures performed and the methodologies employed; and Type of training required to operate the instruments used in the methodology. How is it determined if a test is waived, moderate or high complexity? For moderate and high complexity tests, the FDA evaluates each new commercial test system during the premarket approval process by scoring seven criteria as described in the CLIA regulations.The final score is used to determine whether the test system is classified as moderate or high complexity. See 42 CFR 493.17. For more details, please also see the FDA’s webpage on the CLIA Categorization Criteria and CMS’ webpage on Categorization of Tests. Joelle Weaver MAOM, HTL (ASCP) QIHC From: caroline.pr...@uphs.upenn.edu To: garr...@gmail.com; gmarce...@nj-urology.com Date: Wed, 22 Apr 2015 19:33:35 + Subject: RE: [Histonet] NY State regulations CC: histonet@lists.utsouthwestern.edu Just a CLIA reg, but you are correct microtomy, embedding and routine stains are only Moderate Complexity testing. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Garreyf Sent: Wednesday, April 22, 2015 3:26 PM To: Gail Marcella Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] NY State regulations I believe grossing of small biopsies and performing ihc are both considered high complex testing. You must fulfill the clia personnel requirements of high complex testing. I also believe a histotech who only cuts and performs routine stains is not considered highly complex. I'm not sure why? Anyone know? Garrey Sent from my iPhone On Apr 22, 2015, at 10:55 AM, Gail Marcella gmarce...@nj-urology.com wrote: Hi - I was wondering if anyone knows the regulations regarding the NY State Clinical Laboratory license. I have been a Histotech and have worked in IHC for 20+ years and was required to obtain a NY State Clinical Lab License in 2007. I don't have and associates or bachelor degree and was not required to prior to 2007. I was told on a job interview that if I don't have either of these degrees that I cannot gross any specimens or run IHC. I've never heard this before. Has anyone else ever heard of this??? Thanks - Gail ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Nuclear Artifact
When I had this occur recently and sporadically, it was a collection issue. Joelle Weaver MAOM, HTL (ASCP) QIHC From: lbla...@digestivespecialists.com To: ro...@labcorp.com; histonet@lists.utsouthwestern.edu Date: Tue, 21 Apr 2015 13:48:07 -0400 CC: Subject: [Histonet] RE: Nuclear Artifact The first place I would look is to what may be happening before they reach me. If it's only one site with an issue, it sounds more like an issue at collection. Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Roy, Lisa Sent: Tuesday, April 21, 2015 1:41 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Nuclear Artifact Hi HistoNetters: I have run into quite a problem. My lab currently processes all tissue types from 3 different sites. Recently, we have been getting complaints from one of the sites that the biopsies have a nuclear artifact. It is described as washed out or poor to no nuclear detail. Pictures have been uploaded (Nuclear Artifact). The Medical Director at said site is convinced that a processor error is occurring. Our site is not seeing this on any of our slides. Biopsies from all three sites are processed and embed together. We have done all trouble shooting that we can think of. Leica service has come to inspect our Peloris processor and all areas checked out as functioning properly. The problem is not consistent daily. Seems to be worst toward the end of the week. We have been running the same processing protocol, staining protocol and cutting protocols for years now. This problem has just developed over the last 2 months. Any ideas, no matter how far-fetched, would be greatly appreciated at this point. Lisa Roy, HT(ASCP) Histology Supervisor LabCorp at St. Vincent Hospital 123 Summer St Worcester, MA (508)363-9420 -This e-mail and any attachments may contain CONFIDENTIAL information, including PROTECTED HEALTH INFORMATION. If you are not the intended recipient, any use or disclosure of this information is STRICTLY PROHIBITED; you are requested to delete this e-mail and any attachments, notify the sender immediately, and notify the LabCorp Privacy Officer at privacyoffi...@labcorp.com or call (877) 23-HIPAA / (877) 234-4722. ___ 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] prevent wrinkles when cutting
Why are you cutting such a long ribbon? You usually only a need a series of 3-4 sections even for ribbon cutting. Might be easier to control if you don't try to move such a long ribbon to the waterbath. Drag the shorter ribbon towards you on the waterbath. Make sure the water is not too cool. Face the block to full face but superficial, chill on ice for some moisture, take sections while the block is still very cold. Use a slow, steady, smooth stroke if doing manual cutting. Make sure your embedding works well for the way you orient the block in the holder. Angles work well for many tissues that are prone to wrinkling. Its mostly just practice though. The more you cut, the easier it becomes and usually the better you get at it. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 20 Apr 2015 19:06:17 +0200 From: j.benavi...@eae.csic.es To: histonet@lists.utsouthwestern.edu Subject: Re: FW: [Histonet] prevent wrinkles when cutting Hi there, I´m curious about the soaking thing. We have never done it in our lab. Which is the purpose to do it? Than, after facing the blocks, we chill them in a cold plate so, if wanting to do the soaking , when should we? I guess before placing them on the cold plate, but that may cause a bit of ice formation? Thanks a lot for your help Julio On 20/04/2015 18:40, Grantham, Andrea L - (algranth) wrote: Rachel, First off, are you chilling and soaking the blocks after you face them? Do that and see if there is a difference. Don't try to get many sections to your ribbons. Shoot for a smaller ribbon (5-6) sections that are good. Cut slowly but consistently. What microtome are you using? Are you using disposable blades and are they sharp? Don't expect them to cut well if you use the same blade to face the blocks. If you aren't using disposables, get some! They will make your life easier. You might try to find a histotech at a local hospital lab who might be able to give you a hands-on lesson. Don't despair! We all sat down at our microtomes those first times and suffered trying to get perfect sections. It takes practice. You might make some blank blocks or blocks with tissue you can spare to practice your cutting techniques. I used to do this with my students and it really helped them. Good luck! Andi G. From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Rachel M Gonzalez [rac...@gbi-inc.com] Sent: Monday, April 20, 2015 9:07 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] prevent wrinkles when cutting Hi Thursday was the first time I ever used a microtome I move to a lab that does not have someone dedicated to cutting. I already miss her. I have no problems getting ribbons of 10-30 sections long but the pieces are half the size of the original block. I am guessing they are wrinkling. What am I doing wrong? Thanks Rachel Senior Scientist ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] prevent wrinkles when cutting
No ice forms in fixed, paraffin embedded tissue blocks at usual temperatures and length of chilling time and temperatures. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 20 Apr 2015 19:06:17 +0200 From: j.benavi...@eae.csic.es To: histonet@lists.utsouthwestern.edu Subject: Re: FW: [Histonet] prevent wrinkles when cutting Hi there, I´m curious about the soaking thing. We have never done it in our lab. Which is the purpose to do it? Than, after facing the blocks, we chill them in a cold plate so, if wanting to do the soaking , when should we? I guess before placing them on the cold plate, but that may cause a bit of ice formation? Thanks a lot for your help Julio On 20/04/2015 18:40, Grantham, Andrea L - (algranth) wrote: Rachel, First off, are you chilling and soaking the blocks after you face them? Do that and see if there is a difference. Don't try to get many sections to your ribbons. Shoot for a smaller ribbon (5-6) sections that are good. Cut slowly but consistently. What microtome are you using? Are you using disposable blades and are they sharp? Don't expect them to cut well if you use the same blade to face the blocks. If you aren't using disposables, get some! They will make your life easier. You might try to find a histotech at a local hospital lab who might be able to give you a hands-on lesson. Don't despair! We all sat down at our microtomes those first times and suffered trying to get perfect sections. It takes practice. You might make some blank blocks or blocks with tissue you can spare to practice your cutting techniques. I used to do this with my students and it really helped them. Good luck! Andi G. From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Rachel M Gonzalez [rac...@gbi-inc.com] Sent: Monday, April 20, 2015 9:07 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] prevent wrinkles when cutting Hi Thursday was the first time I ever used a microtome I move to a lab that does not have someone dedicated to cutting. I already miss her. I have no problems getting ribbons of 10-30 sections long but the pieces are half the size of the original block. I am guessing they are wrinkling. What am I doing wrong? Thanks Rachel Senior Scientist ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: IHC Billing Question
No charge to patient account for negative or positive controls. Only the patient test (s). The controls verify that the test ran accurately, and for interpretation. You just have to figure this into your cost/test. As many have already posted in this string it is why many labs aside from QC reasons, have adopted the single slide for postive/patient and have also eliminated negatives when polymer detection is used. Joelle Weaver MAOM, HTL (ASCP) QIHC From: mw...@wakehealth.edu To: bburn...@capecodhealth.org; jmore...@sidra.org; histonet@lists.utsouthwestern.edu Date: Thu, 16 Apr 2015 14:35:59 + CC: Subject: [Histonet] RE: IHC Billing Question We have not been charging for the negative control, assuming that it was just a cost of doing business. I would be interested to hear if anyone has been charging for their negative controls as well. Martha Ward, MT (ASCP) QIHC Manager Molecular Diagnostics Lab Medical Center Boulevard \ Winston-Salem, NC 27157 p 336.716.2109 \ f 336.716.5890 mw...@wakehealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Burnett, Brandy Sent: Thursday, April 16, 2015 9:48 AM To: 'Joana Moreira'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: IHC Billing Question We recently added HER2 IHC testing in our lab which we are required to use a negative reagent control For each case. Is there a cpt code for negative reagent control reimbursement? Any information on this Would be much appreciated! Thanks Brandy Burnett Histotechnoligist, QIHC(ASCP) CCH Pathology/Histology Expert physicians. Quality hospitals. Superior care. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joana Moreira Sent: Thursday, April 16, 2015 7:25 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC Billing Question Greetings from Doha! This was much probably discussed before, but I was wondering if you could help me with a query in regards to billing. For the sites that are still doing an IHC negative reagent control for each patient specimen, do you bill for the negative control? Using code 88341? I believe it should be billed (since when and if performed correctly the negative control follows a normal IHC technique) however I am completely new to the billing subject. My previous experience is based in Portugal and UK (where billing does not exist) and I've been introduced to this topic since I joined my current institution that will be following the North American Healthcare model. So... any help will be GREATLY appreciated!! Many Thanks in advance, Joana Joana Moreira Supervisor - Anatomical Pathology Department of Pathology Sidra Medical Research Center PO Box 26999 | Doha, Qatar Direct Line +974-4404-2036 jmore...@sidra.org | www.sidra.org Disclaimer: This email and its attachments may be confidential and are intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received. Any views or opinions expressed are solely those of the author and do not necessarily represent those of Sidra Medical and Research Center. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ~~ This email and any files transmitted with it are confidential, and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error contact the Help Desk for Cape Cod Healthcare. helpd...@capecodhealth.org ___ 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] Schiffs
The reagent we use for our manual backup stains using Schiffs states refrigeration for long term storage only. Joelle Weaver MAOM, HTL (ASCP) QIHC From: jkier...@uwo.ca To: b-freder...@northwestern.edu; histonet@lists.utsouthwestern.edu Date: Sat, 18 Apr 2015 01:26:34 -0500 Subject: Re: [Histonet] Schiffs CC: Schiff's reagent does not need to be refrigerated. It just needs to be screw-capped so that it doesn't decompose by loss of sulphur dioxide. For decades, Schiff has been stored in many labs at 4C for no good reason. It is used at room temperature in both of its histochemical applications: the Feulgen and PAS reactions. John Kiernan Anatomy, UWO London, Canada = = = On 17/04/15, Bernice Frederick b-freder...@northwestern.edu wrote: Am I missing something? I ordered Schiffs and sigma tells me it was shipped yesterday. Hello, today is Friday and last I recall Schiffs need to be refrigerated! You'd.. think they would realize this. Sorry all, have to vent. Bernice Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edumailto:b-freder...@northwestern.edu b-freder...@northwestern.edu ___ 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] C3d?
Indirect IF Joelle Weaver MAOM, HTL (ASCP) QIHC From: lseb...@uwhealth.org To: pat...@gmail.com; histonet@lists.utsouthwestern.edu Date: Thu, 2 Apr 2015 12:25:05 + Subject: RE: [Histonet] C3d? CC: Cleveland Clinic does it by IHC and I think also by IF. Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory, Rm A4/204-3224 600 Highland Ave. Madison, WI 53792 (608)265-6596 FAX: (608)262-7174 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello Sent: Wednesday, April 01, 2015 6:14 PM To: HistoNet Subject: [Histonet] C3d? Hello Again My Dear Netters, One of our pathologists was wondering if anyone out in Histoland is performing a C3d stain? If so what type: IHC, IF? Thanks oodles! Paula :-) ___ 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] BS in Histotechnology
For what its worth, in my entire career, the pay has never been the same for an HTL with a bachelors and the same experience as any MT, and sometimes less than an MLT. I think maybe only once or twice I did get paid more ( like 5 cents) for having an HTL versus HT. Hospitals are horrible about that in general. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tpodawi...@lrgh.org To: timothy.mor...@ucsf.edu; jmacdon...@mtsac.edu; histonet@lists.utsouthwestern.edu Date: Tue, 24 Mar 2015 12:06:13 -0400 Subject: RE: [Histonet] BS in Histotechnology CC: So just out of curiosity is the pay on the same level as that of a Med Tech with a BS? Does the BA/BS have to be in Histotechnology or is the BA/BS followed by one of the on-line certificate programs? Tom Tom Podawiltz HT (ASCP) AP Section Head LRGHealthcare -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Tuesday, March 24, 2015 11:47 AM To: Jennifer MacDonald; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] BS in Histotechnology Jennifer, we require a BA/BS degree for all Histotechnologist positions. However, in our 4 step categories Level 1 does not require certification, just the degree and the requirement that they get the certification within a year. Advancement to level 2 to 4 requires an HT or HTL certification (Level 1 = entry level bench tech, Level 2 is bench tech, level 3 is senior tech, level 4 is Lead tech). Supervisor requires and HTL. Considering that we already require a BA/BS degree for all levels, the fact a person has a HT or HTL is not going to matter much for levels 1 thru 4, only for supervisor level. Tim Morken Pathology Site Manager, Parnassus Supervisor, Electron Microscopy/Neuromuscular Special Studies Department of Pathology UC San Francisco Medical Center -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Monday, March 23, 2015 7:52 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] BS in Histotechnology In what areas would a facility hire an HTL over an HT? Is there a need for more HTL programs? 4 Thank you, ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet THIS MESSAGE IS CONFIDENTIAL. This e-mail message and any attachments are proprietary and confidential information intended only for the use of the recipient(s) named above. If you are not the intended recipient, you may not print,distribute, or copy this message or any attachments. If you have received this communication in error, please notify the sender by return e-mail and delete this message and any attachments from your computer. Any views or opinions expressed are solely those of the author and do not necessarily represent those of LRGHealthcare. ___ 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] IHC
need your vendor pricing for detection, ancillaries and antibody. Divide by amount applied/used per test. Add in materials costs and a labor value. Add in overhead. Joelle Weaver MAOM, HTL (ASCP) QIHC From: craiga...@gmail.com Date: Thu, 12 Feb 2015 19:29:20 -0700 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] IHC I am new to IHC, can anyone explain an easy way to calculate the equation of IHC cost per slide? Thank you for your help... Sincerely, Craig Sent from my iPhone ___ 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 Sections
same Joelle Weaver MAOM, HTL (ASCP) QIHC From: mpe...@grhs.net To: lsmal...@juno.com; histonet@lists.utsouthwestern.edu Date: Mon, 9 Feb 2015 14:04:57 + Subject: RE: [Histonet] Frozen Sections CC: We provide assistance while the dept. is staff with histology techs. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of lsmal...@juno.com Sent: Friday, February 06, 2015 9:41 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Frozen Sections Hi, I need to ask Histoland a questionHow many HT departments provide assistance to the pathologist in the performance of frozen sections (cutting and staining of slides) to be evaluated by the pathologist? Thank you very much in advance! Lorraine Fast, Secure, NetZero 4G Mobile Broadband. Try it. http://www.netzero.net/?refcd=NZINTISP0512T4GOUT2 ___ 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] it happened again - the foreign reply
I get the same thing everytime. No, I don't know why it appears. Joelle Weaver MAOM, HTL (ASCP) QIHC From: histot...@imagesbyhopper.com To: Histonet@lists.utsouthwestern.edu Date: Sat, 7 Feb 2015 10:01:24 -0500 CC: Subject: [Histonet] it happened again - the foreign reply Does anyone have a clue as to why I keep getting a foreign reply to every email I send to histonet? Is the group seeing the same foreign message I am seeing? Am I the only one getting this message? Michelle ___ 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] CLIA Inspection Question
Probably depends on your environment or organization, but personally I would go for CAP if you are doing pathology. Joelle Weaver MAOM, HTL (ASCP) QIHC From: histot...@imagesbyhopper.com To: bszpu...@umail.iu.edu; histonet@lists.utsouthwestern.edu Date: Sat, 7 Feb 2015 09:30:34 -0500 Subject: RE: [Histonet] CLIA Inspection Question CC: Hi Histonetters, It's me again! ;) I am interested in your thoughts on this: would it be better to simply apply for a CAP accreditation and get both the CAP and CLIA certificates at the same time? My thoughts are these: if meeting the CAP guidelines is effectively meeting the CLIA requirements, would it make more sense to prep for one bird and get two at the same time? Would I still need to look at the CLIA regs, under this scenario? Out of my element, but definitely trying to learn! Thanks for the input I have received so far ... you all are a wonderful resource. :) Michelle ___ 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] Her2 IHC validation
Yes, check the ASCO/CAP guidelines there are correlation rates for positives and negatives. Joelle Weaver MAOM, HTL (ASCP) QIHC From: mw...@wakehealth.edu To: histonet@lists.utsouthwestern.edu Date: Thu, 22 Jan 2015 20:21:53 + Subject: [Histonet] Her2 IHC validation In advance of preparing for our CAP inspection window, I am working on our validation write-up for our Her2 IHC and was looking for some data concerning the correlation rates.We compared our IHC staining to FISH Her2 results on the same case. Is there a minimum correlation rate? I have been unable to find one in my reading. Thank you in advance for your help. Martha Ward, MT (ASCP) QIHC Manager Molecular Diagnostics Lab Medical Center Boulevard \ Winston-Salem, NC 27157 p 336.716.2109 \ f 336.716.5890 mw...@wakehealth.edu ___ 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] Cost Analysis:
I used the vendor reagent contract/proposal/organizational pricing. You need the cost for each reagent, bulk, detection, ancillaries, slides, coverslips, labels and antibody. I broke it down by each component in the per slide unit, then figured it the other way by adding each individual cost for each antibody on the menu to get a cost/IHC test for each test on the current IHC menu. I then added the overhead estimate %, instrumentation costs/maintenance/repair contract annualized, and an estimated wage/labor unit based on time and wage/hour . You can then look at these types of costs too, which could be added in to the cost/test or looked at separately. This gives a pretty good estimate of operational cost/test. I put this against the current reimburshment/test for reference. You can do the same thing with any routine process in the lab. This is just how I did it. I used excel to do the calculations. Joelle Weaver MAOM, HTL (ASCP) QIHC From: craiga...@gmail.com Date: Fri, 16 Jan 2015 16:27:49 -0700 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cost Analysis: Hello Histonet, Can someone please help me with a formula to figure out cost/analysis of IHC antibody per slide, detection system per slide? I am trying to break down all of our current lab costs (even processing) and I am new at this any help is greatly appreciated. Sent from my iPhone ___ 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] How are you applying this?
Yes, have prepared this summary for each newly validated AB over the past couple of years, with the included statement and signature of the medical director. Joelle Weaver MAOM, HTL (ASCP) QIHC From: wanda.borow...@sanfordhealth.org To: histonet@lists.utsouthwestern.edu Date: Tue, 13 Jan 2015 21:02:53 + Subject: [Histonet] How are you applying this? Hi All, Below is a copy of the revised COM.4 CAP checklist question. Now that Anatomic Pathology is having to comply with the All Common checklist, how are you applying this to your Immunohistochemistry ASR’s which are not FDA approved. We do new antibody validation and parallel testing with new lot numbers and clones. Is this enough? Can’t really see how the highlighted area pertains to this. Any advice would be appreciated. Thank. REVISED** 04/21/2014 COM.4 Method Validation/Verification Approval Phase II There is a summary statement, signed by the laboratory director (or designee who meets CAP director qualifications) prior to use in patient testing, documenting evaluation of validation/verification studies and approval of each test for clinical use. NOTE: This checklist item is applicable only to tests implemented after June 15, 2009. The summary statement must include a written assessment of the validation/verification study, including the acceptability of the data. The summary must also include a statement approving the test for clinical use with the approval signature such as, This validation study has been reviewed, and the performance of the method is considered acceptable for patient testing. For an FDA-cleared/approved test, a summary of the verification data must address analytic performance specifications, including analytic accuracy, precision, interferences, and reportable range, as applicable. In addition, for modified FDA-cleared/approved tests or LDTs, the summary must address analytical sensitivity, analytical specificity and any other parameter that is considered important to assure that the analytical performance of a test (e.g. specimen stability, reagent stability, linearity, carryover, and cross-contamination, etc.), as appropriate and applicable. If the laboratory makes clinical claims about its tests, the summary must address the validation of these claims. See the Method Performance Specifications section for details concerning validation/verification. Evidence of Compliance: ✓ Summary of validation/verification studies with review and approval REFERENCES 1) Lawrence Jennings, Vivianna M. Van Deerlin, Margaret L. Gulley (2009) Recommended Principles and Practices for Validating Clinical Molecular Pathology Tests. Archives of Pathology Laboratory Medicine: Vol. 133, No. 5, pp. 743-755 Wanda Borowicz HT(ASCP) Histology Supervisor Sanford Health North 1720 S. University Dr. Route 1902 Fargo, ND 58103 Ph-701 417 4930 Fax-701 417 4399 wanda.borow...@sanfordhealth.orgmailto:wanda.borow...@sanfordhealth.org --- Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain privileged and confidential 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] QC daily HEs
Both. The pathologist has to sign off. Joelle Weaver MAOM, HTL (ASCP) QIHC From: tejohn...@genoptix.com To: histonet@lists.utsouthwestern.edu Date: Mon, 29 Dec 2014 18:09:19 + Subject: [Histonet] QC daily HEs What are the CLIA/CAP labs doing for daily HE QC? Does a pathologist need to review the HE control slide daily, or do you have an ASCP certified tech delegated to doing this? Teri Johnson, HT(ASCP)QIHC Manager Clinical Trial Testing Genoptix, Inc. SAN5, Rm. 2005 760.516.5954 (office) 760.516.6201 (fax) CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and contains information that is confidential and proprietary to Genoptix Medical Laboratory or its subsidiaries. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, immediately contact the sender by 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] Re: Block and Slide Retention
Good point about lab closings and block/slide archives Dr. Richmond. I seem to remember a requirement for a policy for what a lab will do with their archives in the event of closing in the CAP checklist. Having a policy of course, is only part of the resolution. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Sat, 6 Dec 2014 17:46:11 -0500 From: rsrichm...@gmail.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: Block and Slide Retention Blake Taylor, Surgical Pathology Supervisor, Lexington Medical Center in SC asks: We currently keep our blocks and slides indefinitely but would like to revise our retention policy. I know CAP has a minimum of 10 years, Just wanted some feedback on what others thoughts on this are. We are thinking maybe 15-18 years??? I think that with the rapid advent of molecular and genetic studies that can be done on paraffin embedded tissue, that the 10 year minimum is going to need to be extended, though I haven't heard of any proposals. A non-trivial problem, because of the temperature control needed for storing paraffin blocks. A related problem: what should be done with archived blocks when a lab closes, as so many will in the next few years? Bob Richmond Samurai Pathologist Maryville TN ___ 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] Centralizing AP services
In that process right now. We have multiple partners, and today started the offical merging/integration of two major health campus AP laboratories( one academic, one non-academic, hospital/clinical), and 3+ smaller sites, outreach, and probably at least two more sites to follow soon. Joelle Weaver MAOM, HTL (ASCP) QIHC From: richard.car...@hhchealth.org To: histonet@lists.utsouthwestern.edu Date: Mon, 1 Dec 2014 18:53:08 + Subject: [Histonet] Centralizing AP services I would like to connect with individuals who have been involved with the centralization of Anatomic Pathology services within a healthcare system that has multiple partners. Thank you. Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax 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, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ 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] Processor
Agree with VIP for conventional tissue processing Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 1 Dec 2014 14:15:23 -0500 From: tina.vanme...@gmail.com To: tanyaabb...@catholichealth.net Subject: Re: [Histonet] Processor CC: histonet@lists.utsouthwestern.edu Sakura VIP 5 or 6 On Mon, Dec 1, 2014 at 2:03 PM, Abbott, Tanya tanyaabb...@catholichealth.net wrote: Looking for a tissue processor to process 200-300 cassettes per run, any favourites? Tanya G. Abbott RT (CSMLS) Manager Technologist, Histology/Cytology St. Joseph Medical Center Reading, PA 19603-0316 ph 610-378-2635 fax 610-898-5871 email: tanyaabb...@catholichealth.net 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. ___ 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] Specimen numbering systems
Numeric for the Specimen and Alpha for the Block. Joelle Weaver MAOM, HTL (ASCP) QIHC From: donna.wil...@baylorhealth.edu To: histonet@lists.utsouthwestern.edu Date: Fri, 21 Nov 2014 19:02:56 + Subject: [Histonet] Specimen numbering systems Can large facilities of more than 500 beds please let me know how they are numbering their Surgical specimens. Alpha for the Specimens and numeric for the Block or Numeric for the Specimen and Alpha for the Block. Thanks, Donna Willis, HT/HTL(ASCP) Anatomic Pathology Manager Baylor University Medical Center 3500 Gaston Ave|Dallas, Texas 75246 214-820-2465 office|214-725-6184 mobile BaylorScottandWhite.com ** This e-mail may contain confidential and/or privileged information. 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 (or have received this e-mail in error) please notify the sender immediately and destroy this e-mail. Any unauthorized copying, disclosure or distribution of the material in this e-mail is strictly forbidden and possibly a violation of federal or state law and regulations. Baylor Health Care System, its subsidiaries, and affiliates hereby claim all applicable privileges related to this information. ___ 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] PT testing for ER/PR by IHC
yes Joelle Weaver MAOM, HTL (ASCP) QIHC From: ihcman2...@hotmail.com To: histonet@lists.utsouthwestern.edu Date: Tue, 28 Oct 2014 12:55:34 -0500 Subject: RE: [Histonet] PT testing for ER/PR by IHC All, If you perform ER/PR staining by IHC, are you REQUIRED to participate in Proficiency Testing like that provided by CAP? Thank-you in advance, Glen Dawson BS, HT(ASCP), QIHC Histology Technical Specialist Mercy Health System Janesville, WI ___ 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] ALK IHC
Recently all the pathologists I work with prefer the ALK FISH. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 23 Oct 2014 13:41:15 -0700 From: marktara...@gmail.com To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] ALK IHC Does anyone stain lung cancer specimens for ALK using IHC? If not, any opinions? thanks Mark ___ 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] ALK IHC
I can tell you that my biggest trouble in all dealing with ALK was finding enough positive cases. Joelle Weaver MAOM, HTL (ASCP) QIHC From: joyce.we...@emoryhealthcare.org To: marktara...@gmail.com; joellewea...@hotmail.com CC: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] ALK IHC Date: Fri, 24 Oct 2014 20:29:42 + We've always done FISH.. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph’s Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Tarango Sent: Friday, October 24, 2014 3:49 PM To: Joelle Weaver Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] ALK IHC Did you ever run ALK IHC on lung cancer cases or have they always used FISH? thanks Mark Tarango On Fri, Oct 24, 2014 at 12:34 PM, Joelle Weaver joellewea...@hotmail.com wrote: Recently all the pathologists I work with prefer the ALK FISH. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 23 Oct 2014 13:41:15 -0700 From: marktara...@gmail.com To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] ALK IHC Does anyone stain lung cancer specimens for ALK using IHC? If not, any opinions? thanks Mark ___ 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 This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] ALK IHC
I can tell you that my biggest trouble in all dealing with ALK was finding enough positive cases. Joelle Weaver MAOM, HTL (ASCP) QIHC From: joyce.we...@emoryhealthcare.org To: marktara...@gmail.com; joellewea...@hotmail.com CC: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] ALK IHC Date: Fri, 24 Oct 2014 20:29:42 + We've always done FISH.. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph’s Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Tarango Sent: Friday, October 24, 2014 3:49 PM To: Joelle Weaver Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] ALK IHC Did you ever run ALK IHC on lung cancer cases or have they always used FISH? thanks Mark Tarango On Fri, Oct 24, 2014 at 12:34 PM, Joelle Weaver joellewea...@hotmail.com wrote: Recently all the pathologists I work with prefer the ALK FISH. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 23 Oct 2014 13:41:15 -0700 From: marktara...@gmail.com To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] ALK IHC Does anyone stain lung cancer specimens for ALK using IHC? If not, any opinions? thanks Mark ___ 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 This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] ALK IHC
I think it is probably better with the rabbit monoclonal IHC than maybe in the past. IHC is MUCH cheaper, easier and faster than the FISH. Doing ALK FISH manually was easier than Her2 FISH manual, but still takes much more time than any IHC, and is expensive ( but necessary for certain cases). Seems like the IHC would be nice screen with a reflex to FISH. Joelle Weaver MAOM, HTL (ASCP) QIHC From: richard.car...@hhchealth.org To: marktara...@gmail.com; Histonet@lists.utsouthwestern.edu Date: Fri, 24 Oct 2014 20:15:24 + Subject: RE: [Histonet] ALK IHC CC: We are in the process of bringing this on-line. We are using a rabbit monoclonal (clone D5F3) from Cell Signaling Technologies (Danvers, MA). There are cases that are obviously positive and then there cases that are Equivocal (like HER2) where you need to do the FISH test. The advantages of the IHC are less cost, faster result, can be used on specimens with limited tumor cells present, and it may prove useful for those tumors that show genomic heterogeneity. Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 (860) 545-2204 Fax -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Tarango Sent: Thursday, October 23, 2014 4:41 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] ALK IHC Does anyone stain lung cancer specimens for ALK using IHC? If not, any opinions? thanks Mark ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet 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, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ 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] ALK IHC
I can tell you that my biggest trouble in all dealing with ALK was finding enough positive cases. Joelle Weaver MAOM, HTL (ASCP) QIHC From: joyce.we...@emoryhealthcare.org To: marktara...@gmail.com; joellewea...@hotmail.com CC: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] ALK IHC Date: Fri, 24 Oct 2014 20:29:42 + We've always done FISH.. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph’s Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Tarango Sent: Friday, October 24, 2014 3:49 PM To: Joelle Weaver Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] ALK IHC Did you ever run ALK IHC on lung cancer cases or have they always used FISH? thanks Mark Tarango On Fri, Oct 24, 2014 at 12:34 PM, Joelle Weaver joellewea...@hotmail.com wrote: Recently all the pathologists I work with prefer the ALK FISH. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 23 Oct 2014 13:41:15 -0700 From: marktara...@gmail.com To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] ALK IHC Does anyone stain lung cancer specimens for ALK using IHC? If not, any opinions? thanks Mark ___ 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 This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] ALK IHC
I can tell you that my biggest trouble in all dealing with ALK was finding enough positive cases. Joelle Weaver MAOM, HTL (ASCP) QIHC From: joyce.we...@emoryhealthcare.org To: marktara...@gmail.com; joellewea...@hotmail.com CC: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] ALK IHC Date: Fri, 24 Oct 2014 20:29:42 + We've always done FISH.. Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph’s Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Tarango Sent: Friday, October 24, 2014 3:49 PM To: Joelle Weaver Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] ALK IHC Did you ever run ALK IHC on lung cancer cases or have they always used FISH? thanks Mark Tarango On Fri, Oct 24, 2014 at 12:34 PM, Joelle Weaver joellewea...@hotmail.com wrote: Recently all the pathologists I work with prefer the ALK FISH. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 23 Oct 2014 13:41:15 -0700 From: marktara...@gmail.com To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] ALK IHC Does anyone stain lung cancer specimens for ALK using IHC? If not, any opinions? thanks Mark ___ 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 This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Processors
Agree Joelle Weaver MAOM, HTL (ASCP) QIHC From: j.rowa...@alborglaboratories.com To: nguy0...@gmail.com; histonet@lists.utsouthwestern.edu Date: Thu, 23 Oct 2014 11:25:23 +0300 Subject: RE: [Histonet] Processors CC: hi colleague if your daily processed specimens less than hundred, go ahead for VIP5. Best Regards, Jamal M. Al Rowaihi Anatomic Pathology Supervisor | Al Borg Medical Laboratories | Mobile +966 503629832| j.rowa...@alborglaboratories.com Palestine St, Al Rajhi Building, P.O. Box 52817, Jeddah 21573, KSA| Phone: +966 12 670 0099 | Fax: +966 12 676 4984 | www.alborglaboratories.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of GMail Sent: Thursday, October 23, 2014 12:33 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Processors Please help me decide on a processor, I am currently inquiring about refurbished processors for a small derm path lab with very low volumes. I have quotes for VIP5 for $24-27k, VIP2000 for $8k, VIP E150 for $14k and a Leica TP1020 type 4 for $17. Which one would you recommend? What's durable and won't break down often? Should I go for the vip2000 compared to vip5 to save money? ___ 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] Histology Tracking systems
I have used a keyboard at embedding, but no mouse. The other tracking uses I have seen use scanning of bar codes or QR codes not keyboard or mouse entry. Joelle Weaver MAOM, HTL (ASCP) QIHC From: donna.wil...@baylorhealth.edu To: histonet@lists.utsouthwestern.edu Date: Thu, 16 Oct 2014 21:00:27 + Subject: [Histonet] Histology Tracking systems I know this might be a strange question but, do any Histology Labs out in Histoland use a keyboard and mouse at Embedding and Microtomy to perform tracking, slide label printing and Quality Assurance recording. Thanks in advance for your replies. Donna Willis, HT/HTL(ASCP) Anatomic Pathology Manager Baylor University Medical Center 3500 Gaston Ave|Dallas, Texas 75246 214-820-2465 office|214-725-6184 mobile BaylorScottandWhite.com ** This e-mail may contain confidential and/or privileged information. 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 (or have received this e-mail in error) please notify the sender immediately and destroy this e-mail. Any unauthorized copying, disclosure or distribution of the material in this e-mail is strictly forbidden and possibly a violation of federal or state law and regulations. Baylor Health Care System, its subsidiaries, and affiliates hereby claim all applicable privileges related to this information. ___ 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: Labeling Errors
Thanks Tim, these references are VERY helpful. Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: lcolb...@pathmdlabs.com; histonet@lists.utsouthwestern.edu Date: Tue, 14 Oct 2014 17:57:46 + CC: Subject: [Histonet] RE: Labeling Errors Laurie, The question to ask is, what is ACHIEVABLE with the technology you have in place? The term is ALRA or ALRP...As Low as Reasonably Achievable, or Possible. For instance, when we hand-wrote slide labels, and used offline cassette printers we accepted that we would have a rather high rate of human errors. Same with hand-applying labels after staining. With barcoding, printing cassettes directly from the LIS, printing and applying labels at the microtome our error rate is down by an order magnitude, but occasional errors still occur due to humans shortcutting the system, or faults in the system itself (ie, not flagging duplicate labels scanned). None of those errors are acceptable but we still need to figure out how to design the system to prevent them. The papers below give numbers to this problem. The patient ID error without automation came out to 4+ per 1000 specimens. The general error rate was/is: 1/100 with all hand-written workflow 1/1000 with LIS printing of cassettes and labels, but human-applied 1/10,000 with barcoding and single piece workflow throughout the system and interfaces to instruments (stainers) Makary MA et al. Surgical specimen identification errors Surgery 2007 Apr;141(4):450-5 Nakhleh RE, et al. Amended reports ... Q-probes study of 1,667,547 accessioned cases ... Arch Pathol Lab Med. 1998 Apr;122(4):303-9 Resar RK. Making noncatastrophic health care processes more reliable... Health Serv Res. 2006; 41:1677-1689. Tim Morken Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center San Francisco, CA CONFIDENTIALITY NOTICE: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential, proprietary, and/or privileged information protected by law. If you are not the intended recipient, you may not use, copy, or distribute this email message or its attachments. If you believe you have received this email message in error, please contact the sender by reply email and destroy all copies of the original message. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert Sent: Tuesday, October 14, 2014 10:21 AM To: Histonet Post (histonet@lists.utsouthwestern.edu) Subject: [Histonet] Labeling Errors Is there a national average or benchmark for acceptable labeling errors in Histology? Laurie Colbert HT (ASCP) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: white plastic scrapers
I believe at some point I got some at a paint shop like Sherwin Williams. Carry mine with me in my box of tools, works great. Joelle Weaver MAOM, HTL (ASCP) QIHC From: algra...@email.arizona.edu To: bmolin...@texasheart.org; Histonet@lists.utsouthwestern.edu Date: Tue, 14 Oct 2014 16:22:43 + CC: Subject: [Histonet] RE: white plastic scrapers Southeast Pathology was giving out scrapers at NSH this year but in case you didn't get one - go to the cooking section of Target or Walmart and see if they have a scraper to use on teflon surfaces. A squeegee works good on molten wax surfaces too. Otherwise, a snow scraper might work too. Retired but lurking, Andi G. From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Betsy Molinari [bmolin...@texasheart.org] Sent: Tuesday, October 14, 2014 5:04 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] white plastic scrapers Hi all, Where can I purchase the whit plastic scrapers used to scrape the paraffin off embedding centers and other surfaces. I believe ours went out with the trash. Thanks. Betsy Molinari HT(ASCP) Texas Heart Institute Cardiovascular Pathology 6770 Bertner Ave Houston,TX 77030 832-355-6524 (lab) 832-355-6812 (fax) http://www.texasheart.org Betsy Molinari Senior Histology Research Technician 832-355-6524 | bmolin...@texasheart.orgmailto:bmolin...@texasheart.org | www.texasheart.orghttp://www.texasheart.org 6770 Bertner Ave., MC 1-283, Houston, TX 77030 [Texas Heart Institute]https://secure3.convio.net/thi/site/SPageNavigator/GlobalSiteOptInPage.html[THI News] [THI on Facebook] http://www.facebook.com/Texas.Heart.Institute [THI on Flicker] http://www.flickr.com/photos/texasheart/sets/ [THI on Google] https://plus.google.com/u/0/118043615690351997044/posts [THI on Pinterest] http://pinterest.com/texasheartinst/ [THI on Twitter] http://twitter.com/Texas_Heart [THI on You Tube] http://www.youtube.com/TexasHeartInstitute ___ 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] TGIF
Wow, I have been up too long, sorry for the typos...I hope you all can get the point and joke. Happy weekend! Joelle Weaver MAOM, HTL (ASCP) QIHC From: joellewea...@hotmail.com To: timothy.mor...@ucsfmedctr.org; histonet@lists.utsouthwestern.edu Date: Fri, 26 Sep 2014 20:24:35 + Subject: RE: [Histonet] TGIF CC: This is super funny, Tim. My personal favorite is on occasion HR people have mispronounced as offered me a history position. Not sure what that would me I would do? Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: histonet@lists.utsouthwestern.edu Date: Fri, 26 Sep 2014 16:08:14 + Subject: [Histonet] TGIF Some fun for FRIDAY! http://histosearch.com/imageupload/what-my-friends-think-i-do-histotech/ Tim Morken Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center Box 1656 505 Parnassus Ave San Francisco, CA 94143 USA 415.514-6042 (office) tim.mor...@ucsfmedctr.orgmailto:tim.mor...@ucsfmedctr.org CONFIDENTIALITY NOTICE: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential, proprietary, and/or privileged information protected by law. If you are not the intended recipient, you may not use, copy, or distribute this email message or its attachments. If you believe you have received this email message in error, please contact the sender by reply email and destroy all copies of the original message. ___ 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] Dragon Voice Recognition software
The work that can be done in histology-pathology is endless! I know that in past positions that sometimes transcriptionists have felt threatened by voice recognition dictation and software when it was suggested. I don't really blame them for these feelings, but it never turned out the way they worried it might. Machines or computer software never completely replace people, they don't think, make decisions or have judgment. The people just have to function at a higher level or in an alternate way since the rudimentary processes for the people are reduced . I just set up Dragon dictation for the microscopic for the pathologists, but it will be in Orchard Pathology, so could not help with the interface to your system Ronnie. But it did not replace the information management function or its oversight, just changed the tasks that needed to be performed somewhat, and increased overall efficiency. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Fri, 26 Sep 2014 10:07:53 -0500 From: jaylundg...@gmail.com To: ronald.hous...@nationwidechildrens.org Subject: Re: [Histonet] Dragon Voice Recognition software CC: histonet@lists.utsouthwestern.edu I'd imagine it would really upset the transcriptionists, because you wouldn't need them anymore? On Thu, Sep 25, 2014 at 8:06 AM, Houston, Ronald ronald.hous...@nationwidechildrens.org wrote: Is anyone using this transcribing directly into Sunquest CoPathPlus? How successful was the transition, what problems did you encounter, and what resistance if any was there from pathologists, PAs and transcriptionists? Thanks Ronnie Houston, MS HT(ASCP)QIHC FIBMS Anatomic Pathology Manager ChildLab, a Division of Nationwide Children's Hospital www.childlab.com 700 Children's Drive Columbus, OH 43205 (P) 614-722-5450 (F) 614-722-2899 ronald.hous...@nationwidechildrens.orgmailto: ronald.hous...@nationwidechildrens.org www.NationwideChildrens.orghttp://www.nationwidechildrens.org/ One person with passion is better than forty people merely interested. ~ E.M. Forster ___ 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] MediaLab is Looking for Histology Course Authors
I wanted to say that when I have worked with Medilab on histology related courses in the past that it has been a great experience for me. I highly recommend it as a great learning opportunity for anyone who is interested in working with education, development and training in their practice area. I just wanted to give some first hand feedback, and encourage anyone who may have the interest or inclination to consider becoming an author or reviewer. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 25 Sep 2014 14:30:16 -0400 From: j...@medialabinc.net To: histonet@lists.utsouthwestern.edu Subject: [Histonet] MediaLab is Looking for Histology Course Authors Actively seeking authors to write and review online *histology courses* for *MediaLab*! MediaLab is a leading publisher of online continuing education (CE) courses and competency assessments. Our online products are used at more than 2,000 laboratories and university CLS/HT/HTL programs worldwide. This is a great opportunity to *gain resume-boosting publishing experience, **earn honorariums* for your participation, and fill the *need to provide quality histology CE credits*. Authors can take advantage of MediaLab's online CourseBuilder to *write courses anytime, anywhere*. CourseBuilder is easy to use, with an intuitive interface similar to Microsoft Word or PowerPoint. Authors can quickly create content pages, practice questions, and exam questions, and upload relevant images. Courses developed by MediaLab are *featured on our websites MediaLabInc.net and LabCE.com*. Questions from these courses also become part of the LabCE.com Quiz Game, with over 1,000 daily players. Authors and reviewers may also*contribute to other online programs that we develop on behalf of major laboratory partners*. To learn more about becoming a MediaLab author for histology courses, visit our online information page atwww.medialbinc.net/authors.aspx . Please contact Judi Bennett at j...@medialabinc.net or call 877-776-8460, ext. 721 . Thank you, Judi Judi Bennett, MT, BSM Program Director - MediaLab, Inc. e-mail j...@medialabinc.net Phone (877) 776-8460 ext. 721 cell phone 404-915-2999 fax (678) 401-0284 ___ 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: FDA Disclaimer
Tim has aleady supplied alot of information here. When I needed the disclaimer, I used the language and wording directly from the ANP checklist placed in quotations within the reports when I put together the basic templates in LIS. Depending on your system, you might be able to link it to the test mneumonic or other means to drop it in automatically when this test is ordered or reported in the final pathology report. Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: kaarring...@anthc.org; histonet@lists.utsouthwestern.edu Date: Wed, 24 Sep 2014 18:24:11 + CC: Subject: [Histonet] RE: FDA Disclaimer Karla, the thing is, they may be called IVD under FDA nomenclature, but they are not all FDA approved. Class I exempt antibodies (the vast majority) don't need FDA approval because they are ancillary tests used in conjunction with other tests to arrive at a Dx. Only stand-alone tests like ER, Pr, Her2 and EGFR are in Class II and require FDA approval. An FDA certified company can list any antibody (except the stand alones) as IVD Class I simply by submitting a list to FDA. The company must have FDA approved quality controls in place and follow a slew of regulations to do so, but it is simply a paperwork exercise after that. So, the disclaimer you mention says that the antibody in question is not FDA approved, but is not required to be FDA approved. The CAP and ASCP suggested this disclaimer so that customers would be made to understand that although the tests are not under FDA approval it does not mean they are not valid tests. Tim Morken Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center San Francisco, CA CONFIDENTIALITY NOTICE: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential, proprietary, and/or privileged information protected by law. If you are not the intended recipient, you may not use, copy, or distribute this email message or its attachments. If you believe you have received this email message in error, please contact the sender by reply email and destroy all copies of the original message. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Arrington, Karla A Sent: Wednesday, September 24, 2014 10:44 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] FDA Disclaimer To All: We are starting up IHC at the lab and I have a question about disclaimer. If we are using all FDA approved antibodies, do we need the FDA Disclaimer on our pathology reports? And if so, what should it say? Karla Arrington =) Karla Arrington, HT(ASCP), HIT(AHIMA) Lead Histology Technician ANMC Pathology 907-729-1810 kaarring...@anthc.org ___ 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] RE: Surgical Pathology reports
Pretty much same here. The policy I wrote complies with the ANP checklist for critical findings, give fairly broad scope the pathologist to determine when this is needed or just good patient care, and provides for documentation when this occurs. Joelle Weaver MAOM, HTL (ASCP) QIHC From: toni.rathbo...@rwjuh.edu To: debbie.l...@mgh.net; histonet@lists.utsouthwestern.edu Date: Tue, 23 Sep 2014 17:34:16 + CC: Subject: [Histonet] RE: Surgical Pathology reports Yes, more often than you may imagine. Unexpected findings are always called and documented. See ANP12175. Although not required, another reason is the courtesy extended by the pathologist to the physician. This may occur if a preliminary report is to be issued, or the final report not signed out while the pathologist waits for additional tests to be completed. The pathologist may call if he/she knows that the physician is especially interested in getting the results for patient care reasons, and wants to explain why there may be delays to the final report. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Lake,Debbie Sent: Tuesday, September 23, 2014 1:23 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] Surgical Pathology reports Do pathologists ever call pathology reports to a physician? If so, what types of diagnoses do they call? There are no critical test results in Pathology that CAP deems necessary to call as in other areas of the laboratory.. How do others handle this? Debra Lake MT(ASCP) Manager Micro, Blood Bank, Pathology Marion General Hospital Marion, IN 46952 (765) 660-6521 Fax: (765-651-7330) If you are not the intended recipient(s), you are notified that any disclosure, copying, distribution or any action taken or omitted to be taken in reliance on the contents of this information is prohibited and may be unlawful. If you receive this message in error, or are not the named recipient(s), please notify the sender, delete this e-mail from your computer, and destroy any copies in any form immediately. ___ 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] Control block/slide regulation question
No regulations that I can think of that stipulate a manufacturer produced control material must have a certain FDA status for use in a clinical facility, or that the producing facility must be CLIA or GLP. I think that manufacturers want to create an impression of their product by promoting it if they are CLIA licensed or a GLP facility. I know they often use pretty stringent quality control, with lot tracking and provide a certificate of analysis ( showing that they tested them in house and the results), with some control products. Which does show a good faith effort to establish the reliability of the control. However, since the burden of proving that any test system works in house is on the user ( CLIA CAP method validation), not the control producer, it seems they might be off the hook for meeting a specific regulation or accreditation requirement, especially with CLIA, since it is an old law targeting clinical laboratories. It is not that big of a leap though, and I can imagine that someone could argue that a faulty control could cause or contribute to patient risk by leading to erroneous test interpretations ( enter FDA regulations). Manufacturers may not be bound to any specific legal requirements, but it seems to me that it would be bad business if over time, their controls never worked for any lab! More research oriented people may be able to comment if control material is used for FDA trials or other research, whether there is an actual legal, regulatory or GLP requirement, that the source or distributor of controls be CLIA, GLP or otherwise licensed or accredited for this type of work? Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: histonet@lists.utsouthwestern.edu Date: Tue, 16 Sep 2014 19:24:58 + Subject: [Histonet] Control block/slide regulation question Histonetters, question came up about whether there are any regulations concerning where control blocks or slides are made. Specifically, whether a control TMA block must be made in a CLIA certified lab, as opposed to a research core facility. I don't think there are any such regulations but would like to hear from anyone who has other knowledge. From what I know all that is required is that the TMA block/slides be validated per CLIA regulations within the CLIA -certified lab that is using them. I've never known a vendor of controls to give any information concerning any type of FDA regulatory designation (IVD) either. So are they regulated at all? (maybe I should not even ask at the risk of giving them some bright ideas!?). Tim Morken Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center USA 415.514-6042 (office) tim.mor...@ucsfmedctr.orgmailto:tim.mor...@ucsfmedctr.org CONFIDENTIALITY NOTICE: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential, proprietary, and/or privileged information protected by law. If you are not the intended recipient, you may not use, copy, or distribute this email message or its attachments. If you believe you have received this email message in error, please contact the sender by reply email and destroy all copies of the original message. ___ 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: Radioactive specimens policy
Had CAP inspection yesterday, while this was not specifically raised as an issue, my pathologist advised me to address in policy even though it is not terribly applicable in this lab situation. I was able to include with the exclusion list, specifically addressing the seeds and breast masses, sentinel lymph nodes, and this works with this being a reference facility that has no attached surgical facilities and so already has limits on the specimen types accepted for testing. This most likely would not suffice for a hospital situation. So short answer, I put a policy statement together within another policy, but a free standing policy might be needed depending on how much you see/handle these types of specimens. Hope this helps. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 4 Sep 2014 13:16:28 -0400 From: rsrichm...@gmail.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: Radioactive specimens policy Amanda Reichard, HTL (ASCP)cm, at Licking Memorial Health Systems in Newark, Ohio asks: Would anyone be willing to share their policy/procedure for radioactive specimen acceptance, transport, storage, and disposal? - We are currently revising our policy and would like to see what precautions, if any, other institutions establish in the laboratory. I've never seen a written policy - these questions are customarily swept under the rug - but I've seen references though I have no very current ones. By far the most common specimens are breast masses and sentinel lymph nodes with technetium 99m, which has a half-life of only 6 hours. These specimens don't require any special handling beyond Universal Precautions. I haven't been able to get a lot of information about the radioactive seeds used to treat prostate cancer, and occasionally received in TURP specimens. The isotopes used have half-lives of around 70 days, so they would be regarded as being potentially hazardous for around two years (ten half-lives). It usually takes a phone call to find out how long ago the seeds were put in. Bob Richmond Samurai Pathologist Maryville TN ___ 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] QIHC test
Dako education guides, available from their website. Not answer books, but good for reviewing theory. If the MSH one is like their other study guides, the learning activity is to look up and fill in the answers from other resources materials. Joelle Weaver MAOM, HTL (ASCP) QIHC From: amber.mcken...@gastrodocs.net To: histonet@lists.utsouthwestern.edu Date: Wed, 3 Sep 2014 14:26:52 + Subject: [Histonet] QIHC test I ordered the MSH online study guide for the QIHC, but it was only questions...no answer key in the back. What books am I supposed to get the answers from? Any other study suggestions? Thanks! ___ 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] Funny, hope link works
http://tissuepathology.com/2014/08/28/bye-bye-88305-sung-to-american-pie/#axzz3Bn0mloT9 Joelle Weaver MAOM, HTL (ASCP) QIHC ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] IHC Validation:
Yes, ultimately up to lab director/medical director/pathologist as to determination of specificity, selectivity, and if you have enough examples, and the staining reactivity conforms to the intended clinical use during their assessment and hopefully approval of your protocol. I have used some TMAs with success, especially if you make with your own in-house processed tissues. I try to strongly favor using several expression levels of normal and diseased tissue whenever possible that reflect what it will be used for in the patient test tissues. If single sections, I try use both expected or known negative and positive tissue both normal and diseased , when practical for the first validation set when I get past optimization. For small adjustments I may need only a few more confirming positives- up to MD in my situation. I also have polymer detection, but I still like some negatives for me. Some people may not feel this is necessary, and the pathologist may not need the negatives ( using internal controls), but this helps me, so I do it to feel more confident in my results as I present the slides for review. I don't see why you couldn't use internal negatives, if you clarify what tissue element acts as the internal negative in the tissue type in the validation summary and SOP. Basically, for amount or # to stain, I follow the CAP guidelines ( newer ones), for well characterized. For markers with specific guidelines for validation and correlation, I follow the CAP guidelines exactly. Setting up the process/SOP s, I used the CLSI guidebook on validation of IHC assays. Both resources (CAP CLSI) have been very helpful for me. That is what has been working for me, I hope this helps. Joelle Weaver MAOM, HTL (ASCP) QIHC From: craiga...@gmail.com Date: Fri, 29 Aug 2014 10:29:15 -0700 To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] IHC Validation: How do most people validate IHC? I want to create a tissue microarray. I wanted to use an average of 6-8 positive tissues. Is it necessary to validate using negative tissues when there is always an internal negative control in all tissue sections. Now with new polymer detection systems there is not background, etc. Is IHC validation ultimately up to the discretion of the laboratory director? Please advise. Thx- Sent from my iPhone ___ 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] On the lighter side...
Jim, you and many others who have devoted so much of your lives to this craft profession, are appreciated by all of us who have learned and benefited from your knowledge and years of experience over the years. Thanks to ALL of you who have stuck in there the decades of time needed to gather all those experiences, and especially for being willing to share with us. It is people like yourself, and Peggy, and many others too numerous to name in an email, that keep the rest of us inspired to keep going when we get weary! Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Fri, 8 Aug 2014 08:40:42 -0400 From: renafa...@gmail.com To: jburc...@gmail.com Subject: Re: [Histonet] On the lighter side... CC: histonet@lists.utsouthwestern.edu; lisa.whi...@va.gov 37 years On Friday, August 8, 2014, Jim Burchette jburc...@gmail.com wrote: 40 blessed years that I would not trade for anything. I have met so many wonderful people (well, maybe a few not so wonderful...) and have learned so much. The good Lord has blessed me with a talent that I feel has allowed me to make a contribution to society. On Friday, August 8, 2014, White, Lisa M. lisa.whi...@va.gov javascript:; wrote: 15 years as HT...26 years total in medicine started as an EMT and after some time discovered that patients in a jar is a blessing J thus the transfer to Pathology..and that is the rest of the story. Lisa White, HT(ASCP) Classification: Internal and External Use\\Not VA Sensitive This message has been categorized by White, Lisa M. on Friday, August 08, 2014 at 7:32:08 AM in accordance with VA Handbook 6500 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu javascript:; javascript:; http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- Jim Burchette Fly Fishing Bum *'(((* ___ Histonet mailing list Histonet@lists.utsouthwestern.edu javascript:; 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] questions
Priority driven block order, by specimen type/protocol, defined in SOP ( TAT for 'stat, ASAP routine) Fixation is monitored for all tissues, just easier to do all the same, made entry field in LIS, and tracking log for manual back up for computer down times. Keep to CAP guidelines for breast, 6-72, disclaimers when needed for alternate fixation, decal, or missing times such as for referrals where it is not sent or recorded. I am the only, technical person, but this is what I do for SOP as of right now. Congrats on up coming retirement! Joelle Weaver MAOM, HTL (ASCP) QIHC From: dorothy.l.w...@healthpartners.com To: histonet@lists.utsouthwestern.edu Date: Thu, 7 Aug 2014 11:54:00 -0500 Subject: [Histonet] questions I have a couple of questions to ask where there is no right or wrong answer, just curious as to the process that other labs use. 1. After processing, how do you determine the order in which to cut and stain the blocks..numerical or priority driven? 2. Do you adhere to the 6-72 hours of fixation for breasts or make certain all breast tissue is fixed for a minimum time of, say, 24 hours but, of course no longer than 72? I appreciate your responses and thanks for your time!! I am retiring at the end of this year and trying to optimize some processes beforehand:). Dorothy Webb, HT (ASCP) Regions Histology Technical Specialist 651-254-2962 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 communication in error, please return it to the sender immediately and delete the original message and any copy of it from your computer system. If you have any questions concerning this message, please contact the sender. Disclaimer 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] RE: Glassware Cleaning, CAP Checklist Item GEN.41770
Do the same as Brian. It is not that involved really, and its not worth getting a deficiency over. Joelle Weaver MAOM, HTL (ASCP) QIHC From: bcoo...@chla.usc.edu To: lcolb...@pathmdlabs.com; histonet@lists.utsouthwestern.edu Date: Tue, 5 Aug 2014 19:07:05 + CC: Subject: [Histonet] RE: Glassware Cleaning, CAP Checklist Item GEN.41770 I've never been asked by a CAP auditor either, but our internal inspectors used to inquire about this in a previous lab all the time. We use Bromocresol Purple as an indicator here, and we have a simple log sheet wherein our crew just tests one piece of cleaned glassware each day. They write the type of glassware they test, and place a checkmark in a yellow or purple column based upon what they see. If purple, they rewash, retest and document accordingly. Brian D. Cooper, HT (ASCP)CM | Histology Supervisor Department of Pathology and Laboratory Medicine Children's Hospital Los Angeles 4650 Sunset Blvd MS#43- Los Angeles, CA 90027 Ph: 323.361.3357 Pager: 213-209-0184 bcoo...@chla.usc.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert Sent: Tuesday, August 05, 2014 11:06 AM To: Histonet Post (histonet@lists.utsouthwestern.edu) Subject: [Histonet] Glassware Cleaning, CAP Checklist Item GEN.41770 Do others in Histology follow these CAP Guidelines for cleaning glassware? I'm not sure if this question actually applies to Histology. I have never had an inspector ask me about it, but I'm wondering if anyone has been questioned. Laurie Colbert, HT (ASCP) Histology Supervisor PATH MD 8158 Beverly Blvd. Los Angeles, CA 90048 (323) 648-3214 direct (424) 245-7284 main lab The information contained in this transmission may contain privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only for the use of the person(s) named above. If you are not the intended recipient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. ___ 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 or legally 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 this 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] looking for equipment
Marie Get back in touch with me in about a month if you have not found what you need. I may have most of the basic items ( microtomes, H E stainer, tissue processors, oven, hot plates, other stuff) up for grabs soon. Thank you Joelle Weaver MAOM, HTL (ASCP) QIHC From: tas...@live.com To: histonet@lists.utsouthwestern.edu Date: Thu, 17 Jul 2014 07:53:26 -0400 Subject: [Histonet] looking for equipment Hi Histonet family, I'm looking for operational histology equipment or ones that might need minor repairs. If anyone wants to get rid of any, can you kindly inform me. I will take care of any shipping expenses. You may contact me Marie (HT)at 410-371-6051 or email me at tas...@live.com Thank you ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Storage of HER2 neu control slides
I do the complete drain dry, date, then refrigeration. Use them within 6 weeks. The Oracle IVD, IFU says bake overnight, but I don't see that happening too often. Joelle Weaver MAOM, HTL (ASCP) QIHC From: richard.car...@hhchealth.org To: lseb...@uwhealth.org; Histonet@lists.utsouthwestern.edu Date: Mon, 14 Jul 2014 14:22:43 + CC: Subject: [Histonet] RE: Storage of HER2 neu control slides We keep all of our positive control slides at RT. The breast predictive marker slides often sit for a few weeks (after cutting) before being used. I think everyone's situation will be different due to laboratory humidity, tissue fixation, and tissue processing which removes the water from the tissue which has been shown to be the one of the culprits in antigen degradation in stored unstained slides. Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 Office (860) 545-2204 Fax richard.car...@hhchealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A Sent: Monday, July 14, 2014 8:44 AM To: Histonet (Histonet@lists.utsouthwestern.edu) Subject: [Histonet] Storage of HER2 neu control slides Good morning, I'd like to get some opinions on the storage of positive control slides for HER2 neu. We currently keep a number of positive control slides in a -20 degree freezer as some antigens tend to lose reactivity at room temperature; ER and PR come to mind. What has peoples' experiences been with the storage of these control slides? Thanks for any and all replies, Linda Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory 600 Highland Ave. Madison, WI 53792 (608)265-6596 FAX: (608)262-7174 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet 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, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ 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: Formalin in the OR
Thank you for your story about this patient event with formalin in the OR. I am sometimes confronted with the response that I am overly detailed about things and particularly with regulations and safety. If you have never experienced something like this, it is easy to get lax and expect that it will never occur.This is a good reminder, that while mistakes like this one may be infrequent, when they do happen it can be terribly tragic. No one ever wants to be involved with anything remotely similar to the circumstance you describe. In my opinion, just best to do everything you can think of to not even invite the possibility. Keep the formalin where you can limit the handlers and potential mix ups as much as possible! Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Fri, 13 Jun 2014 20:31:10 + From: koelli...@comcast.net To: tbr...@holyredeemer.com Subject: Re: [Histonet] RE: Formalin in the OR CC: histonet@lists.utsouthwestern.edu Heartbreakingly sad, I do not know where the current regulations are but safety, as Terri rightly pointed out, is an accident that did happen. Not an anecdote, you can look up March 1985, Jackson Memorial Hospital in Miami (years after I left). Patient went to surgery, had some cerebrospinal fluid (CSF) removed during operation but an UNMARKED container of gluteraldehyde (aldehyde) fixative got marked as CSF with all the comings and goings over many hours. When the CSF was set to be reinjected as replacement, the fixative got reinjected as replacement instead of his CSF. Patient obviously died. Can't believe that is the only actual safety issue that has ever cropped up with surgery and formalin. So maybe a warning for both; no unlabeled bottles and no fixative right in the actual surgery suite. Ray Seattle WA - Original Message - From: Terri Braud tbr...@holyredeemer.com To: histonet@lists.utsouthwestern.edu Sent: Friday, June 13, 2014 10:52:43 AM Subject: [Histonet] RE: Formalin in the OR Wow, this is such a safety issue with an accident waiting to happen. I totally agree with Peggy that Formalin should not be allowed in an OR room. Even a gallon spill would be cause to evacuate and can you imagine the consequences of that? We have a small room off of the OR suites stocked with a 5 gallon carboy over a 5 gal spill container Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 2. Re: Formalin in operating (surgery) rooms (Lee Peggy Wenk) -Original Message- From: Lee Peggy Wenk Sent: Friday, June 13, 2014 7:44 AM To: Candace J. Wagner ; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Formalin in operating (surgery) rooms I think this is mostly a safety issue, and suggest NOT allowing any amount of formalin in OR/surgery rooms. - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ 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] Should I leave histology world
Yes thanks for the perspective. I have a bias towards my own experience, and this seems to be good advice. I work in a molecular based lab now and they are very unaware of what it typically is like in a clinical histopathology lab. Good to point other environments are out there that are clinical, and also that research in general can be very different than clinical settings. Some people are just more suited to certain environments over the other. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Wed, 4 Jun 2014 01:32:11 + From: koelli...@comcast.net To: joellewea...@hotmail.com CC: timothy.mor...@ucsfmedctr.org; optimusprimehistot...@hotmail.com; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Should I leave histology world Alpha Histotech- I'll put in my few words even though I'm not active anymore and possibly from different perspective. But also using a few assumptions and if my assumptions are wrong then the rest of what I say is probably meaningless. Not IDíng your e-mail address but if you've worked 3 jobs nightshift including a large reference lab, do you live near a big city? And if so is it a city close to a college or university. Research histology should not be overlooked. You will find many molecular or other such non-histo labs that actually do some or even a lot of histology by non-histology personnel or lab workers. Sometimes it is OK, sometimes even great. Sometimes, and I witnessed it, it is at an embarrassing histo level. I can walk up or down university hallways and see a genetics lab or some other molecular lab and see a microtome or cryostat in there. Sometimes those PI's will send histo work to a core lab. Sometimes they don't want to pay per block so do it (and staining and IHC and FISH) themselves. Someone with even minimal wide-ranging histo experience might be welcomed. No timed block cutting counts. Learn some immunology, genetics, molecular techniques, comparative medicine, physiology, etc, etc along the way. Many places even pay for college level courses while employed there. Just a thought if you are near that kind of area. Ray in Seattle From: joelle weaver joellewea...@hotmail.com To: Timothy Morken timothy.mor...@ucsfmedctr.org, Alpha Histotech optimusprimehistot...@hotmail.com, histonet@lists.utsouthwestern.edu Sent: Tuesday, June 3, 2014 5:55:09 PM Subject: RE: [Histonet] Should I leave histology world It would be a shame to get discouraged now after all the time you have already put into histology. If you still want to work in histology, I might suggest you try to have a conversation with a manager, supervisor or lead tech and see if they are willing to support you. Tell them you want to spend more time cuting to be able to section with high quality at the rate that works for their productivity standards. If you present it as a win-win proposition, see what resources, people and time they are willing to chip in to help get where they would like you to be. Make some metric or rate to achieve in microtomy your goal for the year, and put it into writing ( good for all goals:). Or if that is too uncomfortable , approach someone individually whose microtomy skills you admire , and see if they are willing to provide some tips and guidance off work time. I also went through a NAACLS program. Still at my first real histology job , the realization that this was the actual training became apparent very quickly. I had moments of exhaustion and feeling overwhelmed, but I now feel I was also fortunate to work initially at a pretty high volume place. It was a great breaking in for embedding and microtomy. Luckily there were also some experienced techs there who saw how much I wanted to learn, and were willing to help me get better. The constructive criticism stung sometimes, but they did me a huge service. But believe me, not everyone was helpful or supportive along the way. Try to ignore those kind of people as much as possible. And I still get criticized sometimes, make mistakes, and I still have more to learn. But here are a couple of other options for you to consider before you decide to leave, and what I did to get more experience when in your situation more quickly; Take on a second histology job that targets specific skills, tissue, or techniques you want more experience in. Believe me I have been criticized and misunderstood for this choice s well many times, but personally I do not regret any of those experiences now. I also feel that small labs are nice to build well rounded skills since you are usually more of a jack of all trades and have less tendency to do one task over your whole shift from day to day. Sometimes you just have to identify the environment that is the right fit for you. Best of luck to you- and let us know how things turn out! Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: optimusprimehistot
RE: [Histonet] Is antigen retrieval open on the Leica BOND RX IHC autostainer?
I don't have the research toggle, but my understanding while at Leica training was that this provided a good amount of flexibility and open-ness. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 2 Jun 2014 13:57:57 -0700 From: wesley.mi...@gmail.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Is antigen retrieval open on the Leica BOND RX IHC autostainer? Hello Everyone, As the title would imply, can anyone speak to the ability to use third-party (i.e. lab made, BD Pharm, etc.) antigen retrieval in the Leica BOND RX automatic IHC stainer? Thanks in advance for the help. Best Regards, Wes -- Wesley C. Minto Research Drug Discovery http://www.bmrn.com/ 530-300-3235 http://plus.google.com/102090614899007051039?prsrc=3 https://twitter.com/wesley_minto ___ 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] Should I leave histology world
It would be a shame to get discouraged now after all the time you have already put into histology. If you still want to work in histology, I might suggest you try to have a conversation with a manager, supervisor or lead tech and see if they are willing to support you. Tell them you want to spend more time cuting to be able to section with high quality at the rate that works for their productivity standards. If you present it as a win-win proposition, see what resources, people and time they are willing to chip in to help get where they would like you to be. Make some metric or rate to achieve in microtomy your goal for the year, and put it into writing ( good for all goals:). Or if that is too uncomfortable , approach someone individually whose microtomy skills you admire , and see if they are willing to provide some tips and guidance off work time. I also went through a NAACLS program. Still at my first real histology job , the realization that this was the actual training became apparent very quickly. I had moments of exhaustion and feeling overwhelmed, but I now feel I was also fortunate to work initially at a pretty high volume place. It was a great breaking in for embedding and microtomy. Luckily there were also some experienced techs there who saw how much I wanted to learn, and were willing to help me get better. The constructive criticism stung sometimes, but they did me a huge service. But believe me, not everyone was helpful or supportive along the way. Try to ignore those kind of people as much as possible. And I still get criticized sometimes, make mistakes, and I still have more to learn. But here are a couple of other options for you to consider before you decide to leave, and what I did to get more experience when in your situation more quickly; Take on a second histology job that targets specific skills, tissue, or techniques you want more experience in. Believe me I have been criticized and misunderstood for this choice s well many times, but personally I do not regret any of those experiences now. I also feel that small labs are nice to build well rounded skills since you are usually more of a jack of all trades and have less tendency to do one task over your whole shift from day to day. Sometimes you just have to identify the environment that is the right fit for you. Best of luck to you- and let us know how things turn out! Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: optimusprimehistot...@hotmail.com; histonet@lists.utsouthwestern.edu Date: Tue, 3 Jun 2014 22:51:31 + Subject: RE: [Histonet] Should I leave histology world CC: Alpha, it is clear to me, after 30+ years in the field, that some are born with the ability to cut fast AND do well at it. The rest of us just have to work harder at developing that skill. But it does take bench time to do it. A recent cache is that it takes 10,000 hours to become an absolute expert at something - that's about 5 years full time work. And that's just one skill. It sounds like you need some good teachers (ie, those who like to teach and like having their students do well). That would be the highest priority if you want to stay in the field as a bench tech. If the factory job isn't working out why not look for a smaller lab in which you can get more extensive experience? I really value the fact that spent my first 11 years in a 4- person lab in which we did everything from grossing to histo to immunos to EM. It may pay less initially but may add more value to your lifetime career. Tim Morken Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center San Francisco, CA -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Alpha Histotech Sent: Tuesday, June 03, 2014 1:35 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Should I leave histology world Hi everyone, I wouldn't give too much detail information as the histology world is very small and everyone knows everyone. I am in a dilemma. I have been a histotech (ASCP HT) for almost 6-7 yrs. I went to a NAACLS school and have a Associate in Science in Histology. In the 6-7 yrs I have changed jobs 3 times. All the jobs were graveyard shifts. The first place I worked for was Quest Diagnostics and I did a good 3 yrs. The other 2 places I won't mention and I currently still have a histology job. My problem is all the places I worked were factory style lab work and they all did derm work. In my career I really only embedded most of the time. I did occasional other stuff like special stains both by hand and using Dako Artisan and other things like cytology cytospin. But I never got to develop in cutting. My first job in quest..I maybe cutted one time for 2 or 3 weeks before they yanked
RE: [Histonet] RE: Microtome
Also my favorite Joelle Weaver MAOM, HTL (ASCP) QIHC From: bcoo...@chla.usc.edu To: sylvia.shoc...@clinicalpathologyassoc.com; histonet@lists.utsouthwestern.edu Date: Mon, 2 Jun 2014 22:04:45 + CC: Subject: [Histonet] RE: Microtome Don't know if you can get one, but far and away, my favorite microtome of all time is the Microm HM-325 (not the newer HM325-2's). Block orientation can be accomplished one handed because of the positioning of the orientation screws (X orientation at left, and Y atop the chuck). The plate on the knife holder and base upon which rests the blade carrier assembly is black in color. Doesn't sound like much, but this helps tremendously in visually aligning the block face to the knife when you have to recut blocks. And these are the easiest microtomes in the world to adjust. I was a supervisor at a reference lab with 14 of these microtomes. I've repaired these when someone has overtightened levers on far too many occasions to count and it is a snap to do so. All you need is a set of allen wrenches and a screwdriver or two. Good luck! Brian D. Cooper, HT (ASCP)CM | Histology Supervisor Department of Pathology and Laboratory Medicine Children's Hospital Los Angeles -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sylvia Shockey Sent: Monday, June 02, 2014 2:20 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Microtome Hello, My name is Sylvia Shockey I work in a histology lab. One of our microtomes is not working properly and would appreciate some advice on purchasing a new one or maybe refurbished. I have had some quotes on a Tanner scientific manual rotary microtome, titan 5000 . Thermo Shandon Finesse and a Thermo Shandon Microm HM325. Mr. Grimm with Thermo fisher has new and used on both of these models. Help me please I don't want to buy a clunker. Thanks for your time. ___ 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 or legally 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 this 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] Jobs for MBAs
Think about lab operations, account manager for a vendor, there are some research and pharma companies with various levels of management, office -practice management, if you are also good with IT, LIS analyst, manager of analysts, business analyst, implementation specialist ( LIS vendors), various types of consulting-J These are just off the top of my head, but the lab is a business and we need people who understand the clinical, the business operations, sales markets. There are probably many options out there depending on your specific experience, interests and inclinations. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Wed, 28 May 2014 18:35:33 -0400 From: igor.deyn...@gmail.com To: Histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] Jobs for MBAs Dear Histonetters, I am wondering if there are any job opportunities for someone with MBA in Marketing Operations? I'm a former scientists and was a Histotech, managed a lab and developed from scratch a histology core facility at a medium size pharma company. I went to get an MBA and finishing soon and want to return into science but from Business side. So, wondering if there are any potential opportunities in Histotechnology for MBAs. I would appreciate any leads and advice. Thank you very much. Igor Deyneko D'Amore - McKim School Of Business Northeastern University 360 Huntington Avenue, Boston, 02116 ___ 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] HER2
Thank you Josie this is very helpful. Joelle Weaver MAOM, HTL (ASCP) QIHC Subject: RE: [Histonet] HER2 Date: Wed, 14 May 2014 07:22:39 -0400 From: jcbrit...@cheshire-med.com To: joellewea...@hotmail.com; histonet@lists.utsouthwestern.edu We use Integrated Oncology-Lab Corp, 521 West 57th Street, 6th floor, New York, NY 10019 800-447-5816 Josie Britton HT (ASCP) QIHC Cheshire Medical Center 580 Court Street Keene, NH 03431 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of joelle weaver Sent: Tuesday, May 13, 2014 6:12 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] HER2 Hi Histonetters I am looking to compile a list of potential sites do send out Her2 slides for correlation on a validated assay. I have the Bond, using Refine detection. My clone is the Cb11, Oracle. Thanks in advance for any information you can provide. Joelle Weaver MAOM, HTL (ASCP) QIHC ___ 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
RE: [Histonet] Scale or Balance
Mopec, did you try them? They make a lot of items for the gross room morgue. Joelle Weaver MAOM, HTL (ASCP) QIHC From: jpi...@wtbyhosp.org To: histonet@lists.utsouthwestern.edu Date: Wed, 14 May 2014 16:01:17 + Subject: [Histonet] Scale or Balance Hey Everyone, Does anyone know of a good brand/vendor for a balance (with a weighing dish) for the gross room? Thanks, Jessica Piche, HT(ASCP) CONFIDENTIALITY NOTICE: This email and any attachments contain confidential information that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulation. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and delete these documents. Copyright (c) Waterbury Hospital ___ 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] HER2
Hi Histonetters I am looking to compile a list of potential sites do send out Her2 slides for correlation on a validated assay. I have the Bond, using Refine detection. My clone is the Cb11, Oracle. Thanks in advance for any information you can provide. Joelle Weaver MAOM, HTL (ASCP) QIHC ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Re: specimen release
I remember when I lived in Ohio there was statute regarding release of POC to parents who were permitted to have it returned to them for mass burial as a formed fetus. The legislature extended the burial right to earlier gestation, and for the most part it was truly not to the point of recognition as a fetus on gross. I don't remember the gestational age, but it was early. We had to package it in a special protected manner, transfer to 70% ethanol as I remember, and they signed some sort of release or consent. The actual transfer to them was done by pastoral care. On other rare occasions, patients or their families have wanted other tissues. It went kind of the same way ( after sign out 2 week period), with consent, and agreement to dispose in accordance with local regulations, except for no pastoral care. My suspicion is this may be something that varies by state statute. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 5 May 2014 16:52:21 -0400 From: rsrichm...@gmail.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: specimen release Gale Limron HT,CT (ASCP), Histology Supervisor, Union Hospital, Dover, Ohio 44622 asks: We are looking into revising our policy/release form regarding the release of specimens to patients and I am interested in knowing what others are doing. This practice (gallstones, tonsils, etc.) has been pretty well stopped by the regulatory agencies, JCAHO I think. To no one's regret. There are some special problems: amputated legs and breasts for burial, fetuses, placentas for (uh, never mind) - and all of these are worth developing policies for. Off-topic, Gale, but congratulations on qualifying both as a histotechnologist and a cytotechnologist. This is going to become a necessity in small hospitals in the very near future. Bob Richmond Samurai Pathologist Maryville TN ___ 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] IHC imaging systems
Amen... the time investment for validation! Celebrate when it is completed :) Joelle Weaver MAOM, HTL (ASCP) QIHC From: michael.lafrini...@ccplab.com To: pat...@gmail.com; histonet@lists.utsouthwestern.edu Date: Thu, 17 Apr 2014 12:57:37 + Subject: RE: [Histonet] IHC imaging systems CC: I am setting up the Ventana system and performing validation, it's taking a little longer to set up then expected but the support has been excellent. Hopefully will have it running and validated in the next few months. Validation is the time consumer I found with setting up a system. Michael R. LaFriniere, HT (ASCP) Executive Director Capital Choice Pathology Laboratory 12041 Bournefield Way, Suite A * Silver Spring, MD 20904 P: 240.471.3427 * F: 240.471.3401 * Cell 410-940-8844 michael.lafrini...@ccplab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello Sent: Tuesday, April 15, 2014 12:59 PM To: HistoNet Subject: [Histonet] IHC imaging systems Hello out there in Histoland, If any of you out there in the clinical environment are using imaging systems to quantify IHC slides, please let me know what system you are using. We are currently using a system that was provided through Dako, but they no longer support it. So time to consider buying a new one. It needs to have an algorithm that allows the system to distinguish between labelled and not labelled cells and the percentage of each. Thanks in advance, Paula -- Paula Sicurello, HTL (ASCP) Supervisor, Clinical Electron Microscopy Laboratory Duke University Health System Rm.#251M, Duke South, Green Zone Durham, North Carolina 27710 P: 919.684.2091 HIPAA Privacy Notification: This message and any accompanying documents are covered by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521, and contain information intended for the specific individual (s) only. This information is confidential. If you are not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, copying or the taking of any action based on the contents of this information is strictly prohibited . If you have received this communication in error, please notify us immediately by e-mail, and delete 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 mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Retirement
Yes we all appreciate knowledgable, helpful honest vendors. We all depend on each other. Never had the pleasure to meet you, but wish you many wonderful retirement years! Joelle Weaver MAOM, HTL (ASCP) QIHC From: lbla...@digestivespecialists.com To: wvantilb...@general-data.com; histonet@lists.utsouthwestern.edu Date: Tue, 15 Apr 2014 15:39:02 -0400 CC: Subject: [Histonet] RE: Retirement Congratulations on your retirement! May you enjoy your time and remember you're supposed to take a picture of the sunrise on your first day of retirement! And personally I don't think vendors are frowned upon. They are full of wise info. What's frowned upon is blatant advertising. Even then the delete key is on the keyboard. Good Luck! Linda Blazek HT (ASCP) Manager/Supervisor GI Pathology of Dayton Digestive Specialists, Inc Phone: (937) 396-2623 Email: lbla...@digestivespecialists.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of VanTilburg, Walt Sent: Tuesday, April 15, 2014 3:18 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Retirement I know it is frowned upon for vendors to write to Histonet, but I hope you will indulge me as I have no easy way to say good bye to some great people. I am retiring next Tuesday the 22nd and for the past 11 year I have met many of you in histo land and have enjoyed the help you all have given me. Without fail every time I entered a lab you unselfishly answered my questions and helped me understand the work flow in the AP labs. For the first couple of years I had to write down and Google almost every third word you said, but I started to catch on and you input and our discussions helped to shape the products that we developed. For that I am grateful. I met a lot of people and made a lot a good friends and saying good bye is hard but the truth is you wore me out and I need to take a break. I would list all of the folk who were especially helpful but the list would be really long so this is just a blanket thank you and good bye. Walt Walter Van Tilburg Vice President of Business Development General Data Healthcare, Inc. 26500 Bruce Road Bay Village, Ohio 44140 440-823-5495 - Mobile 440-808-8983 - Office 440-808-8995 - Fax wvantilb...@general-data.com Visit our web site http://www.general-data.com/healthcare/ Great news! Triangle Biomedical Sciences (TBS) is now a division of General Data Healthcare! Visit us online at www.general-data.com/hc and www.trianglebiomedical.com. http://www.general-data.com/news/general-data-acquires-triangle-biomedical-sciences This email may contain confidential General Data Company, Inc. information: any unauthorized or improper disclosure, copying, distribution or use of the contents of this email and attached document(s) is prohibited and may be a criminal offense. The information contained in this email and attached document(s) is intended only for the personal and confidential use of the recipient(s) named above. If you received this email in error, please reply immediately to the sender delete this message and the attached document(s) without disclosure. ___ 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] Problems with processors and dehydration
sounds like you have been through the drill with this one. Did you already test the solutions with a hydrometer carry over contamination? If the lines are clogging, I would guess things must be co-mingling, intermixing and being flushed back into another station. If it skips stations, well no wonder the tissue is not processing. I wish I could see the tissue ( and instrument), but your description of the tissue when sectioning, makes me wonder if you have carry over of water in the graduated alcohols. Does the tissue float in the molten paraffin with little air bubbles sometimes if gently pressed? No dehydration , no infiltration, will be spongy and pop or almost peel out. Did they tell you what was sitting in the lines during rebuild? I would just replace this thing- it is not worth losing patient tissue if it cannot be corrected after all this. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Sat, 12 Apr 2014 21:41:45 -0400 From: hrfulk...@gmail.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Problems with processors and dehydration I have had some horrible luck with a processor that was purchased new 3 years ago, I won't mention the name. It worked great for 2.5 years, perfect specimens coming off. Then problems started with clogged lines , long drains skipped stations, etc. The company took it back to workon it b/c they couldn't figure out what was wrong, they gave me a loaner of the same kind, used it for a month and the computer went out on it and it spewed paraffin all over inside of machine and lab floor, so the sent me one of their latest models to use while they rebuilt my original processor. I used it for a couple of weeks and their was something wrong with the tissue, I couldn't put my finger on it and I thought I just needed to tweek the program. I was running an identical program to my original processor and it wasn't working well. Meanwhile, they send back my original machine, supposedly rebuilt, and want me to use it and make sure it's going to work before they pick up the latest model they were letting me use. I use my original machine for a week, get wonderful results and the clogged lines start again.Go back to the latest model and am having a horrible time, specimens are almost unreadable. Anything bigger than a shave, is horrible. I don't believe it's fixation, they are spongy and puff up on the ice and peel out of section when cut, which makes me believe poor dehydration. I don't know how that can be, I am running an overnight protocol with 2 formalins, 80% alc, 95% alc, 3-100% acl, 3 xylenes 4 paraffins, all of at least an hour a piece. If anything , they should be overprocess! I don't get any alarms on the machine, I am at a loss, the company is at a loss with all of it, I think it's poor equipment all around. Any suggestions? -- ___ 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] Negative Reagent Control in Diagnostic IHC Testing
Fabulous, thanks. This change is on my list for 2014. Joelle Weaver MAOM, HTL (ASCP) QIHC From: richard.car...@hhchealth.org To: histonet@lists.utsouthwestern.edu Date: Mon, 14 Apr 2014 23:03:37 + Subject: [Histonet] Negative Reagent Control in Diagnostic IHC Testing For those of you who are interested, I have an Editorial in the March issue (Volume 22, Number 3) of Applied Immunohistochemistry Molecular Morphology titled, Negative Reagent Controls in Diagnostic Immunohistochemistry: Do We Need Them? An Evidence-based Recommendation for Laboratories Throughout the World. You can download a Free PDF copy using the Journal's website. Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 Office (860) 545-2204 Fax richard.car...@hhchealth.orgmailto:richard.car...@hhchealth.org 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, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ 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: competency form- Inspector Perspective.
Thank you- good reminder of what the true goals are. Joelle Weaver MAOM, HTL (ASCP) QIHC From: ibern...@uab.edu To: trathbo...@somerset-healthcare.com; sm...@msn.com; joellewea...@hotmail.com; amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: competency form- Inspector Perspective. Date: Thu, 10 Apr 2014 01:57:10 + I recently had the great honor to serve as a CAP inspector in Arizona. The lab we inspected will be accredited. Lest we forget as inspectors or future inspectors, I hope the below perspective illuminates the purpose of the CAP inspection and helps preserve the integrity of the program if adhered to. As inspectors, we are trained to be thorough but to simultaneously use objective judgment i.e. there may be several ways to meet the intent of the question and that we must review all pertinent documentation and then determine if the process meets the intent of the requirement. Keeping in mind that the purpose of CAP inspection is not punitive but quality laboratory improvement to fulfill the regulatory purpose of the inspection (CLIA). Our focus should be, in the interest of time and thoroughness major compliance issue rather than nitpick. This helps us maintain professionalism and preserve the peer-review nature of the program. So what is it that constitutes compliance? Per CAP: - One, that the laboratory has defined a policy, a procedure, or a plan of the three P's for how they are going to do things in the lab. - Secondly, actual practices that matches those three P's. - Finally, documentation to support the fact that practice has indeed matched policies and procedures. So what is a deficiency? Per CAP: A deficiency means that the lab did not meet the intent of the checklist item. It's not the wording; it's not the specifics. It is the intent. If any of the three above criteria are not yet met, we should cite a deficiency We are admonished to remember that there may be many ways to accomplish an objective. The lab may not do things exactly the way that your lab does, but may still be meeting the intent of the requirement(s). Citing a laboratory for not doing it the way we do it is a common inspector error. Per CAP, partial compliance is the following: If there is partial compliance (e.g., some records are inconsistent, one bottle of reagent was not labeled completely, a few temperatures were not recorded, etc.), you must judge whether the degree of non-compliance is likely to have adverse effects on test accuracy, patient care, or worker safety. Also, determine if the lab staff was aware of the inconsistency and if corrective actions were performed. If adverse effects are likely or if there are definite patterns (e.g., missing temperatures only on weekends) without corrective actions only then we must cite a deficiency. Bottom-line, If you feel you were incorrectly cited since you met the intent of the question, you should appeal to CAP. It is an inspected lab's right. If a phase 11 deficiency, submit your evidence of compliance and the Lab Accreditation Committee will either overrule or sustain. I suspect they will overrule. Just saying, but based upon just what you described, it sounds like you all met the intent of the question. MSgt Ian R Bernard, HT(ASCP), MSHA-UAB Anatomic Pathology Lab Manager USAF- Active Duty ibern...@uab.edu ian.bern...@comcast.net -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rathborne, Toni Sent: Wednesday, April 09, 2014 7:04 AM To: 'Sheila Haas'; joelle weaver; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form CAP inspectors may have opinions which differ from our own, and their interpretation of standards may also be different. Have you challenged this deficiency with CAP? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sheila Haas Sent: Wednesday, April 09, 2014 8:52 AM To: joelle weaver; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form What we had here, which did not meet the CAP inspectors requirements apparently, were the procedure (of course); a form with each observation of each task documented along with any corrective action necessary; the correlation of proficiency tests, educational assessments and performance reviews for technical staff; daily evaluations from the pathologists concerning staining, microtomy and grossing; and educational training documentation. We had no idea with all pieces of this documentation that we were anticipated to have more. The form for DO of each task was not detailed enough (despite
RE: [Histonet] RE: competency form
Has some nice tables that summarize things for a good starting point especially if you are building from scratch . Thank you for sharing this. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 10 Apr 2014 10:36:01 -0400 From: cyt...@cox.net To: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] RE: competency form I was having the same problems with developing competency records for my cytotechnologist. I found this article from ADVACE for Adminstrators to be very helpful in creating my competency forms. We just had an on-site CAP inspection and it seemed to satisfy them. Hope this link is helpful. The article's author is Teresa Scott. http://laboratory-manager.advanceweb.com/Web-Extras/Online-Extras/Competency-Assessment.aspx Valerie Biendara SCT(ASCP)IAC Cytology Supervisor NWA Pathology Associates Demarinis wrote: = I would be interested in reviewing the competency form. Could you email it to me as well? Thanks. Carolyn - cdemari...@saratogacare.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Amber McKenzie Sent: Tuesday, April 08, 2014 5:18 PM To: Houston, Ronald; Histonet Subject: [Histonet] RE: competency form Can you pass it on to me as well? I'd love to compare what I've got to what someone else is doing. Thanks, Amber -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald Sent: Tuesday, April 08, 2014 2:37 PM To: Histonet Subject: [Histonet] competency form Can someone please share the competency form(s) they are using to satisfy CAP? I am having problems convincing our QA/Compliance folks of the differences between testing in AP compared to the other lab disciplines, who do read our test results Thanks Ronnie Houston, MS HT(ASCP)QIHC Anatomic Pathology Manager ChildLab, a Division of Nationwide Children's Hospital www.childlab.com 700 Children's Drive Columbus, OH 43205 (P) 614-722-5450 (F) 614-722-2899 ronald.hous...@nationwidechildrens.orgmailto:ronald.hous...@nationwidechildrens.org www.NationwideChildrens.orghttp://www.nationwidechildrens.org/ One person with passion is better than forty people merely interested. ~ E.M. Forster ___ 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 This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify Saratoga Hospital immediately by e-mail at priv...@saratogacare.org and destroy all copies of this communication and any attachments. ___ 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] Telepathology
There is a nice publication on validation of WSI on their site, similar to LDT. Joelle Weaver MAOM, HTL (ASCP) QIHC From: wdesalvo@outlook.com To: mtitf...@aol.com; histonet@lists.utsouthwestern.edu Date: Thu, 10 Apr 2014 08:55:39 -0700 Subject: RE: [Histonet] Telepathology CC: In the US, FDA has designated the WSI instruments as Class I and, to date, no company has received approval/clearance for use. Until the FDA issue is resolved, the use of WSI for primary diagnosis is prohibited. Outside the US, WSI can be used in all facets of pathology, including primary diagnosis, and is used extensively. That said, in the US, using WSI for pathology processes such as frozen section diagnosis, case consultation, special stain and IHC review, can occur because these processes do not produce a primary diagnosis. There are many other uses for WSI in pathology lab that make the consideration for use and implementation cost effective. CAP has released guidelines for validating WSI in the lab and there is the option to expand the use of WSI by using the laboratory developed test route. The best resource for WSI, in my mind, is the Digital Pathology Association (DPA) web site. I am a member and this group is dedicated to the advancement and education of WSI. Check out the web site William DeSalvo, BS HTL(ASCP) To: histonet@lists.utsouthwestern.edu From: mtitf...@aol.com Date: Thu, 10 Apr 2014 08:14:23 -0400 Subject: [Histonet] Telepathology Victor Tobias asks about telepathology- I seem to remember there is a rule somewhere that primary diagnosis can only be made using a glass slide. As to chapter and verse, I don't know. However there are reports in the literarature that it has been tried out for F/S in Alaska and Finland. Michael Titford USA Pathology Mobile AL USA ___ 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] RE: competency form
Is the question that Ronnie posed yesterday requesting justification of the need and extent of competency documentation for histology, or is it just a form needed? The general checklist pretty much sums up the necessity for doing, and required elements to me- GEN. 55500 and CLIA. Maybe I am not understanding? As for a form, I would expect that the specific items on any forms will vary by your personnel and by the testing and processes you perform. What I did to document initial training and competency was a make a summary checklist for each bench with tasks and direct observations DO for initial training documentation of satisfactory performance before patient testing. I just put all those checklists together in a summary table for each person. High complexity; such as grossing, IHC, FISH scoring get more attention and documentation, the waived tests, you have more discretion,- but I thought it easier to do everything about the same. I have not been inspected on this document yet ( so can't say if CAP will have issues with it- but will know soon...) but here is basically what I did to meet GEN.55500 or the main parts; Defined how competency is monitored- method and frequency ( just included as part of the competency SOP) Orientation and initial training documentation in a checklist for general lab, safety Training checklist on each technical bench, instrument, major procedure PT records and performance/results DO- a practical assessment ( block, slides, stains), for the assessment of previously analyzed specimens, and a PI feedback checklist for the technical from this audit of issues- how/what to improve Check off in performing QC, calibration, patient ID procedures ( acceptable error rates), examples for file DO of grossing, other performance such as instrument programming/maintenance Written quiz, policies procedures, troubleshooting( problem solving documentation) Continuing education participation records Joelle Weaver MAOM, HTL (ASCP) QIHC From: sm...@msn.com To: amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Date: Wed, 9 Apr 2014 11:10:18 + Subject: RE: [Histonet] RE: competency form CC: We were recently dinged by CAP for our competency assessments in all areas. While that's no longer my immediate responsibility, I would love to be able to assist the lab manager with some information so we can tweek our assessments if you all wouldn't mind sharing with me as well. Thanks a bunch. Sheila Haas MicroPath Laboratories, Inc. Quality Assurance Coordinator From: amber.mcken...@gastrodocs.net To: ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Date: Tue, 8 Apr 2014 21:17:44 + CC: Subject: [Histonet] RE: competency form Can you pass it on to me as well? I'd love to compare what I've got to what someone else is doing. Thanks, Amber -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald Sent: Tuesday, April 08, 2014 2:37 PM To: Histonet Subject: [Histonet] competency form Can someone please share the competency form(s) they are using to satisfy CAP? I am having problems convincing our QA/Compliance folks of the differences between testing in AP compared to the other lab disciplines, who do read our test results Thanks Ronnie Houston, MS HT(ASCP)QIHC Anatomic Pathology Manager ChildLab, a Division of Nationwide Children's Hospital www.childlab.com 700 Children's Drive Columbus, OH 43205 (P) 614-722-5450 (F) 614-722-2899 ronald.hous...@nationwidechildrens.orgmailto:ronald.hous...@nationwidechildrens.org www.NationwideChildrens.orghttp://www.nationwidechildrens.org/ One person with passion is better than forty people merely interested. ~ E.M. Forster ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: competency form
The NSH does have some good basic forms that may help in getting your organization's forms together. I would probably evolve them from those into what fits in with your situation. There have been a couple of webinars in the past dealing with competency in histology and meeting requirements under CLIA and CAP. I think that it is a recurring topic that comes up since competency crosses over into many other arenas such as personnel staffing, education training, compliance, test performance( reliability/reproducibility), errors and process improvements, and potentially other areas that supervisors and managers juggle every day. Joelle Weaver MAOM, HTL (ASCP) QIHC From: sm...@msn.com To: foreig...@gmail.com; sad...@wisc.edu Date: Wed, 9 Apr 2014 12:24:36 + Subject: RE: [Histonet] RE: competency form CC: histonet@lists.utsouthwestern.edu; ronald.hous...@nationwidechildrens.org Thanks for the reference Patrick! Date: Wed, 9 Apr 2014 08:22:34 -0400 From: foreig...@gmail.com To: sad...@wisc.edu Subject: Re: [Histonet] RE: competency form CC: histonet@lists.utsouthwestern.edu; ronald.hous...@nationwidechildrens.org We based ours off the Michigan Society of Histotechnologist's Competency Assessment Handbook (available on their website for a nominal fee). We took some of their forms/ideas and modified them for our use. Patrick Laurie(HT)ASCP QIHC Histology Manager Celligent Diagnostics, LLC 101 East W.T. Harris Blvd | Suite 1212 | Charlotte, NC 28262 Work: 704-970-3300 Cell: 704-266-0869 On Wed, Apr 9, 2014 at 8:19 AM, Sally Ann Drew sad...@wisc.edu wrote: I don't know if it's reasonable to share with all of us, but I bet there are a lot of us that would be interested in how others are approaching these topics. I doubt there are that many workshops on the issue-or have there been teleconferences maybe that cover the subject? _Sally Sally Ann Drew,MT(ASCP) UW SMPH-Dept. of Pathology TRIP/TSB-TRIP Lab Manager CSC, K4/435 608.265.4378 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Amber McKenzie Sent: Tuesday, April 08, 2014 4:18 PM To: Houston, Ronald; Histonet Subject: [Histonet] RE: competency form Can you pass it on to me as well? I'd love to compare what I've got to what someone else is doing. Thanks, Amber -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald Sent: Tuesday, April 08, 2014 2:37 PM To: Histonet Subject: [Histonet] competency form Can someone please share the competency form(s) they are using to satisfy CAP? I am having problems convincing our QA/Compliance folks of the differences between testing in AP compared to the other lab disciplines, who do read our test results Thanks Ronnie Houston, MS HT(ASCP)QIHC Anatomic Pathology Manager ChildLab, a Division of Nationwide Children's Hospital www.childlab.com 700 Children's Drive Columbus, OH 43205 (P) 614-722-5450 (F) 614-722-2899 ronald.hous...@nationwidechildrens.orgmailto: ronald.houston@nationwidechild rens.org www.NationwideChildrens.orghttp://www.nationwidechildrens.org/ One person with passion is better than forty people merely interested. ~ E.M. Forster ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet 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: competency form
True there is inspector variation. Maybe we should all pool our resources and see what we can come up with collaboratively? It is great to know what the CAP feedback has been so we can all fill in any gaps. Joelle Weaver MAOM, HTL (ASCP) QIHC From: trathbo...@somerset-healthcare.com To: sm...@msn.com; joellewea...@hotmail.com; amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: competency form Date: Wed, 9 Apr 2014 13:04:17 + CAP inspectors may have opinions which differ from our own, and their interpretation of standards may also be different. Have you challenged this deficiency with CAP? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sheila Haas Sent: Wednesday, April 09, 2014 8:52 AM To: joelle weaver; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form What we had here, which did not meet the CAP inspectors requirements apparently, were the procedure (of course); a form with each observation of each task documented along with any corrective action necessary; the correlation of proficiency tests, educational assessments and performance reviews for technical staff; daily evaluations from the pathologists concerning staining, microtomy and grossing; and educational training documentation. We had no idea with all pieces of this documentation that we were anticipated to have more. The form for DO of each task was not detailed enough (despite listing each task and proficiency or corrective action of each task) according to the inspectors. I was hoping someone could share a form so as to assist us in seeing what holes there are in our form. While this DO form is definitely not our only form, the inspectors specifically commented on this one. If anyone can assist, it would be helpful. Thank you, Sheila Haas MicroPath Laboratories, Inc. Quality Assurance Coordinator From: joellewea...@hotmail.com To: sm...@msn.com; amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: competency form Date: Wed, 9 Apr 2014 12:26:47 + Is the question that Ronnie posed yesterday requesting justification of the need and extent of competency documentation for histology, or is it just a form needed? The general checklist pretty much sums up the necessity for doing, and required elements to me- GEN. 55500 and CLIA. Maybe I am not understanding? As for a form, I would expect that the specific items on any forms will vary by your personnel and by the testing and processes you perform. What I did to document initial training and competency was a make a summary checklist for each bench with tasks and direct observations DO for initial training documentation of satisfactory performance before patient testing. I just put all those checklists together in a summary table for each person. High complexity; such as grossing, IHC, FISH scoring get more attention and documentation, the waived tests, you have more discretion,- but I thought it easier to do everything about the same. I have not been inspected on this document yet ( so can't say if CAP will have issues with it- but will know soon...) but here is basically what I did to meet GEN.55500 or the main parts; Defined how competency is monitored- method and frequency ( just included as part of the competency SOP) Orientation and initial training documentation in a checklist for general lab, safety Training checklist on each technical bench, instrument, major procedure PT records and performance/results DO- a practical assessment ( block, slides, stains), for the assessment of previously analyzed specimens, and a PI feedback checklist for the technical from this audit of issues- how/what to improve Check off in performing QC, calibration, patient ID procedures ( acceptable error rates), examples for file DO of grossing, other performance such as instrument programming/maintenance Written quiz, policies procedures, troubleshooting( problem solving documentation) Continuing education participation records Joelle Weaver MAOM, HTL (ASCP) QIHC From: sm...@msn.com To: amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Date: Wed, 9 Apr 2014 11:10:18 + Subject: RE: [Histonet] RE: competency form CC: We were recently dinged by CAP for our competency assessments in all areas. While that's no longer my immediate responsibility, I would love to be able to assist the lab manager with some information so we can tweek our assessments if you all wouldn't mind sharing with me as well. Thanks a bunch. Sheila Haas MicroPath Laboratories, Inc. Quality Assurance
RE: [Histonet] Re: High complexity testing
yes, I know- just meant the things that were more complicated- as in my checklist is longer. I mis-spoke, or mis-typed I guess. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Wed, 9 Apr 2014 13:12:58 -0400 From: tbr...@holyredeemer.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: High complexity testing Just to clarify, IHC is not high complexity testing. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 Message: 12 Date: Wed, 9 Apr 2014 12:26:47 + From: joelle weaver joellewea...@hotmail.com Subject: RE: [Histonet] RE: competency form Is the question that Ronnie posed yesterday requesting justification of the need and extent of competency documentation for histology, or is it just a form needed? The general checklist pretty much sums up the necessity for doing, and required elements to me- GEN. 55500 and CLIA. Maybe I am not understanding? As for a form, I would expect that the specific items on any forms will vary by your personnel and by the testing and processes you perform. What I did to document initial training and competency was a make a summary checklist for each bench with tasks and direct observations DO for initial training documentation of satisfactory performance before patient testing. I just put all those checklists together in a summary table for each person. High complexity; such as grossing, IHC, FISH scoring get more attention and documentation, the waived tests, you have more discretion,- but I thought it easier to do everything about the same. I have not been inspected on this document yet ( so can't say if CAP will have issues with it- but will know soon...) but here is basically what I did to meet GEN.55500 or the main parts; Defined how competency is monitored- method and frequency ( just included as part of the competency SOP) Orientation and initial training documentation in a checklist for general lab, safety Training checklist on each technical bench, instrument, major procedure PT records and performance/results DO- a practical assessment ( block, slides, stains), for the assessment of previously analyzed specimens, and a PI feedback checklist for the technical from this audit of issues- how/what to improve Check off in performing QC, calibration, patient ID procedures ( acceptable error rates), examples for file DO of grossing, other performance such as instrument programming/maintenance Written quiz, policies procedures, troubleshooting( problem solving documentation) Continuing education participation records Joelle Weaver MAOM, HTL (ASCP) QIHC - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ 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: competency form
I appreciate your thoughts. True, seems like they couldn't be too specific in their requirements if they cannot list specifically what they require ( when you specifically ask), what a sentence! We will all find out if that is the case or not soon enough. Anyhow, I just want to agree with you that all the signs seem to be that there will be tightening, based on their magazine articles and web site postings, etc; seems like validation verification, competency, PT ( interlaboratory correlation) will be at the top of the list...stay tuned. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Wed, 9 Apr 2014 20:37:55 + From: suetp...@comcast.net To: joellewea...@hotmail.com CC: trathbo...@somerset-healthcare.com; sm...@msn.com; amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] RE: competency form So I went to one of the CAP webinars regarding competency And when I asked what about histology there were complete silence on the other end of the line and than they said there was nothing for histology. At our site they want something for very division so I put together a basic form and use it for the multitude of major tasks in histology. We are not getting inspeted until next year but from what I hear CAP is planning on making major changes for the pathology protion of CAP's checklist, what that means I do not know. Since CAP canot give us concrete rules for histology I think that anything a lab does is better than nothing, and shows initiative on their part to meet CAP's requirements. Since this is a peer review the inspector can suggest alternatives but cannot say you are in violation because the do not like your form. Just my thoughts S. Paturzo TJUH ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Now HERE's an embedding tamper!
Wow Tim, you are right- that is quite a tamper! Congratulations on your find. Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: histonet@lists.utsouthwestern.edu Date: Tue, 8 Apr 2014 22:07:21 + Subject: [Histonet] Now HERE's an embedding tamper! A while ago I posted asking about embedding tampers for Mega molds (whole mount prostate for the most part). There were a few ideas, but not what I was looking for. Finally I found it. Here is an embedding tamper made from an espresso coffee tamper. Stainless steel. Large. Heavy. Fantastic. http://i1248.photobucket.com/albums/hh491/tmorken/tamper3_zpscbd10f47.jpg http://i1248.photobucket.com/albums/hh491/tmorken/tamper2_zps114d76ae.jpg http://i1248.photobucket.com/albums/hh491/tmorken/Tamper1_zpse28869cf.jpg Tim Morken Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center Box 1656 505 Parnassus Ave San Francisco, CA 94143 USA 415.514-6042 (office) tim.mor...@ucsfmedctr.orgmailto:tim.mor...@ucsfmedctr.org ___ 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] Independent Predictive Markers needing comparison with Benchmarks
Agree, I think that list is a good start. Joelle Weaver MAOM, HTL (ASCP) QIHC From: vickroy@mhsil.com To: histonet@lists.utsouthwestern.edu Date: Mon, 7 Apr 2014 13:35:58 -0500 Subject: [Histonet] Independent Predictive Markers needing comparison with Benchmarks I am working with my pathology group to agree on which markers need to have a comparison with published benchmarks and interobserver variability among pathologists. Currently we compare ER, PR, and Her2. I have suggested that we need to compare ALK1, ROS1, and possible MMR IHC stains. Can anyone list any other predictive markers they are comparing to benchmarks and do you agree with the ones I've suggested? Thanks James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Instrument Verification
Pretty much what is in place here for existing/established instruments. Joelle Weaver MAOM, HTL (ASCP) QIHC From: mill...@emhs.org To: joellewea...@hotmail.com; l...@premierlab.com; mw...@wakehealth.edu; robin...@mercyhealth.com; tbr...@holyredeemer.com; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: Instrument Verification Date: Fri, 4 Apr 2014 10:08:54 + I must say, the first time I read ANP.23045 I had the same reaction you all did. After reading it over a couple of times, we started looking at it differently. The question is not about validation--- it is about verifying that the equipment will function and perform as intended. It doesn't have anything to do with protocols and procedures for staining, cutting, processing, etc. If you look at any service report for service performed on your instrument, it is likely that the service engineer has some sort of notation on the report that states the unit was run and monitored for performance and meets all specs. To comply with the CAP question we merely wrote a procedure for Instrument-Equipment Performance Verification stating that 1)The verification of instrument/equipment function will be performed by a qualified service engineer upon installation, after scheduled preventative maintenance, major instrument repairs, or relocation. 2) Use of the instrument/equipment will resume after the verification of its performance has been successfully completed.3) The service engineer will provide the Histology Laboratory with a report indicating that performance function was tested and satisfactory. Of course, we also have all service reports (which include the notation that the function checks were performed and acceptable) available for each instrument. Suzie Miller, MLT ASCP Senior Histotech Mercy Health System of Maine Laboratory -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of joelle weaver Sent: Thursday, April 03, 2014 7:52 PM To: Elizabeth Chlipala; Martha Ward-Pathology; Cynthia Robinson; Terri Braud; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: Instrument Verification I do understand and sympathize with the situation in many clinical labs with staff , sometimes barely enough to do the work and it is challenging to keep up with expanding documentation also. I would like to meet the GLP, but do struggle to be as extensive in my documentation. I do try to get as close to the ISO standards as possible, just to cover myself. I agree with Elizabeth's post that this seems to be the direction CAP has been heading over the years. I think that if you get new instruments, methodology, technology they will certainly want to see the more robust documentation. For example ( see the current CAP today on IHC validation), this will surely be the guideline of tomorrow But for those older, in long use instruments and technology, my opinion is that if you have documentation in line with what the checklist stipulated when it went into use, and also all PM, maintenance, and QC- and have documented any corrective actions, this will probably fly for now? What does everyone else think? Joelle Weaver MAOM, HTL (ASCP) QIHC From: l...@premierlab.com To: mw...@wakehealth.edu; robin...@mercyhealth.com; tbr...@holyredeemer.com; histonet@lists.utsouthwestern.edu Date: Thu, 3 Apr 2014 14:16:58 -0600 CC: Subject: [Histonet] RE: Instrument Verification Hello All Coming from a GLP environment this type of equipment validation is standard in our setting. This is just my opinion but I think the CAP checklist is moving towards the type of equipment documentation that is already required in a GxP or ISO environment. I always thought that instrument qualification (IQ) - operational qualification (OQ) and process qualification (PQ) or simply stated IQ/OQ/PQ were used only in GxP settings but you now see some of the larger clinical labs running these types of validations on their equipment and processes. To me it does make sense that some type of equipment validation should be required whether it is a two page document on the microtomes, waterbaths, etc. or complete IQ/OQ/PQ's on major pieces of equipment such as tissue processors, immunostainers and IHC retrieval units. I believe that all of these are important processes that should be completed in histology laboratories today.We are a GLP compliant lab and every single piece of equipment is calibrated and validated as designated in our Master Validation Plan. IHC stainers and retrieval units should be validated, even our refrigerators and freezers are calibrated and validated. Our pipettors are calibrated quarterly, and any piece of equipment that generates a weight or temperature is calibrated yearly. For example
RE: [Histonet] (no subject)
What I did recently for two new processors, conventional type- I did parallel trial slides of multiple tissue types ( same types as patients) for fixation, morphology , processing artifacts for 9 programs. I grossed them in and recorded fixation times, type, thickness, overall dimensions. I ran on the test programs. Then I embedded and sectioned and evaluated the results by microscopic review by techs then the medical director of the H E stained sections for each program and tissue type. Looking at any autolysis, nuclear detail, poor dehydration, other processing problems in each set. Then I just made a simple evaluation sheet for any tissue processing related issues, with a number rating/scale for the results. Retained records of the validation runs and the stained sections used for validation. Defined acceptable tissue types and dimensions for the processing programs in the SOP, and then I just created back up/recovery procedure and reprocessing procedure and ran through those for comparison. When completed, I just compiled into validation summary report. Joelle Weaver MAOM, HTL (ASCP) QIHC From: lmurp...@aultman.com To: Histonet@lists.utsouthwestern.edu Date: Thu, 3 Apr 2014 15:26:17 + CC: Subject: [Histonet] (no subject) How is everyone validating the tissue processor for new CAP ANP.23045 question on function and verification of equipment? LeAnn Murphy Aultman Hospital Canton, Ohio ___ 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: Instrument Verification
I do understand and sympathize with the situation in many clinical labs with staff , sometimes barely enough to do the work and it is challenging to keep up with expanding documentation also. I would like to meet the GLP, but do struggle to be as extensive in my documentation. I do try to get as close to the ISO standards as possible, just to cover myself. I agree with Elizabeth's post that this seems to be the direction CAP has been heading over the years. I think that if you get new instruments, methodology, technology they will certainly want to see the more robust documentation. For example ( see the current CAP today on IHC validation), this will surely be the guideline of tomorrow But for those older, in long use instruments and technology, my opinion is that if you have documentation in line with what the checklist stipulated when it went into use, and also all PM, maintenance, and QC- and have documented any corrective actions, this will probably fly for now? What does everyone else think? Joelle Weaver MAOM, HTL (ASCP) QIHC From: l...@premierlab.com To: mw...@wakehealth.edu; robin...@mercyhealth.com; tbr...@holyredeemer.com; histonet@lists.utsouthwestern.edu Date: Thu, 3 Apr 2014 14:16:58 -0600 CC: Subject: [Histonet] RE: Instrument Verification Hello All Coming from a GLP environment this type of equipment validation is standard in our setting. This is just my opinion but I think the CAP checklist is moving towards the type of equipment documentation that is already required in a GxP or ISO environment. I always thought that instrument qualification (IQ) - operational qualification (OQ) and process qualification (PQ) or simply stated IQ/OQ/PQ were used only in GxP settings but you now see some of the larger clinical labs running these types of validations on their equipment and processes. To me it does make sense that some type of equipment validation should be required whether it is a two page document on the microtomes, waterbaths, etc. or complete IQ/OQ/PQ's on major pieces of equipment such as tissue processors, immunostainers and IHC retrieval units. I believe that all of these are important processes that should be completed in histology laboratories today.We are a GLP compliant lab and every single piece of equipment is calibrated and validated as designated in our Master Validation Plan. IHC stainers and retrieval units should be validated, even our refrigerators and freezers are calibrated and validated. Our pipettors are calibrated quarterly, and any piece of equipment that generates a weight or temperature is calibrated yearly. For example if you do not validate your IHC retrieval units how can you really tell if they reach the temperature that they are programmed to reach, does the temperature stay consistent through the retrieval process, did it retrieve for the time programmed? The only way to determine this is to perform a validation. How do you troubleshoot problems if you do not know if your instruments are performing to their specification without testing those specifications - that's what equipment validation is and that's why in my opinion its important. Histology laboratories are now responsible for running IHC that directly effects a patients treatment - meaning the numerous therapeutic and prognostic markers we routinely run now. Validation is an important process especially if you are using image analysis for these markers. I hate to say it but we better get used to it, because this is not going away. And now the shameless plug - I will be giving a 90 minute lecture at the Florida State Meeting https://classic.regonline.com/custImages/24/241449/FSH2014OnlineProgram.pdf on this exact topic, so if you want to learn how to create a Master Validation Plan and learn how to perform a basic validation or a more detailed IQ/OQ and PQ and to what extent you need to validate a particular piece of equipment - sign up for the meeting plus there are lots of other great topics being presented too. Liz Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC Premier Laboratory, LLC PO Box 18592 Boulder, CO 80308 (303) 682-3949 office (303) 682-9060 fax (303) 881-0763 cell l...@premierlab.com www.premierlab.com March 10, 2014 is Histotechnology Professionals Day Ship to Address: Premier Laboratory, LLC 1567 Skyway Drive, Unit E Longmont, CO 80504 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha Ward-Pathology Sent: Thursday, April 03, 2014 1:22 PM To: Cynthia Robinson; Terri Braud; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Instrument Verification I'm with you. There really appears to be no value to this particular requirement.I would only be concerned with it if I had just purchased it, or moved
RE: [Histonet] RE: IHC antibody optimizing validating
only 1/2 way through reading the article, but Terri makes a good point about the proficiency testing. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Wed, 26 Mar 2014 12:48:46 -0400 From: tbr...@holyredeemer.com To: richard.car...@hhchealth.org; histonet@lists.utsouthwestern.edu CC: Subject: [Histonet] RE: IHC antibody optimizing validating Fortunately, they say nothing at all because if that were the case, they would no longer be able to peddle their Proficiency Programs for IHC, since those too, are fixed and processed elsewhere. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 -Original Message- From: Cartun, Richard [mailto:richard.car...@hhchealth.org] Sent: Wednesday, March 26, 2014 11:47 AM To: Terri Braud; histonet@lists.utsouthwestern.edu Subject: RE: IHC antibody optimizing validating I have not read the entire document yet. What do they say about using tissues that have been fixed and processed elsewhere? Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 Office (860) 545-2204 Fax richard.car...@hhchealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Terri Braud Sent: Tuesday, March 25, 2014 3:35 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: IHC antibody optimizing validating CAP is very clear that in order to validate a new antibody, that: once the stain has been optimized, that for a well characterized antibody with a limited spectrum of antigenic targets, like Chromogranin or PSA, the validation can be limited. A panel of 10 positive and 10 negative neoplasms would be sufficient in this setting. For an antibody that is not well characterized and/or has a wide range of reported reactivity, a more extensive validation is necessary. The number of tissues tested should in the circumstance be large enough to determine whether the staining profile matches that previously described. An exception to the above requirements is that studies nay not be feasible for antigens such as ALK that are only seen in rare tumors. Thus sayeth CAP. And if you're like me, I am not digging through all my cases to try to come up with 30-40 neoplasms for each antibody, so I just order Tissue Micro Arrays with the neoplasms I need. 20 positive and 20 negative neoplastic tissues on one slide for easy staining and validation. The money you save on reagents to stain one little slide, more than makes up for the cost of the slide. I hope this helps. Terri L. Braud, HT(ASCP) - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ 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] IHC antibody optimizing validating
I think that there is some variability to the methodology in this, and also depends on the constraints of your staining platform or if doing manual IHC. Below are my current habits, working alone and performing multiple validations at the same time...others may have their own way of accomplishing. The big thing to me is to keep excellent records for CAP. My opinion is, that the number of slides or different protocols needed to optimize is the number of slides or trials it takes to get the desired target staining versus high background, non-specific staining, other variables - until you are satisfied you have the desired staining of the specific tissue element, antigen, protein bacteriaetc; that the antibody targets. So I am not sure there is a specific required number, but if you do one for each retrieval stringency in your platforms ( automated), and then change the incubation times if you can, and maybe the AB titer a couple of trials, that is at least 4-8 slides, maybe more or less depending on your system. Sometimes you can hit it right off working from the specification sheet, but sometimes not. Usually after a couple of tests though, you can see if you are getting there or which direction to proceed. For setting up a completely new protocol with unfamiliar antibody, I use an expected positive, sometimes normal, sometimes tumor section ( depending on the antibody) same tissue at this point, that I know to be well fixed and processed, and change one of the staining variables after each attempt( tissue stays constant) sticking pretty close to the specification sheet if IVD. If none of the usual tweaks work, I try different tissue and go back into it again. I document the changes and the results each time so I don't lose track of things on my worksheets.If you are doing an IVD, then the specification sheet is the way to go with how to start and follow the recommendations and tweak for your lab conditions- changing one variable at a time until you are satisfied with the result. Usually the optimization and best slide/protocol is determined in consultation with a pathologist. Once the stain is optimized, I do parallel runs of known positives and negatives ( usually at least 10 cases for IVD ( which may be 25 slides or more if needed) and more for ASR antibodies). Until you have enough to establish the stain is working consistently across multiple tissue samples, best to stress the tissue type you expect to use the stain on in your testing and to use your own fixation, processing and slide handling that you will again do with patient tissues in your parallel/validation studies. The pathologist or medical director will review all the validation slides and either accept and sign off on the test, or send you back to the drawing board. For ASR, I consult literature to start, but there isn't much in the specification sheets as far as exact of manufacturer's recommendations. So this relies more on experience and close review of results from optimization slides and tweaking from there. For those, I personally do at least 25 cases. For predictive markers I do 20 negative (have tumor-but non amplified/-) and 20 positive ( tumor and +/amplified) -so at least forty slides/tissue samples minimum for predictive markers, then you do the correlation. Keep everything for CAP. Joelle Weaver MAOM, HTL (ASCP) QIHC From: cda...@che-east.org To: histonet@lists.utsouthwestern.edu Date: Tue, 25 Mar 2014 09:51:07 -0400 Subject: [Histonet] IHC antibody optimizing validating Will you help me? I understand we are to use the known positives controls that the manufactures' recommends in the package insert when optimizing the stains, but I need to know what is your general procedure for optimizing (how many different staining protocols do you test) and validating a new antibody (how many different or known positive and negative tissues do you test [predictive markers I understand are 20])? Cassandra Davis cda...@che-east.org 302-575-8095 Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ 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: IHC antibody optimizing validating
TMAs are great if that is one of your options, but unless you make them you have the PA issues that might enter in. CAP does gives specifics, but I was just giving the information and process that is currently in place where I presently work to hopefully help, not trying to supersede CAP guidelines for sure- where would that land me? Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Tue, 25 Mar 2014 15:34:30 -0400 From: tbr...@holyredeemer.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: IHC antibody optimizing validating CAP is very clear that in order to validate a new antibody, that: once the stain has been optimized, that for a well characterized antibody with a limited spectrum of antigenic targets, like Chromogranin or PSA, the validation can be limited. A panel of 10 positive and 10 negative neoplasms would be sufficient in this setting. For an antibody that is not well characterized and/or has a wide range of reported reactivity, a more extensive validation is necessary. The number of tissues tested should in the circumstance be large enough to determine whether the staining profile matches that previously described. An exception to the above requirements is that studies nay not be feasible for antigens such as ALK that are only seen in rare tumors. Thus sayeth CAP. And if you're like me, I am not digging through all my cases to try to come up with 30-40 neoplasms for each antibody, so I just order Tissue Micro Arrays with the neoplasms I need. 20 positive and 20 negative neoplastic tissues on one slide for easy staining and validation. The money you save on reagents to stain one little slide, more than makes up for the cost of the slide. I hope this helps. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 Today's Topics: 8. IHC antibody optimizing validating (Davis, Cassie) Message: 8 Date: Tue, 25 Mar 2014 09:51:07 -0400 From: Davis, Cassie cda...@che-east.org Subject: [Histonet] IHC antibody optimizing validating Will you help me? I understand we are to use the known positives controls that the manufactures' recommends in the package insert when optimizing the stains, but I need to know what is your general procedure for optimizing (how many different staining protocols do you test) and validating a new antibody (how many different or known positive and negative tissues do you test [predictive markers I understand are 20])? Cassandra Davis cda...@che-east.org 302-575-8095 * - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ 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: Slide Consults
it doesn't bother me to have two labels/tracking numbers. I retain theirs so that they keep the liability of identification with the patient blocks and specimen source since I do not have these items to be able to cross check with the slides. The in- house ID is really just for in house processing and tracking, and to be able to use the LIS to capture for QC reports. I leave both visible though and both appear on all work-products. You just ignore the other number when filing and it seems to not be a problem. Joelle Weaver MAOM, HTL (ASCP) QIHC From: becky.garri...@jax.ufl.edu To: Lynn.O'donn...@wchn.org; histonet@lists.utsouthwestern.edu Date: Thu, 20 Mar 2014 13:46:28 + CC: Subject: [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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Microwave Tissue Processing
Aikhan I am happy to share my experience, and very inspirational your concern for the burden on the patient and their families. Your language is just fine ! Do not be concerned. We are on this list to help one another. MW processing fairly common here. Some people love it, and some people are not fully confident in it yet. My first advice would be that the biggest issue to adoption seems to be understanding that it works differently than conventional processing, though the end result accomplishes the same purpose. It works very well if people take the time to learn to use it correctly. It is based more on physics of MW energy and tissue components than just passive reagent diffusion like conventional processors. It is wise to take some time to learn about how this works before starting, though getting past this barrier should be easier for you since you are not accustomed to using a conventional processor. The vendors that I know are Thermo-Shandon, Sakura, Milestone -at least these are the instruments I have personally used ( various models). They all have advantages and disadvantages, it just depends on what your needs are. The Milestone I would say is particularly adopted to very high volumes. The vendors have proprietary technology and some reagents, but most use formalin, but just accelerate the fixation rate with MW energy instead of convection heat and agitation. The big concern is that you are working with much shorter times and so you have to adjust your thinking on this aspect. Also some tissues- liver cores, skins and bloody specimens such as endometrial biopsies will get very dry if you are not careful with the heat and microwave exposure- my theory is that is has to do with the polarity or water content of these tissues. The outer surface becomes almost coagulated and tough, must like over-cooked food in the microwave. Important notes are: That generally you cannot REPROCESS microwave processed tissue. So you have to take the time to do it correctly from the beginning, and all tissue can be sucessfully processed when a suitable program is set up. As you know, you CAN reprocess with conventional, though the results are often not much improved. So carefully consider this as you set up your process ( see below my suggestions for this). The tissue thickness and overall dimensions are even more important with MW than with any type of conventional processing to get uniform and optimal results. On the positive side, large samples( cut thinly), breast tissue and other fatty specimens seem to do exceptionally well, much better than conventional. Graded ethanols are typically used for dehydration as in conventional processing. So, really most of the reagents are the same in the instruments I have used, with the exception that isopropanol is substituted for xylene as a transition and clearing reagent. Even though this seems counterintutitive, it actually seems to work pretty well. If you are accustomed to processing manually, you will be amazed at the tissue quality and speed you can gain by using any type of automated processing- you will be leaps and bounds ahead if you are successful in adopting microwave assisted processing. Advantages signifigantly reduce turn around, faster pateint results- some program are less than 1 hour, really speeding up diagnosis. For some patients and samples this may outweigh almost any disadvantagesthe vendors typically can assit with the intial set up and this takes care of many of the issues I mention under disadvantagescleaner, less exposure to hazardous chemicials Disadvantages Takes more time in the inital design of the programs,and validationYou may need to customize or adjust programs for particular tissues more so than conventional, so a little more technical attention and time is needed, in some labs this may be a barrier I hope that some of this information can be of help to you. Please let me know if I can assist further in any way. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Mon, 17 Mar 2014 14:49:12 +0600 Subject: Re: [Histonet] Microwave Tissue Processing From: aikhan...@gmail.com To: joellewea...@hotmail.com Hi Joelle Weaver, From your posting I learned that you have experience of using Microwave tissue processor for last 8-10 years. I would be grateful if you can help me in light of your experience. We are giving histopathology service in our country, Bangladesh. We have a peculiar situation: Many patients are from rural areas, they come to the city, have to stay till a diagnosis is made, an expensive matter for them bearing all these costs; there's no insurance system here. Presently tissue processing is manual in our lab; around 150 paraffin blocks daily. Needing to produce rapid result under financial constraint we are thinking of microwave processing, but we don't have any experience with these. We know there are other choices as well: conventional carousel (like Shandon
RE: [Histonet] Frozen section PPE
nitrile gloves, maybe gown or apron, sometimes eye protection, mask if suspected TB. Joelle Weaver MAOM, HTL (ASCP) QIHC From: jpi...@wtbyhosp.org To: histonet@lists.utsouthwestern.edu Date: Mon, 17 Mar 2014 19:28:45 + Subject: [Histonet] Frozen section PPE Hi Everyone, We were wondering what people are wearing while doing frozen sections? Mask, goggles, lab coat? We'd like to know what everyone else is doing to protect themselves. Thank you, Jessica Piche, HT(ASCP) Waterbury Hospital CONFIDENTIALITY NOTICE: This email and any attachments contain confidential information that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulation. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and delete these documents. Copyright (c) Waterbury Hospital ___ 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: CAP Annual Results Comparison for FISH/ISH
Thank you Dr. Cartun, these numbers are helpful for reference Joelle Weaver MAOM, HTL (ASCP) QIHC From: richard.car...@hhchealth.org To: one...@wvuhealthcare.com; histonet@lists.utsouthwestern.edu Date: Fri, 14 Mar 2014 20:01:54 + CC: Subject: [Histonet] RE: CAP Annual Results Comparison for FISH/ISH I'm not aware of published benchmarks for FISH/ISH, but if you're doing IHC for ER, PR, and HER2 in breast CA you may find the following information useful: Lal P, et al: ER and PR and histologic features in 3,655 invasive breast carcinomas. Am J Clin Pathol 2005;123:541-546. ER+ tumors - 74% PR+ tumors - 49 HER2+ tumors - 16% Fitzgibbons PL, et al: Recommendations for validating ER and PR IHC assays. Arch Pathol Lab Med 2010;134:930-935. For women over 65 years of age, the % of negative cases should not exceed 20%. For low-grade invasive carcinomas, the proportion of negative cases should not exceed 5%. My own data for invasive breast CA: ER+ tumors - 85% PR+ tumors - 70% HER2+ tumors - 14% Please keep in mind that with the introduction of new monoclonal antibodies, more sensitive detection systems, and the recommendation that tumors with 1% immunoreactive cells be called Positive, the old benchmarks for ER and PR are no longer valid. Richard Richard W. Cartun, MS, PhD Director, Histology Immunopathology Director, Biospecimen Collection Programs Assistant Director, Anatomic Pathology Hartford Hospital 80 Seymour Street Hartford, CT 06102 (860) 972-1596 Office (860) 545-2204 Fax richard.car...@hhchealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of O'neil, Beth Sent: Wednesday, March 12, 2014 2:41 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP Annual Results Comparison for FISH/ISH Would fellow Histonetters be able to explain how they answer the following CAP question: ANP.22970 For immunohistochemical and FISH/ISH tests that provide independent predictive information, the laboratory at least annually compares its patient results with published benchmarks, and evaluates interobserver variability among the pathologists in the laboratory. Where would one even find published benchmarks? Thank you Beth Ann O'Neil, MT(ASCP)SC, HTL, QIHC Histology Supervisor/Technical Specialist West Virginia University Hospitals one...@wvuhealthcare.com 304-293-7629 (office) 304-293-6014 (lab) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet 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, or an employee or agent responsible for delivering the message to the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message, including any attachments. ___ 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] Microwave Tissue Processing
I have used a couple of vendor's MW processing instruments over the past 8-10 years. So it is used, even if it has not become as commonplace as conventional in every setting or market. It seems to be more favored in high volume settings, for pretty obvious reasons. In teaching and instruction * my opinion * - you should teach them the theory and fundamentals for practice for ALL the possible tissue processing technologies they may encounter, and this is consistent with the approach to practice of the topics on the ASCP exam.They have to know the fundamental basics and then it is easy to expand to more emerging practices and technology. It would be more of a disservice to me if you left anything( either conventional technology or MW out), in your treatment of that topic. Joelle Weaver MAOM, HTL (ASCP) QIHC From: kgoodkow...@goodwin.edu To: histonet@lists.utsouthwestern.edu Date: Fri, 14 Mar 2014 11:47:26 + Subject: [Histonet] Microwave Tissue Processing Hello all, I had an opportunity to demo a microwave tissue processing unit for my students. Is anyone using microwave technology for tissue processing and if so, could you please provide me some information on your experience with this? There are many pros that I can see, including its ease of use and quick processing time which fits well with the student lab schedule. I am wondering, however, what the likelihood will be that students will use this technology once in the field. I don't want to do them a disservice by not using conventional tissue processing methods. The majority of hospitals in the CT/MA area use conventional tissue processors. Thank you. Sent from my iPad Kelli Goodkowsky Director Clinical Education, Histologic Science Goodwin College (860) 727-6917 ___ 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: GI biopsies
Yes Dr. Richmond GI biopsies are prone to processing issues and shatter/chatter artifact. I like to put three true levels on one slide with unstained for later SS IHC , OR put two parallel ribbons on one slide, ( 2 slides of 2 ribbons, for 4 actual levels). I put three ribbons for Hirshsprungs on each slide to provide the section numbers without making multitudes of slides. I have a hard time getting this accepted- The pathologist almost always wants three ribbons on 2-3 slides, and I think that is because only some of the sections are truly readable- the section quality is too variable for these specimens for them to feel comfortable. I like to reveiw these under the microscope since when they are tiny, it is hard to see the shatter, folds and fragmentation on the water bath. I agree it is definately a quality problem to be addressed. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Fri, 14 Mar 2014 08:37:46 -0400 From: rsrichm...@gmail.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: GI biopsies An anonymous query: I was just curious about how your institutions handle GI biopsies, specifically how many slides you cut off the bat. We presently cut 2 levels on each GI biopsy block, but I'm hearing that more and more places only cut 1 slide per GI biopsy block. Please share what you are doing at your establishment. Well, I take what I can get. Many histotechs lack the skill, or are unwilling to lay more than one ribbon on a slide. I do like more than one level. A more serious problem is maintaining the quality of GI biopsy sections, one of the most difficult quality assurance issues in histopathology. (It was reviewed in J HIstotechnol last year - I can find the reference.) The problem is at its worst with duodenal biopsies, where some services never prepare an adequate slide. As the celiac disease fad spreads and bread is the Evil Food of the Year, I am really concerned about signing out duodenal biopsies where I can't even distinguish the lymphocytes. Edwards Deming lives! Bob Richmond Samurai Pathologist Maryville TN ___ 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: MUM-1
I have the bond and I use the BIO SB concentrate, RaBMab, EP190 at 1:50 and it stains great on tonsil and kidney tubules. Joelle Weaver MAOM, HTL (ASCP) QIHC From: lseb...@uwhealth.org To: cda...@che-east.org; histonet@lists.utsouthwestern.edu Date: Thu, 13 Mar 2014 16:19:11 + CC: Subject: [Histonet] RE: MUM-1 This is our protocol for the Ultra; maybe it will help. 64 CC1, 32 incubation (MUM-1, 760-4529) @ 36 degrees, Hem II/4. This is with UltraView DAB detection. We use tonsil as well however we validated with HD, LN, GI, tonsil, etc. Good luck! Linda A. Sebree University of Wisconsin Hospital Clinics IHC/ISH Laboratory 600 Highland Ave. Madison, WI 53792 (608)265-6596 FAX: (608)262-7174 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Davis, Cassie Sent: Thursday, March 13, 2014 8:54 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] MUM-1 Good morning Histonet Folks, I am hoping one of you will help me. I am in the process of optimizing an IHC protocol on the MUM-1 antibody on paraffin tissue for the Benchmark XTstainer and I am not thrilled with the results I am getting. I have tried the usual adjustments and the results are less than optimal in my opinion. I am using a normal tonsil control right now but if you have another suggestion please do not hesitate to recommend. I am praying somebody might have done this before and would be willing to share their staining protocol or tips with this. Cassandra Davis cda...@che-east.org 302-575-8095 Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ 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] RE: CAP Annual Results Comparison for FISH/ISH
are you looking for the stats in the notes for ANP. 22970 (2012) ? overall ER negative breast ca ( invasive DCIS) should not exceed 30% ( lower average 20-35% in post menopausal) , lower in well differentiated tumors...etc. I sure CAP can also send or repeat them to you if you prefer to call them. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 13 Mar 2014 14:06:23 -0400 From: tbr...@holyredeemer.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP Annual Results Comparison for FISH/ISH Try calling CAP. They provided the benchmarks we use for our annual statistics for ER/PR. I don't have the recent CAP checklist handy, but on the 9.25.2012 checklist, the benchmarks for ER/PR are published in the notes section of the question. I hope this helps. Sincerely, Terri Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 Message: 3 Date: Wed, 12 Mar 2014 18:40:53 + From: O'neil, Beth one...@wvuhealthcare.com Subject: [Histonet] CAP Annual Results Comparison for FISH/ISH Would fellow Histonetters be able to explain how they answer the following CAP question: ANP.22970 For immunohistochemical and FISH/ISH tests that provide independent predictive information, the laboratory at least annually compares its patient results with published benchmarks, and evaluates interobserver variability among the pathologists in the laboratory. Where would one even find published benchmarks? Thank you Beth Ann O'Neil, MT(ASCP)SC, HTL, QIHC Histology Supervisor/Technical Specialist West Virginia University Hospitals one...@wvuhealthcare.com 304-293-7629 (office) 304-293-6014 (lab) ** - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ 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: CAP Annual Results Comparison for FISH/ISH
sorry , saw the Predictive, missed FISH - getting ready to do this myself. I would just call CAP, if I get to do that soon I will send along what information they supply. Joelle Weaver MAOM, HTL (ASCP) QIHC From: joellewea...@hotmail.com To: tbr...@holyredeemer.com; histonet@lists.utsouthwestern.edu Date: Thu, 13 Mar 2014 18:44:37 + Subject: RE: [Histonet] RE: CAP Annual Results Comparison for FISH/ISH CC: are you looking for the stats in the notes for ANP. 22970 (2012) ? overall ER negative breast ca ( invasive DCIS) should not exceed 30% ( lower average 20-35% in post menopausal) , lower in well differentiated tumors...etc. I sure CAP can also send or repeat them to you if you prefer to call them. Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Thu, 13 Mar 2014 14:06:23 -0400 From: tbr...@holyredeemer.com To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP Annual Results Comparison for FISH/ISH Try calling CAP. They provided the benchmarks we use for our annual statistics for ER/PR. I don't have the recent CAP checklist handy, but on the 9.25.2012 checklist, the benchmarks for ER/PR are published in the notes section of the question. I hope this helps. Sincerely, Terri Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 Message: 3 Date: Wed, 12 Mar 2014 18:40:53 + From: O'neil, Beth one...@wvuhealthcare.com Subject: [Histonet] CAP Annual Results Comparison for FISH/ISH Would fellow Histonetters be able to explain how they answer the following CAP question: ANP.22970 For immunohistochemical and FISH/ISH tests that provide independent predictive information, the laboratory at least annually compares its patient results with published benchmarks, and evaluates interobserver variability among the pathologists in the laboratory. Where would one even find published benchmarks? Thank you Beth Ann O'Neil, MT(ASCP)SC, HTL, QIHC Histology Supervisor/Technical Specialist West Virginia University Hospitals one...@wvuhealthcare.com 304-293-7629 (office) 304-293-6014 (lab) ** - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ 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
