[Histonet] RFID Tracking

[Wooten, Jennifer via Histonet]

Good afternoon,
Does anyone use RFID to track specimens in their laboratories?

Thank you,
Jennifer Wooten, BA, BS, HTL (ASCP)CM

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Re: [Histonet] Moderate vs High Complexity for routine histology

[Wooten, Jennifer via Histonet]

Good morning,
Under CLIA, Histology processes (processing, embedding, cutting, staining) are 
considered pre-analytic (not testing) and are not classified under either 
complexity level. Currently, the only activities that are considered high 
complexity are grossing, ISH, and reporting results.

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Technical Quality Assurance Auditor

-Original Message-
From: James P Montgomery 
Sent: Friday, October 20, 2023 2:04 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Moderate vs High Complexity for routine histology

Hello,

Is routine histology considered moderate or high complexity by CAP?  It looks 
like CLIA doesn't even assign a complexity rating as far as I can tell.  I know 
grossing is considered high complexity but what about routine processing, 
embedding, cutting, and special/IHC/ISH staining?  I've had a CAP inspector say 
histotechs are moderate, but a QA manager felt they were high complexity.

Thanks

James



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Re: [Histonet] What is considered Grossing according to CLIA and CAP? Definition?

[Wooten, Jennifer via Histonet]

Per the grossing definition in ANP.11610 below, grossing is defined as a tissue 
examination requiring judgment and knowledge of anatomy. This includes the 
dissection of the specimen, selection of tissue, and any level of 
examination/description of the tissue including color, weight, measurement or 
other characteristics of the tissue. CLIA Regulation 42 CFR Part 493.1489 would 
apply for high complexity testing personnel qualifications.

CAP regulations:

ANP.11600 Gross Examination - Qualifications
All macroscopic tissue gross examinations are performed by a qualified 
pathologist or pathology resident, or another qualified physician (see note), 
or under the supervision of a qualified pathologist.

ANP.11605 Gross Examination - Non-Pathologist
When individuals other than a pathologist or pathology resident assist in gross 
examinations, the extent of their activities and the nature of supervision 
(direct vs. indirect) is defined in a written protocol.

ANP.11610 Gross Examination - High Complexity Testing Qualifications
If individuals other than a pathologist or pathology resident (or an individual 
who meets the grossing subspecialty qualifications listed under ANP.11600) 
assist in gross
examinations, such individuals qualify as high complexity testing personnel.

NOTE: Grossing is defined as a tissue examination requiring judgment and 
knowledge of anatomy. This includes the dissection of the specimen, selection 
of tissue, and any level
of examination/description of the tissue including color, weight, measurement 
or other characteristics of the tissue. The laboratory director may delegate 
the dissection of specimens
to non-pathologist individuals; these individuals must be qualified as high 
complexity testing personnel under the CLIA regulations. The minimum 
training/experience required of such
personnel is:
1. An earned associate degree in a chemical or biological science or medical 
laboratory
technology, obtained from an accredited institution, OR
2. Education/training equivalent to the above that includes the following:
● 60 semester hours or equivalent from an accredited institution. This 
education must include 24 semester hours of medical laboratory technology 
courses, OR 24 semester hours of science courses   that includes six 
semester hours of chemistry, six semester hours of biology, and 12 semester 
hours of  chemistry, biology or medical laboratory technology in any 
combination, AND
● Laboratory training including either completion of a clinical 
laboratory training program approved or accredited by the ABHES, NAACLS, or 
other organization approved by HHS (note that this  training may be included in 
the 60 semester hours listed above), OR at least three months of recorded 
laboratory training in each specialty in which the individual performs high 
complexity testing.

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Pronouns: she/her/hers
Technical Quality Assurance Auditor | Quality Systems | Tricore
Mobile: 505.440.0158
www.tricore.org

-Original Message-
From: Michelle Bell 
Sent: Monday, February 27, 2023 4:31 PM
To: Donna Emge ; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] What is considered Grossing according to CLIA and CAP? 
Definition?

This is so hard to unpack everything that could be wrong with this situation.  
The weights the lab assistants take would lead me to the conclusion that this 
would be part of grossing, because it is reportable.  It’s such a slippery 
slope when you start delegating tasks associated with high complexity testing.  
If I were the manager, I would reach out to your accrediting agency for 
guidance and support.

From: Donna Emge via Histonet 
Sent: Monday, February 27, 2023 9:39:08 AM
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] What is considered Grossing according to CLIA and CAP? 
Definition?

I hope someone here can help. I recently visited a lab that has the lab 
assistants weigh placentas and document, cut the membrane off in one piece 
around the placenta, cut the umbilical cord off 1” from the placenta, then 
weigh again, document the weight again, and add the formalin for the PAs to 
gross the next day.  They consider what the lab assistants are doing as 
processing, not part of grossing. Is this correct? The PAs and Pathologists 
would like the lab assistants to do this at our lab.

   1. What is the CLIA and CAP actual definition of grossing? Where do I
   find this?
   2. Is what the lab assistants are doing at that lab actually a part of
   grossing, or are they just processing the placentas by the regulatory
   definition?


Thank you in advance,



*Donna Emge, HT (ASCP)*
UChicago Medicine | AdventHealth
GL Regional Laboratory Manager | Histology

Donna.Emge(@)AdventHealth.com
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Re: [Histonet] Cassette printers

[Wooten, Jennifer via Histonet]

We had a GD DirectMark that was marketed to print on 3 sides, but it would jam 
so much just printing on 1 side that we never could explore printing on the 3 
sides.

Jennifer Wooten, BA, BS, HTL (ASCP)CM

-Original Message-
From: Paula Sicurello 
Sent: Wednesday, December 28, 2022 11:44 AM
To: HistoNet 
Subject: [Histonet] Cassette printers

Good Morning Listers,
We are in the market for a new cassette printer.  Has anyone used the General 
Data LaserTrack FLEX system?  I'm interested in how well it actually prints on 
3 sides of the cassettes.
Any input about any other vendors printers is helpful.  I have quotes from 
General Data, Sakura, and Leica.
Please provide your opinions and related experiences with each of the vendor's 
cassette printer.  We currently have a General Data CL12 that is dying a slow, 
painful death.
Thanks oodles for your help.

Paula Sicurello
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[Histonet] Cryostat vacuums

[Wooten, Jennifer via Histonet]

Does anyone use a vacuum to clean out their cryostats, either on or off-board?

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Technical Supervisor | Anatomic Pathology | University Hospital

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Re: [Histonet] release of body parts

[Wooten, Jennifer via Histonet]

We release specimens to patients here, especially because of our unique 
cultural demographic. If the specimen is in formalin, we will drain, rinse, and 
place contents in a new clean container with labels. The patient also signs a 
release form acknowledging that the specimen was preserved in formalin and will 
slowly degrade over time, and is not suitable for consumption etc.

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Technical Supervisor | Anatomic Pathology | University Hospital
Desk: 505.272.5486 | Fax: 505.272.0240
TriCore Reference Laboratories
2211 Lomas Blvd NE
Albuquerque, NM 87106
www.tricore.org

-Original Message-
From: Cartun, Richard [mailto:richard.car...@hhchealth.org]
Sent: Wednesday, August 18, 2021 10:56 AM
To: Nancy Schmitt
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] release of body parts

We no longer release any tissue to a patient that comes to our Pathology 
Laboratory in formalin, and our Legal Department supports this decision.  I 
know that our "Labor & Delivery" Unit has released placentas to patients; 
however, if the specimen doesn't come to Pathology, we don't get involved.  For 
certain types of specimens received in formalin (POC, fetus, amputation, etc.) 
a patient can request the release of their specimen, but they have to make 
arrangements with a funeral home or mortuary to take procession of the specimen 
here at the hospital and, yes, they (funeral home/mortuary) must sign the 
release form.

Please keep in mind that each state may have statues on the release of human 
tissue to patients or their families.  I also know that some towns here in CT 
have ordinances preventing residents from burying human tissue on their 
property.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & The Martin M. Berman, MD
  Immunopathology/Morphologic Proteomics Laboratory
Assistant Director, Anatomic Pathology
Department of Pathology & Laboratory Medicine
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596 Office
(860) 545-2204 (Fax)


-Original Message-
From: Nancy Schmitt via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, August 18, 2021 12:33 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] release of body parts

This email is from outside HHC. BE CAREFUL when opening attachments or links 
from unknown senders.

Hello-
We are seeing a bit more of patients that are requesting to take their body 
parts with them (uterus, POC, etc); I am talking home  - not the funeral home.
Are you using a release of body parts form to fill out with the patient?
Are you draining off the formalin, or sending in formalin with parafilm around 
the lid?
Thank you for your thoughts,
Nancy Schmitt MLT, HT(ASCP)
Pathology Support Services
Dubuque, IA  52001


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Re: [Histonet] Histonet Digest, Vol 213, Issue 6

[Wooten, Jennifer via Histonet]

We just recently purchased the Epredia NX50, which we use with our older 
HM525s. We love it, I just wish they would make height adjustability a standard 
option on them!

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Pronouns: she/her/hers
Technical Supervisor | Anatomic Pathology | University Hospital
jennifer.woo...@tricore.org
Desk: 505.272.5486 | Fax: 505.272.0240
TriCore Reference Laboratories
2211 Lomas Blvd NE
Albuquerque, NM 87106
www.tricore.org

-Original Message-
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Subject: Histonet Digest, Vol 213, Issue 6

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Re: [Histonet] Histonet Digest, Vol 212, Issue 1

[Wooten, Jennifer via Histonet]

We surface decal with decal I for about 20-30 minutes (as long as you don't 
need to do any molecular studies). You can usually get 3-4 good sections before 
its crunchy again.

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Pronouns: she/her/hers
Technical Supervisor | Anatomic Pathology | University Hospital
jennifer.woo...@tricore.org
Desk: 505.272.5486 | Fax: 505.272.0240
TriCore Reference Laboratories
2211 Lomas Blvd NE
Albuquerque, NM 87106
www.tricore.org

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 

Sent: Thursday, July 1, 2021 11:00 AM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 212, Issue 1

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Re: [Histonet] Specimen tracking scenario, accountability

[Wooten, Jennifer via Histonet]

Hi Curt,
That sounds like a very difficult position to be in, especially with many of 
them not barcoded. Photo documentation might be your best bet; we use the 
Vantage tracking system throughout our process, and the Arcos system for 
tracking filed blocks once completed. You might want to reach out to Epredia to 
see if their Arcos system allows for scanning of trays without barcodes.

Good luck!

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Pronouns: she/her/hers
Technical Supervisor | Anatomic Pathology | University Hospital
jennifer.woo...@tricore.org
Desk: 505.272.5486 | Fax: 505.272.0240
TriCore Reference Laboratories
2211 Lomas Blvd NE
Albuquerque, NM 87106
www.tricore.org

-Original Message-
From: Curt Tague 
Sent: Tuesday, June 22, 2021 10:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Specimen tracking scenario, accountability

So we're in a reference lab setting here, it's a little different than the 
hospital environment... I've been in both.

We receive specimens from a variety of different hospitals, physician offices 
and even other labs for histology (TC), we send the slides back. What I'd like 
to do is implement some system for tracking blocks throughout the process but 
with so many different clients and number systems/prefixes, most of which are 
NOT barcoded, it can be a challenge tracking the blocks throughout the whole 
process... from receipt to embedding to microtomy...
Aside from manually documenting every blocks on a paper log sheet, would anyone 
have any suggestions on how to track these things?

My initial thought is a simple digital photo of the basket at embedding (when 
removed from the processor) then another photo of blocks you take to your 
microtome and perhaps one last photo when blocks are taken from your cutting 
station to be filed or returned... the simple issue is tracking who is in 
possession of what blocks at all times... accountability... but this seems to 
present challenges too...

Any thoughts are appreciated.

Curt

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[Histonet] Changing decal question

[Wooten, Jennifer via Histonet]

Good afternoon,
I would like to inquire what everyone's decal (RBD and/or Decal I) changing 
routines are. We are trying to determine if we should continue to change 
weekly, or based on how many specimens we put in it, or what the pH is. Any 
help is greatly appreciated, thanks!

Jennifer Wooten, BA, BS, HTL (ASCP)CM
Pronouns: she/her/hers
Technical Supervisor | Pathology | University Hospital
jennifer.woo...@tricore.org
Desk: 505.272.5486 | Fax: 505.272.0240
TriCore Reference Laboratories
2211 Lomas Blvd NE
Albuquerque, NM 87106
www.tricore.org


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