[Histonet] RE: Cap ER/PR
Karen, when this has happened in the past CAP has told me to run the test and score it, then when the survey summary comes with the scores and discussion, to have the pathologist review and score the answers and document the review. It's about the best you can do when something gets missed. You may want to have two reviewers sign off in this case. 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 Heckford, Karen - SMMC-SF Sent: Wednesday, October 29, 2014 10:08 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cap ER/PR Good Morning, Apparently while I was out on disability a CAP ER/PR PM2-A 2014 did not get done. Somehow one of our pathologists got it and forgot she had it. That being said, does anyone have a equivalent test they do instead. We only do this CAP testing to show competency. Thanks, Karen Heckford HT ASCP CE Lead Histology Technician St. Mary's Medical Center 450 Stanyan St. San Francisco, Ca. 94117 415-668-1000 ext. 6167 karen.heckf...@dignityhealth.org Caution: This email message, including all content and attachments, is CONFIDENTIAL and may be of a nature that is LEGALLY PRIVILEGED. The information contained in this email message is intended only for the use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you have received this document in error. Any further review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by reply email. 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: Cap ER/PR
I agree with Tim Morken 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 Morken, Timothy Sent: Wednesday, October 29, 2014 8:15 PM To: 'Heckford, Karen - SMMC-SF'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Cap ER/PR Karen, when this has happened in the past CAP has told me to run the test and score it, then when the survey summary comes with the scores and discussion, to have the pathologist review and score the answers and document the review. It's about the best you can do when something gets missed. You may want to have two reviewers sign off in this case. 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 Heckford, Karen - SMMC-SF Sent: Wednesday, October 29, 2014 10:08 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cap ER/PR Good Morning, Apparently while I was out on disability a CAP ER/PR PM2-A 2014 did not get done. Somehow one of our pathologists got it and forgot she had it. That being said, does anyone have a equivalent test they do instead. We only do this CAP testing to show competency. Thanks, Karen Heckford HT ASCP CE Lead Histology Technician St. Mary's Medical Center 450 Stanyan St. San Francisco, Ca. 94117 415-668-1000 ext. 6167 karen.heckf...@dignityhealth.org Caution: This email message, including all content and attachments, is CONFIDENTIAL and may be of a nature that is LEGALLY PRIVILEGED. The information contained in this email message is intended only for the use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you have received this document in error. Any further review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by reply email. 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP question ANP.22978 - Her2 assay validation
https://www.biomax.us/tissue-arrays/Breast/ theres the link, they have various kinds, so just choose the one that comes with the IHC results Vanessa Perez Garcia Pathology Reference Lab 210-892-3746 210-892-3732 vpe...@pathreflab.com -Original Message- From: Martha Ward-Pathology [mailto:mw...@wakehealth.edu] Sent: Wednesday, April 30, 2014 7:11 AM To: Vanessa Perez Subject: RE: CAP question ANP.22978 - Her2 assay validation Thanks. I like the idea of the microarray slide as well. Where did you purchase your slide? martha -Original Message- From: Vanessa Perez [mailto:vpe...@pathreflab.com] Sent: Tuesday, April 29, 2014 5:18 PM To: Martha Ward-Pathology; histonet@lists.utsouthwestern.edu Subject: RE: CAP question ANP.22978 - Her2 assay validation From what I have read and understand you should be able to do a write up the retroactive review based on the PT results. What we did here was bought a microarray slide that came with the HER2/ER/PR results, ran them on our machine, and compared our results to the ones that came with the slide. Vanessa Perez Garcia Pathology Reference Lab 210-892-3746 210-892-3732 vpe...@pathreflab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha Ward-Pathology Sent: Tuesday, April 29, 2014 2:47 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP question ANP.22978 - Her2 assay validation Hello all, I have been reading through the most recent revisions and want to see how others are handling this question. The explanation states that it is for new and existing assays and that if your validation does not meet current standards that you must supplement and bring it into compliance. Furthermore if you do not have any documentation from the initial validation the assay must be fully revalidated and documented. Our lab has been performing the Herceptest from Dako (FDA approved) since before 2008 and participating in the HER2 proficiency testing since it was first offered. We have our statistical results comparing our IHC patient results to FISH Her2 results since 2008 and we have always done well on our CAP proficiency testing (95%-100%).We do inter-pathologist result comparisons, using know CAP slides and have 95% to 100% agreements. What I do not have however is the original results of the slides that were stained to set up the original assay. Under these circumstances will we need to completely revalidate the assay, using the mandated 20+/20- cases, or can we simply do a retroactive formal review and write up of our past performances on our proficiency testing challenges? Thanks in advance for your help with this! Martha Ward, MT (ASCP) QIHC Manager Molecular Diagnostics Lab Medical Center Boulevard \ Winston-Salem, NC 27157 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP question ANP.22978 - Her2 assay validation
From what I have read and understand you should be able to do a write up the retroactive review based on the PT results. What we did here was bought a microarray slide that came with the HER2/ER/PR results, ran them on our machine, and compared our results to the ones that came with the slide. Vanessa Perez Garcia Pathology Reference Lab 210-892-3746 210-892-3732 vpe...@pathreflab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha Ward-Pathology Sent: Tuesday, April 29, 2014 2:47 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP question ANP.22978 - Her2 assay validation Hello all, I have been reading through the most recent revisions and want to see how others are handling this question. The explanation states that it is for new and existing assays and that if your validation does not meet current standards that you must supplement and bring it into compliance. Furthermore if you do not have any documentation from the initial validation the assay must be fully revalidated and documented. Our lab has been performing the Herceptest from Dako (FDA approved) since before 2008 and participating in the HER2 proficiency testing since it was first offered. We have our statistical results comparing our IHC patient results to FISH Her2 results since 2008 and we have always done well on our CAP proficiency testing (95%-100%).We do inter-pathologist result comparisons, using know CAP slides and have 95% to 100% agreements. What I do not have however is the original results of the slides that were stained to set up the original assay. Under these circumstances will we need to completely revalidate the assay, using the mandated 20+/20- cases, or can we simply do a retroactive formal review and write up of our past performances on our proficiency testing challenges? Thanks in advance for your help with this! Martha Ward, MT (ASCP) QIHC Manager Molecular Diagnostics Lab Medical Center Boulevard \ Winston-Salem, NC 27157 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP Question, New Reagent Lot Confirmation of
A pathologist is designated to sign off in our lab. 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
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
[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
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
[Histonet] RE: CAP survey Question
We do the same process as Linda does here at Beaumont. Sue Sue Hunter, Supervisor Advanced Diagnostics Beaumont Health System Royal Oak MI 248-898-5146 shun...@beaumont.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sebree Linda A Sent: Wednesday, December 04, 2013 4:34 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP survey Question We also have Ultras Jim. We don't print out the run logs. IHC personnel review the controls before they go to a pathologist in order to catch any problems. The pathologists are supposed to review the controls associated with each case they sign out. Our pathology report has a statement included that the negative and positive controls have stained appropriately. By signing off on each case, the pathologist is attesting to the fact that he has indeed reviewed the controls...we do not police them. So far, this works for us. 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 Vickroy, Jim Sent: Wednesday, December 04, 2013 2:51 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP survey Question For a long time I have had our IHC techs print out the run logs from each IHC run on the Benchmark Ultras. The techs then check the slides to make sure the positive and negative controls have worked properly before the slides are sent to the individual pathologists. The pathologists are also supposed to check the controls before looking at the patient slides. Lately in the interest of reducing turnaround time I have been asked why we run the log reports and have a tech look over the controls before they send them to the pathologists since the pathologist will also evaluate the controls. I have been doing this because I wanted the documentation that someone reviewed the controls each time an IHC stain was done. I believe if the pathologists would document someplace that the control slides were reviewed before the patient slides were viewed then I could eliminate the techs looking over the controls also. Problem is how are others documenting that the controls are reviewed? Is this done by the techs, the pathologists, or both? We of course have also used this data for quality assurance of our stains. Thanks for your help. Jim 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP survey Question
We also have Ultras Jim. We don't print out the run logs. IHC personnel review the controls before they go to a pathologist in order to catch any problems. The pathologists are supposed to review the controls associated with each case they sign out. Our pathology report has a statement included that the negative and positive controls have stained appropriately. By signing off on each case, the pathologist is attesting to the fact that he has indeed reviewed the controls...we do not police them. So far, this works for us. 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 Vickroy, Jim Sent: Wednesday, December 04, 2013 2:51 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP survey Question For a long time I have had our IHC techs print out the run logs from each IHC run on the Benchmark Ultras. The techs then check the slides to make sure the positive and negative controls have worked properly before the slides are sent to the individual pathologists. The pathologists are also supposed to check the controls before looking at the patient slides. Lately in the interest of reducing turnaround time I have been asked why we run the log reports and have a tech look over the controls before they send them to the pathologists since the pathologist will also evaluate the controls. I have been doing this because I wanted the documentation that someone reviewed the controls each time an IHC stain was done. I believe if the pathologists would document someplace that the control slides were reviewed before the patient slides were viewed then I could eliminate the techs looking over the controls also. Problem is how are others documenting that the controls are reviewed? Is this done by the techs, the pathologists, or both? We of course have also used this data for quality assurance of our stains. Thanks for your help. Jim 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
[Histonet] Re: Cap is in the house
Good morning from warm, muggy San Diego! I understand why some folks have a bit of a short fuse with superfluous seeming emails from the Histonet. It's the same reason we are not allowed to send emails out to all associates at work. Most have an over-active email account anyway and it's just another one that takes their time to read. For those folks, I recommend subscribing to the Histonet digest. You get one, maybe two emails a day only, with the complete compilation of the day's questions, comments, witty retorts, etc. You can visit here: http://lists.utsouthwestern.edu/mailman/listinfo/histonet and change your mail delivery. Otherwise, I recommend a quick scan and liberal use of the delete button. Teri Johnson Manager, Histology GNF - San Diego, CA 858-332-4752 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP standard GEN 61300
I am very interested in this as well. We have an ongoing issue with humidity/static. I have been unable to find anything that lists a recommended humidity level for histology. New construction building codes for labs list 30% - 80% and the equipment manufacturers list 30% - 80% for their recommended operating environment. Based on two different digital readers, our humidity is sometimes in the 20% range (mostly in winter but not always). A hand operated device reads about 40% higher than the digitals so I don't quite know what to make of it. Anyway, I will appreciated any input. Tom McNemar, HT(ASCP) Histology Co-ordinator Licking Memorial Health Systems (740) 348-4163 (740) 348-4166 tmcne...@lmhealth.org www.LMHealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Knutson, Deanne Sent: Monday, May 06, 2013 8:13 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] CAP standard GEN 61300 Fellow Histonetters, I am looking for advice concerning CAP standard GEN 61300 Climate Control. To those that take humidity records in your lab, what exact % range do you use for a normal range? And what do you do if and when you are out of this range? Thank you for sharing your workflow info with me. Deanne Knutson Anatomic Pathology Supervisor St. Alexius Medical Center 701-530-6730 dknut...@primecare.orgmailto:dknut...@primecare.org 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. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail, including attachments, is intended for the sole use of the individual and/or entity to whom it is addressed, and contains information from Licking Memorial Health Systems which is confidential or privileged. If you are not the intended recipient, nor authorized to receive for the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this e-mail and attachments is prohibited. If you have received this in error, please advise the sender by reply e-mail and delete the message immediately. You may also contact the LMH Process Improvement Center at 740-348-4641. E-mail transmissions cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] RE: CAP standard GEN 61300
We are also going through humidity issues post inspection. Our values are based on the specifications in the equipment manuals and are 30%-80%. We use a digital reader. We have been dipping below that and are working to get the humidity up. We have brought in a small humidifier but it is not keeping up on very dry days. It is in our policy to report out of range values to our supervisor and she is now looking in to a more permanent solution. We would also appreciate any comments on how other labs have increased their humidity. Katelin Lester, HTL On May 6, 2013 7:47 AM, Tom McNemar tmcne...@lmhealth.org wrote: I am very interested in this as well. We have an ongoing issue with humidity/static. I have been unable to find anything that lists a recommended humidity level for histology. New construction building codes for labs list 30% - 80% and the equipment manufacturers list 30% - 80% for their recommended operating environment. Based on two different digital readers, our humidity is sometimes in the 20% range (mostly in winter but not always). A hand operated device reads about 40% higher than the digitals so I don't quite know what to make of it. Anyway, I will appreciated any input. Tom McNemar, HT(ASCP) Histology Co-ordinator Licking Memorial Health Systems (740) 348-4163 (740) 348-4166 tmcne...@lmhealth.org www.LMHealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Knutson, Deanne Sent: Monday, May 06, 2013 8:13 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] CAP standard GEN 61300 Fellow Histonetters, I am looking for advice concerning CAP standard GEN 61300 Climate Control. To those that take humidity records in your lab, what exact % range do you use for a normal range? And what do you do if and when you are out of this range? Thank you for sharing your workflow info with me. Deanne Knutson Anatomic Pathology Supervisor St. Alexius Medical Center 701-530-6730 dknut...@primecare.orgmailto:dknut...@primecare.org 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. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail, including attachments, is intended for the sole use of the individual and/or entity to whom it is addressed, and contains information from Licking Memorial Health Systems which is confidential or privileged. If you are not the intended recipient, nor authorized to receive for the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this e-mail and attachments is prohibited. If you have received this in error, please advise the sender by reply e-mail and delete the message immediately. You may also contact the LMH Process Improvement Center at 740-348-4641. E-mail transmissions cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. 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: CAP standard GEN 61300
To address Gen 61300, you have to check your instrument manuals, and MSDS for all your reagents. Create the acceptable ranges and then monitor. Make sure you create a process to address out of range issues. We use Tutela Medical devices to monitor both temp and humidity. Our facilites installed and maintains records. http://www.tutelamedical.com/ William DeSalvo, BS HTL(ASCP) Production Manager-Anatomic Pathology Chair, NSH Quality Management Committee Owner/Consultant, Collaborative Advantage Consulting Date: Mon, 6 May 2013 08:12:01 -0700 From: katelin09...@gmail.com To: tmcne...@lmhealth.org Subject: Re: [Histonet] RE: CAP standard GEN 61300 CC: histonet@lists.utsouthwestern.edu; dknut...@primecare.org We are also going through humidity issues post inspection. Our values are based on the specifications in the equipment manuals and are 30%-80%. We use a digital reader. We have been dipping below that and are working to get the humidity up. We have brought in a small humidifier but it is not keeping up on very dry days. It is in our policy to report out of range values to our supervisor and she is now looking in to a more permanent solution. We would also appreciate any comments on how other labs have increased their humidity. Katelin Lester, HTL On May 6, 2013 7:47 AM, Tom McNemar tmcne...@lmhealth.org wrote: I am very interested in this as well. We have an ongoing issue with humidity/static. I have been unable to find anything that lists a recommended humidity level for histology. New construction building codes for labs list 30% - 80% and the equipment manufacturers list 30% - 80% for their recommended operating environment. Based on two different digital readers, our humidity is sometimes in the 20% range (mostly in winter but not always). A hand operated device reads about 40% higher than the digitals so I don't quite know what to make of it. Anyway, I will appreciated any input. Tom McNemar, HT(ASCP) Histology Co-ordinator Licking Memorial Health Systems (740) 348-4163 (740) 348-4166 tmcne...@lmhealth.org www.LMHealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Knutson, Deanne Sent: Monday, May 06, 2013 8:13 AM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] CAP standard GEN 61300 Fellow Histonetters, I am looking for advice concerning CAP standard GEN 61300 Climate Control. To those that take humidity records in your lab, what exact % range do you use for a normal range? And what do you do if and when you are out of this range? Thank you for sharing your workflow info with me. Deanne Knutson Anatomic Pathology Supervisor St. Alexius Medical Center 701-530-6730 dknut...@primecare.orgmailto:dknut...@primecare.org 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. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail, including attachments, is intended for the sole use of the individual and/or entity to whom it is addressed, and contains information from Licking Memorial Health Systems which is confidential or privileged. If you are not the intended recipient, nor authorized to receive for the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this e-mail and attachments is prohibited. If you have received this in error, please advise the sender by reply e-mail and delete the message immediately. You may also contact the LMH Process Improvement Center at 740-348-4641. E-mail transmissions cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP checklist question
We put in a procedure stating that should we change the schedule we will test a variety of tissue (10 different types) and have the pathologist assess the run. We have not changed a schedule in years but we seek to comply... -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Hannen, Valerie Sent: Monday, February 25, 2013 1:21 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP checklist question Hi gang.. I am working on a self-inspection CAP checklist and came across the following: ANP.23120 Tissue Processor Tissue processing schedules are validated. Note: New tissue processing schedules must be validated against the standard laboratory processing schedule. Evidence of compliance: Written procedure for validation of new tissue processing schedules AND WC records documenting validation What do you all make of this?? We have not had any new processing schedules introduced into our lab in years. So, I really don't know how to proceed on this one. Any insite will be greatly appreciated. Valerie A. Hannen, MLT(ASCP),HTL,SU(FL) Histology Section Chief Parrish Medical Center 951 N. Washington Ave. Titusville, Florida 32976 Phone:(321) 268-6333 ext. 7506 Fax: (321) 268-6149 valerie.han...@parrishmed.com = This email is intended solely for the use of the individual to whom it is addressed and may contain information that is privileged, confidential or otherwise exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately delete this message. 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
[Histonet] RE: CAP Gen.55500
Another area I am wondering about is competency for the PA's. Anyone have something they can share? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Michelle Lamphere Sent: Thursday, February 21, 2013 3:02 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] CAP Gen.55500 Good afternoon We were wondering how other labs handle their training/competencies in response to the revised Competency Assessment question in the Gen Lab portion of the checklist. (GEN.55500) 1. How do you do your training before you start your competency? 2. How do you differentiate initial training from initial competency? 3. Is semiannually after the date of hire? Or after training? Or not until after initial competency? And how does that apply to skills that would only be utilized once or twice a year (such as a special stain that you do not perform on a routine basis but still offer)? 4. How do you train without using actual patients? Example...accessioning, embedding, processing, etc 5. What template do you use to incorporate all six elements that are listed? 6. What are you incorporating as your test system? I really appreciate any insight or advice you can offer. Thank you! Michelle M Lamphere, HT (ASCP) Senior Tech, Histology Children's Medical Center 1935 Medical District Drive Dallas, TX 75235 Office :214-456-2798 Histology: 214-456-2318 Fax: 214-456-0779 Please consider the environment before printing this e-mail This e-mail, facsimile, or letter and any files or attachments transmitted with it contains information that is confidential and privileged. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please notify Children's Medical Center Dallas immediately at 214-456- or via e-mail at priv...@childrens.com. Children's Medical Center Dallas and its affiliates hereby claim all applicable privileges related to this information. Please consider the environment before printing this e-mail. This e-mail, facsimile, or letter and any files or attachments transmitted with it contains information that is confidential and privileged. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please notify Children's Medical Center Dallas immediately at 214-456- or via e-mail at priv...@childrens.com. Children's Medical Center Dallas and its affiliates hereby claim all applicable privileges related to this information. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP Gen.55500
Michelle, The competencies must be keyed to the persons job description. You hired the person with some kind of assurance they could do the work for a particular job. They them must be trained into your system for that job. 1. How do you do your training before you start your competency? A: The training is driven by a checklist of whatever it is they need to be trained at. You assume they know how to cut sections but you will orient them to the microtome, etc that your lab uses, show them how it works and then have them do it. Once they demonstrate they can do it, you have completed that portion of training and you can also sign off their competency. Then you go down the checklist. It may take many months before they complete the entire training if they are expected to be general histotechs rotating to all sections. 2. How do you differentiate initial training from initial competency? A: Training first, then competency. Even if they know how to do it, there will be differences in the way your lab does it verses what they have done elsewhere. The key is for them to know how to do it in your lab and what you expect from them. 3AIs semiannually after the date of hire? Or after training? Or not until after initial competency? A: They are hired, they are trained and at 6 months you review their competency and give a 6-month evaluation. We keep records of all the cases they do in the first 6 months and use that as evidence of competency. You need to determine if they are done training, need more work, etc. After that they are reviewed annually. (so, initial hire, 6 month competency review, then at 18 months they get their first annual review) 3B And how does that apply to skills that would only be utilized once or twice a year (such as a special stain that you do not perform on a routine basis but still offer)? A: there will always be some things that are not done very often. We only include routine processes in the initial training and competency. They can be trained in rare tests at the time those come in. After they are trained we require people to do at least one of the rare tests per year, even on a control, to maintain competency. If they do not do that they are taken off the list of people who can do that test and must retrain. 4. How do you train without using actual patients? Example...accessioning, embedding, processing, etc A: all LIS have TEST modules that can also be loaded with dummy patients to use as training modules as well. All other histology training can be done initially on excess tissue saved for that purpose. You can get bx needles and make your own biopsies to train people to embed well. Etc. Make paraffin blocks from excess tissue of various types for initial microtome training. Use controls for special stains. Etc. 5. What template do you use to incorporate all six elements that are listed? A: We have a standard institution-wide template for this. It is up to each area to fill it with the job description that applies and determine how the elements are applied. It is a lot of work initially, but pays off in standardized evaluations later on. 6. What are you incorporating as your test system? A: The test system is your standard procedures, but no one actually takes part in the entire system 9ie, tissue procurement to reporting). BUT they must know the elements of each part to understand the whole. So, you can educate them about the parts that take place outside the lab, but they are trained on the parts that take place in your lab that they will actually do. I stress that understanding the entire test system and their part in it is very, very valuable to their understanding of their role. Have fun! Tim Morken 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 Michelle Lamphere Sent: Thursday, February 21, 2013 12:02 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] CAP Gen.55500 Good afternoon We were wondering how other labs handle their training/competencies in response to the revised Competency Assessment question in the Gen Lab portion of the checklist. (GEN.55500) 1. How do you do your training before you start your competency? 2. How do you differentiate initial training from initial competency? 3. Is semiannually after the date of hire? Or after training? Or not until after initial competency? And how does that apply to skills that would only be utilized once or twice a year (such as a special stain that you do not perform on a routine basis but still offer)? 4. How do you train without using actual patients? Example...accessioning, embedding, processing, etc 5. What template do you use to incorporate all six
[Histonet] RE: CAP guideline for fixation time
Our OR and Breast Health staff have done pretty well getting on board with this. We rarely have one that hasn't been documented. We have a place on the requisition (located just under the date field so they will see it) where time out of body (for the cold ischemic time), and time into formalin is documented. Then we document the rest on the requisition and the pathologist takes it from there. 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 Victor A. Tobias Sent: Friday, January 04, 2013 6:21 PM To: 'histonet' Subject: [Histonet] CAP guideline for fixation time Per CAP guideline, in our reports of predictive markers(ER/PR/Her2), Pathologists need to check that the total fixation time of specimens is within the CAP guideline. Is this information readily available to the pathologists at the time of writing the report? How are others documenting this? Have a great weekend. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst Harborview Medical Center Dept of Pathology Room NJB244 Seattle, WA 98104 vtob...@u.washington.edumailto:vtob...@u.washington.edumailto:vtob...@u.washington.edu%3cmailto:vtob...@u.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edumailto: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] RE: CAP guideline for fixation time
We have it documented within the APLIS, when the order is placed within our EMR,, for requisitions we have them document them on the requisition at the time it is taking place with a sticker,, but since the most of our orders are electronic it is part of the workflow, this is done for all specimens as we see the importance of other biomarkers for future -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Weems, Joyce K. Sent: Monday, January 07, 2013 11:00 AM To: 'Victor A. Tobias'; 'histonet' Subject: [Histonet] RE: CAP guideline for fixation time Our OR and Breast Health staff have done pretty well getting on board with this. We rarely have one that hasn't been documented. We have a place on the requisition (located just under the date field so they will see it) where time out of body (for the cold ischemic time), and time into formalin is documented. Then we document the rest on the requisition and the pathologist takes it from there. 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 Victor A. Tobias Sent: Friday, January 04, 2013 6:21 PM To: 'histonet' Subject: [Histonet] CAP guideline for fixation time Per CAP guideline, in our reports of predictive markers(ER/PR/Her2), Pathologists need to check that the total fixation time of specimens is within the CAP guideline. Is this information readily available to the pathologists at the time of writing the report? How are others documenting this? Have a great weekend. Victor Victor Tobias HT(ASCP) Clinical Applications Analyst Harborview Medical Center Dept of Pathology Room NJB244 Seattle, WA 98104 vtob...@u.washington.edumailto:vtob...@u.washington.edumailto:vtob...@u.washington.edu%3cmailto:vtob...@u.washington.edu 206-744-2735 206-744-8240 Fax = Privileged, confidential or patient identifiable information may be contained in this message. This information is meant only for the use of the intended recipients. If you are not the intended recipient, or if the message has been addressed to you in error, do not read, disclose, reproduce, distribute, disseminate or otherwise use this transmission. Instead, please notify the sender by reply e-mail, and then destroy all copies of the message and any attachments. ___ Histonet mailing list Histonet@lists.utsouthwestern.edumailto: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 __ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail, fax, address, or telephone number listed above and delete this e-mail from your computer. Thank You. __ ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Re: CAP guideline for fixation time for ER/PR/HER2
Time of fixation before ER/PR/HER2: I haven't had much luck with getting this information. Nobody wants to deal with the communication issues. Needle biopsy specimens should be popped into formalin as soon as they are out of the patient, and the time recorded. What you can't find out is whether they are willing to fix the specimens before they take the time to X-ray them. Attempts to find out what they're doing are futile. To the OR nurse, a specimen is perfectly fixed all the way through the instant she drops it into formalin, whether a small lumpectomy or a Dolly-sized mammoon. Eventually we're going to have to realize that larger specimens (more than needle biopsy size) require prompt dissection before fixation, if special studies are to be done. Bob Richmond Samurai Pathologist Maryville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP
We got an A+ rating. Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Wednesday, May 30, 2012 9:34 AM To: Bernice Frederick; Fellow HistoNetters Subject: RE: CAP Have fun and good luck -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Wednesday, May 30, 2012 7:16 AM To: Fellow HistoNetters Subject: [Histonet] CAP They're here! Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet __ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail, fax, address, or telephone number listed above and delete this e-mail from your computer. Thank You. __ ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP
Congratulations!! WANDA G. SMITH, HTL(ASCP)HT Pathology Supervisor TRIDENT MEDICAL CENTER 9330 Medical Plaza Drive Charleston, SC 29406 843-847-4586 843-847-4296 fax This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Friday, June 01, 2012 10:41 AM To: Jesus Ellin; Fellow HistoNetters Subject: [Histonet] RE: CAP We got an A+ rating. Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Wednesday, May 30, 2012 9:34 AM To: Bernice Frederick; Fellow HistoNetters Subject: RE: CAP Have fun and good luck -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Wednesday, May 30, 2012 7:16 AM To: Fellow HistoNetters Subject: [Histonet] CAP They're here! Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet __ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail, fax, address, or telephone number listed above and delete this e-mail from your computer. 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
[Histonet] RE: CAP
Have fun and good luck -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Wednesday, May 30, 2012 7:16 AM To: Fellow HistoNetters Subject: [Histonet] CAP They're here! Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet __ This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at either the e-mail, fax, address, or telephone number listed above and delete this e-mail from your computer. Thank You. __ ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP
Best of luck. Tunde Ajibade BS, HTL(ASCP)QIHC Histology Supervisor Medical Center Hospital Odessa,TX Tel: 432-640-2348 Fax:432-640-2303 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bernice Frederick Sent: Wednesday, May 30, 2012 9:16 AM To: Fellow HistoNetters Subject: [Histonet] CAP They're here! Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet CONFIDENTIALITY NOTICE: The documents accompanying this email transmission contain confidential information belonging to the sender 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 and is required to destroy the information after its stated need has been fulfilled. 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 email in error, please notify the sender immediately to arrange for return of these documents. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] RE: CAP vs. CLIA
Thank You Amanda!!! - Original Message - From: Amanda Kelley akell...@slu.edu To: WILLIAM DESALVO wdesalvo@hotmail.com Cc: histonet histonet@lists.utsouthwestern.edu Sent: Monday, May 21, 2012 9:53:41 AM Subject: Re: [Histonet] RE: CAP vs. CLIA I usually do not comment on the histonet, however this topic is near and dear to my heart. We in Histology are support scientific staff to the Pathologist as much as the Laboratory director is to the Pathologist. Scientific duties, which a pathologist can perform (histological and cytological preparation has been delegated down) to our position. Interpretation of Controls and associated material is often left to us and the Pathologist assistant We determine what the Pathologist can interpret Our expertise directly determines patient outcome, if we are not professional in our decisions then the Pathologist is ineffective in his or hers. The Professional business of running the laboratory is performed by the medical laboratory director, and associate director. These are professional positions within the laboratory where a Pathologist has delegated the managerial responsibility to a subordinate. According to CLIA, this position does not exist, only the Pathologist can truly be the Medical laboratory director. Yet in hospitals across the country many Clinical laboratory Scientist's who don't know anything or have limited knowledge of AP are in charge of our AP labs.Their positions are listed as Laboratory Director. This subordinate is the most important person in the lab, yet they too do not turn out results. They are frequently the highest paid in the lab. Their pay is based on the designation of their scientific and managerial background. I believe we can do the same. The business of the pathology lab would be very difficult for the pathologist to handle without this symbiotic relationship of the scientific businessman to the Pathologist. Likewise a Pathologist can not perform their job without the symbiotic relationship to the histotechnologist.Thereby technically, making our jobs indispensable to the Pathologist much like the laboratory director. Our problem is history, where many pathologists trained their out of work brother in law to do the work. Many rural areas still run their labs this way. As long as there is a path to become a histotech by hiring whomsoever to do the job. We will always be left behind. So I believe if CLIA and CAP can recognize the laboratory Manager as an important professional position delegated by the Pathologist then we should be afforded the same courtesy. On Sun, May 20, 2012 at 10:37 PM, WILLIAM DESALVO wdesalvo@hotmail.comwrote: I seemed to have missed something or it might have been all the fresh sea air I got in Tampa at the FSH, but I do not understand the outrage expressed towards CLIA and CAP because we are not listed as testing personnel. I applaud everyone's passion for Histotechnology and the outrage that we are not allowed to fully participate in the test system model, but I think we should be directing more of our outrage to the individuals working in Histotechnology that are not and will not take responsibility to increase the professionalism of our profession and our own acceptance of the current state of Histotechnology. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. As good as we are and as complex parts of the Histotechnology process may be, Histotechnicians, Histotechnologists and Pathology Assistants do not meet the standard stated and do not participate in the post-analytic phase, produce and release patient results. We simply are not able to be credentialed as is the Medical Technologists and Cytotechnologist. I am not saying any one laboratory professional group is better than the other, just that to be considered testing personnel, we must be properly credentialed. Collectively, we as a discipline, science and group should be working to upgrade our education requirements and training so that we can become fully invested partners with the Pathologist. We, not CAP or CLIA, must greatly increase our professionalism before we can truly be considered competent to work in the post-analytical phase. I cannot today accept that every working Histotechnician, Histotechnologist and Pathologist Assistant is able to produce the result and release. I am quite sure that every Medical Technologist and Cytotechnologist is capable and competent to produce and release a patient result. As things stand today, Histotechnology and all of us the working in this discipline are a support function to the one person in our discipline, the Pathologist, that is educated, trained, credentialed and competent to produce and release a patient result. I also believe there are many opportunities within
Re: [Histonet] RE: CAP vs. CLIA
individuals (good, decent and hard working) that work every day, in every type and complexity of lab, that do not have a formal secondary education, have participated in defined clinical trials or have completed a certification exam (required and necessary credentials). Just think how many practitioners of Histotechnology are out there working today that are not properly credentialed. Now think if you know of any Medical Technologist or Cytotechnologist are working that do not have the required credentials. We have many obstacles to increasing the professionalism of Histotechnology; wide and varied backgrounds, lack of standards, lack of automation, lack of certification, but I do not think that CAP or CLIA should be considered one of them. This problem is completely our responsibility. We first have to demand proper credentials, no exceptions, no matter the problem, before we can expect other laboratory professionals to support us in increasing our professionalism and participation in the healthcare delivery system. As important the need for a robust accreditation process, healthy discussion must take place before real change can happen. I suggest we direct our passion and outrage to demand proper credentials to work in Histotechnology and then demand full participation in the test system and proper recognition by all laboratory professionals. William DeSalvo, B.S., HTL(ASCP) From: jel...@yumaregional.org To: timothy.mor...@ucsfmedctr.org; histonet@lists.utsouthwestern.edu Date: Thu, 17 May 2012 17:52:44 + CC: Subject: [Histonet] RE: CAP vs. CLIA I completely agree with you on this. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, May 17, 2012 10:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Jesus wrote: I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. Certainly the regulations limit the high complexity designation to interpretation of procedure results, but that does not mean a facility does not need very highly trained and competent technologists to do the protocols that lead to good interpretation. It simply highlights the difference between running slides through protocols vs looking at the result and determining a diagnosis. I'm sure most here will see the difference. Remember that CAP is a simply a deemed agency of CLIA - that is, CMS (Centers for Medicare and Medicaid, which administers the CLIA regulations) delegates to CAP (and Joint Commission) the authority to accredit laboratories. CAP cannot make up new regulations, only enforce existing CLIA regulations. However, the CLIA regulations are by necessity very general so they can apply to any kind of laboratory operations, current or future. CAP has the leeway to look at what labs are doing and determine if the CLIA regulations apply to those tasks. However, CAP must submit their proposals to CMS/CLIA and CMS/CLIA must pass off on them before they are implemented. CAP checklists are far more complex than they were 20 years ago. But the histo lab is far more complex as well, and regulators (as well as the public) are looking much more closely at histology because of some major mistakes that have happened largely due to lack of rigor in testing validation and implementation. A lot of that has to do with small labs doing complex testing (interpretation) with methods they were/are not fully competent to do primarily due to lack of experience and expertise. While the accreditation process is getting more onerous, it is also forcing labs to be much more professional in their operations - always a good thing, I think. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Willis, Donna G. Sent: Thursday, May 17, 2012 7:26 AM To: 'Jesus Ellin'; 'Horn, Hazel V'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Very well said Jesus. I agree. Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Thursday, May 17, 2012 9:24 AM To: 'Horn, Hazel V'; Willis, Donna G.; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest
RE: [Histonet] RE: CAP vs. CLIA
Bill I have to agree with you on this, but then again we have always been looked as a step children within the lab. What I see is word play here, Cyto tech and Med Tech (CLS) are to be credited with release of a result. But because there Tech ID number is on the result they are accountable for this. As we move forward in the computer age within Anatomic Pathology we are going to be seeing the same shift, but we need our professional societies, to start to transform our profession. I am talking about algorithm analysis, special stains, IHC, bio banking, etc. There are many decisions that make us more than just a point and push tech, for lack there of a better term. I do agree education is a barrier, but once again how did the CLS (Med Tech), Cyto tech evelove? I do recall when they were taught on the job or through military training, so to say they are better because of a degree is far from the truth. Many MANY tech these days are assets to our profession and as we move forward in the future they we need to look for ways to have properly credentialed and EXPERIANCED staff. I my self am witness to the lack of basic lab knowledge a new grads have, but we are also responsible because our clinical rotation programs are scares and we do not have time to train. The future is full of opportunity for all histology tech, educated and experience, we just need to move forward and have the healthy discussion and make the changes needed in order to establish our profession. From: WILLIAM DESALVO [mailto:wdesalvo@hotmail.com] Sent: Sunday, May 20, 2012 8:38 PM To: Jesus Ellin; Timothy Morken; histonet Subject: RE: [Histonet] RE: CAP vs. CLIA I seemed to have missed something or it might have been all the fresh sea air I got in Tampa at the FSH, but I do not understand the outrage expressed towards CLIA and CAP because we are not listed as testing personnel. I applaud everyone's passion for Histotechnology and the outrage that we are not allowed to fully participate in the test system model, but I think we should be directing more of our outrage to the individuals working in Histotechnology that are not and will not take responsibility to increase the professionalism of our profession and our own acceptance of the current state of Histotechnology. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. As good as we are and as complex parts of the Histotechnology process may be, Histotechnicians, Histotechnologists and Pathology Assistants do not meet the standard stated and do not participate in the post-analytic phase, produce and release patient results. We simply are not able to be credentialed as is the Medical Technologists and Cytotechnologist. I am not saying any one laboratory professional group is better than the other, just that to be considered testing personnel, we must be properly credentialed. Collectively, we as a discipline, science and group should be working to upgrade our education requirements and training so that we can become fully invested partners with the Pathologist. We, not CAP or CLIA, must greatly increase our professionalism before we can truly be considered competent to work in the post-analytical phase. I cannot today accept that every working Histotechnician, Histotechnologist and Pathologist Assistant is able to produce the result and release. I am quite sure that every Medical Technologist and Cytotechnologist is capable and competent to produce and release a patient result. As things stand today, Histotechnology and all of us the working in this discipline are a support function to the one person in our discipline, the Pathologist, that is educated, trained, credentialed and competent to produce and release a patient result. I also believe there are many opportunities within our process available now, such as histochemical staining for organisms, that could allow us to participate in the post-analytic step. There will be many more as personalized medicine continues to transform Histotechnology. That said, how can we honestly promote our participation in the post-analytic phase, when there are far too many individuals (good, decent and hard working) that work every day, in every type and complexity of lab, that do not have a formal secondary education, have participated in defined clinical trials or have completed a certification exam (required and necessary credentials). Just think how many practitioners of Histotechnology are out there working today that are not properly credentialed. Now think if you know of any Medical Technologist or Cytotechnologist are working that do not have the required credentials. We have many obstacles to increasing the professionalism of Histotechnology; wide and varied backgrounds, lack of standards, lack of automation, lack of certification, but I do not think
Re: [Histonet] RE: CAP vs. CLIA
individuals (good, decent and hard working) that work every day, in every type and complexity of lab, that do not have a formal secondary education, have participated in defined clinical trials or have completed a certification exam (required and necessary credentials). Just think how many practitioners of Histotechnology are out there working today that are not properly credentialed. Now think if you know of any Medical Technologist or Cytotechnologist are working that do not have the required credentials. We have many obstacles to increasing the professionalism of Histotechnology; wide and varied backgrounds, lack of standards, lack of automation, lack of certification, but I do not think that CAP or CLIA should be considered one of them. This problem is completely our responsibility. We first have to demand proper credentials, no exceptions, no matter the problem, before we can expect other laboratory professionals to support us in increasing our professionalism and participation in the healthcare delivery system. As important the need for a robust accreditation process, healthy discussion must take place before real change can happen. I suggest we direct our passion and outrage to demand proper credentials to work in Histotechnology and then demand full participation in the test system and proper recognition by all laboratory professionals. William DeSalvo, B.S., HTL(ASCP) From: jel...@yumaregional.org To: timothy.mor...@ucsfmedctr.org; histonet@lists.utsouthwestern.edu Date: Thu, 17 May 2012 17:52:44 + CC: Subject: [Histonet] RE: CAP vs. CLIA I completely agree with you on this. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, May 17, 2012 10:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Jesus wrote: I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. Certainly the regulations limit the high complexity designation to interpretation of procedure results, but that does not mean a facility does not need very highly trained and competent technologists to do the protocols that lead to good interpretation. It simply highlights the difference between running slides through protocols vs looking at the result and determining a diagnosis. I'm sure most here will see the difference. Remember that CAP is a simply a deemed agency of CLIA - that is, CMS (Centers for Medicare and Medicaid, which administers the CLIA regulations) delegates to CAP (and Joint Commission) the authority to accredit laboratories. CAP cannot make up new regulations, only enforce existing CLIA regulations. However, the CLIA regulations are by necessity very general so they can apply to any kind of laboratory operations, current or future. CAP has the leeway to look at what labs are doing and determine if the CLIA regulations apply to those tasks. However, CAP must submit their proposals to CMS/CLIA and CMS/CLIA must pass off on them before they are implemented. CAP checklists are far more complex than they were 20 years ago. But the histo lab is far more complex as well, and regulators (as well as the public) are looking much more closely at histology because of some major mistakes that have happened largely due to lack of rigor in testing validation and implementation. A lot of that has to do with small labs doing complex testing (interpretation) with methods they were/are not fully competent to do primarily due to lack of experience and expertise. While the accreditation process is getting more onerous, it is also forcing labs to be much more professional in their operations - always a good thing, I think. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Willis, Donna G. Sent: Thursday, May 17, 2012 7:26 AM To: 'Jesus Ellin'; 'Horn, Hazel V'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Very well said Jesus. I agree. Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Thursday, May 17, 2012 9:24 AM To: 'Horn, Hazel V'; Willis, Donna G.; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest
RE: [Histonet] RE: CAP vs. CLIA
I seemed to have missed something or it might have been all the fresh sea air I got in Tampa at the FSH, but I do not understand the outrage expressed towards CLIA and CAP because we are not listed as testing personnel. I applaud everyone's passion for Histotechnology and the outrage that we are not allowed to fully participate in the test system model, but I think we should be directing more of our outrage to the individuals working in Histotechnology that are not and will not take responsibility to increase the professionalism of our profession and our own acceptance of the current state of Histotechnology. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. As good as we are and as complex parts of the Histotechnology process may be, Histotechnicians, Histotechnologists and Pathology Assistants do not meet the standard stated and do not participate in the post-analytic phase, produce and release patient results. We simply are not able to be credentialed as is the Medical Technologists and Cytotechnologist. I am not saying any one laboratory professional group is better than the other, just that to be considered testing personnel, we must be properly credentialed. Collectively, we as a discipline, science and group should be working to upgrade our education requirements and training so that we can become fully invested partners with the Pathologist. We, not CAP or CLIA, must greatly increase our professionalism before we can truly be considered competent to work in the post-analytical phase. I cannot today accept that every working Histotechnician, Histotechnologist and Pathologist Assistant is able to produce the result and release. I am quite sure that every Medical Technologist and Cytotechnologist is capable and competent to produce and release a patient result. As things stand today, Histotechnology and all of us the working in this discipline are a support function to the one person in our discipline, the Pathologist, that is educated, trained, credentialed and competent to produce and release a patient result. I also believe there are many opportunities within our process available now, such as histochemical staining for organisms, that could allow us to participate in the post-analytic step. There will be many more as personalized medicine continues to transform Histotechnology. That said, how can we honestly promote our participation in the post-analytic phase, when there are far too many individuals (good, decent and hard working) that work every day, in every type and complexity of lab, that do not have a formal secondary education, have participated in defined clinical trials or have completed a certification exam (required and necessary credentials). Just think how many practitioners of Histotechnology are out there working today that are not properly credentialed. Now think if you know of any Medical Technologist or Cytotechnologist are working that do not have the required credentials. We have many obstacles to increasing the professionalism of Histotechnology; wide and varied backgrounds, lack of standards, lack of automation, lack of certification, but I do not think that CAP or CLIA should be considered one of them. This problem is completely our responsibility. We first have to demand proper credentials, no exceptions, no matter the problem, before we can expect other laboratory professionals to support us in increasing our professionalism and participation in the healthcare delivery system. As important the need for a robust accreditation process, healthy discussion must take place before real change can happen. I suggest we direct our passion and outrage to demand proper credentials to work in Histotechnology and then demand full participation in the test system and proper recognition by all laboratory professionals. William DeSalvo, B.S., HTL(ASCP) From: jel...@yumaregional.org To: timothy.mor...@ucsfmedctr.org; histonet@lists.utsouthwestern.edu Date: Thu, 17 May 2012 17:52:44 + CC: Subject: [Histonet] RE: CAP vs. CLIA I completely agree with you on this. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, May 17, 2012 10:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Jesus wrote: I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. Certainly the regulations limit the high complexity designation to interpretation of procedure results, but that does not mean a facility does not need very highly trained and competent technologists to do the protocols that lead to good interpretation
[Histonet] RE: CAP vs. CLIA
CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 2:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If you are not the intended recipient, you are hereby notified that any use, disclosure, copying, or distribution of this message or any of the information included in it is unauthorized and strictly prohibited. If you have received this message in error, please immediately notify the sender by reply e-mail and permanently delete this message and its attachments, along with any copies thereof. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ** The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: CAP vs. CLIA
Thank you! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 8:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 2:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If you are not the intended recipient, you are hereby notified that any use, disclosure, copying, or distribution of this message or any of the information included in it is unauthorized and strictly prohibited. If you have received this message in error, please immediately notify the sender by reply e-mail and permanently delete this message and its attachments, along with any copies thereof. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ** The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you
RE: [Histonet] RE: CAP vs. CLIA
This is a great info source to have. Thanks, Mike -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Pratt, Caroline Sent: Thursday, May 17, 2012 8:22 AM To: Horn, Hazel V; Courtney Pierce Cc: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: CAP vs. CLIA Thank you! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 8:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 2:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If you are not the intended recipient, you are hereby notified that any use, disclosure, copying, or distribution of this message or any of the information included in it is unauthorized and strictly prohibited. If you have received this message in error, please immediately notify the sender by reply e-mail and permanently delete this message and its attachments, along with any copies thereof. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ** The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible
[Histonet] RE: CAP vs. CLIA
I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 2:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If you are not the intended recipient, you are hereby notified that any use, disclosure, copying, or distribution of this message or any of the information included in it is unauthorized and strictly prohibited. If you have received this message in error, please immediately notify the sender by reply e-mail and permanently delete this message and its attachments, along with any copies thereof. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP vs. CLIA
It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 2:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If you are not the intended recipient, you are hereby notified that any use, disclosure, copying, or distribution of this message or any of the information included in it is unauthorized and strictly prohibited. If you have received this message in error, please immediately notify the sender by reply e-mail and permanently delete this message and its attachments, along with any copies thereof. Thank you
Re: [Histonet] RE: CAP vs. CLIA
I received the same alert and interpreted it the same as Hazel did. Also, the state inspector in my facility yesterday had the same interpretation. Sheila Haas Laboratory Manager MicroPath Laboratories, Inc. From: Horn, Hazel V hor...@archildrens.org To: 'Willis, Donna G.' donna.wil...@baylorhealth.edu; 'Courtney Pierce' courtney.pie...@quintiles.com Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Sent: Thursday, May 17, 2012 10:05 AM Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 2:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If you
[Histonet] RE: CAP vs. CLIA
I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory prior to September 1, 1997. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message
[Histonet] RE: CAP vs. CLIA
Very well said Jesus. I agree. Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Thursday, May 17, 2012 9:24 AM To: 'Horn, Hazel V'; Willis, Donna G.; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school
[Histonet] RE: CAP vs. CLIA
You hit the nail on the head! Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jesus Ellin Sent: Thursday, May 17, 2012 10:24 AM To: 'Horn, Hazel V'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I need to list histologists on the Laboratory Personnel Evaluation Roster? Typical histologist duties (e.g., fixation, embedding, microtomy, staining and cover slipping) are not considered testing. Therefore, it is not necessary to list these personnel on the roster. However, if the histologist is performing any part of the macroscopic tissue examination which is considered high complexity testing, it is necessary to list those personnel on the roster. Such personnel must provide documentation at minimum of an associate's degree/transcripts or high school diploma or equivalent for individuals performing grossing at the same laboratory
[Histonet] RE: CAP vs. CLIA
I certainly agree with you Jesus. I felt like my face had been slapped. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Blazek, Linda [mailto:lbla...@digestivespecialists.com] Sent: Thursday, May 17, 2012 9:27 AM To: 'Jesus Ellin'; Horn, Hazel V; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA You hit the nail on the head! Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jesus Ellin Sent: Thursday, May 17, 2012 10:24 AM To: 'Horn, Hazel V'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:26 AM To: 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. In a recent memo from CAP it describes this: Why does CAP require the completion of the Laboratory Personnel Evaluation Roster form and when was this process implemented? As part of CAP's deemed status with CMS as an accrediting organization, CMS required CAP to implement a more stringent process to document that accredited laboratories have appropriately qualified personnel and adequate documentation of personnel qualifications. The Laboratory Personnel Evaluation Roster form requires laboratories to confirm that personnel files contain the information necessary for laboratories to be in compliance with the CLIA personnel qualification regulations and CAP Checklist requirements prior to the inspection. It is also used by the inspection team to assist in the auditing of the records during the inspection to confirm compliance with the Checklist requirements. The process of completing the personnel form took effect in August 2009. And goes on to say: Do I
[Histonet] RE: CAP vs. CLIA
CAP does not consider us testing personnel. How they come by this is a mystery to me. The test is the interpretation of results - providing diagnostic decisions on stains. Histology staff perform the stains - apply reagents to a slide following a pre-determined protocol. The pathologist, or someone he delegates it to, does the interpretation. In the clinical lab the techs actually validate results. Most of these are machine-produced numbers so the tech is validating that the machine works correctly. But since they are signing out the result they are considered as doing the testing. Cytotechs interpret slides and produce an independent result that they sign off and report out. They are doing high complexity testing. A clin lab tech who reads micro slides, plates or whatever and provides a result that they alone sign off on before sending out the result are doing high complexity testing. Tim Morken 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 Horn, Hazel V Sent: Thursday, May 17, 2012 9:17 AM To: 'Blazek, Linda'; 'Jesus Ellin'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I certainly agree with you Jesus. I felt like my face had been slapped. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Blazek, Linda [mailto:lbla...@digestivespecialists.com] Sent: Thursday, May 17, 2012 9:27 AM To: 'Jesus Ellin'; Horn, Hazel V; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA You hit the nail on the head! Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jesus Ellin Sent: Thursday, May 17, 2012 10:24 AM To: 'Horn, Hazel V'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce a test result or set of results. To me this includes both histology and pathology office staff. This is the opinion on myself and our compliance person. Hazel can you tell us where to find the CAP quote. Thanks, Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message
[Histonet] RE: CAP vs. CLIA
Here is the CLIA method of determining a high complexity test. Taken from : http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/IVDRegulatoryAssistance/ucm124208.htm Tim Morken CLIA Categorization Criteria Each specific laboratory test system, assay, and examination is graded for level of complexity by assigning scores of 1, 2, or 3 for each of the seven criteria listed below. A score of 1 indicates the lowest level of complexity, and the score of 3 indicates the highest level. These scores are totaled. Test systems, assays or examinations receiving scores of 12 or less are categorized as moderate complexity, while those receiving scores above 12 are categorized as high complexity. Note: A score of 2 will be assigned to a criteria heading when the characteristics for a particular test are intermediate between the descriptions listed for scores of 1 and 3 Tests may also be categorized as waived.1 Criteria for Categorization (1) Knowledge. Score 1. (A) Minimal scientific and technical knowledge is required to perform the test; and (B) Knowledge required to perform the test may be obtained through on-the-job instruction. Score 3. Specialized scientific and technical knowledge is essential to perform preanalytic, analytic or postanalytic phases of the testing. (2) Training and experience. Score 1. (A) Minimal training is required for preanalytic, analytic and postanalytic phases of the testing process; and (B) Limited experience is required to perform the test. Score 3. (A) Specialized training is essential to perform the preanalytic, analytic or postanalytic testing process; or Substantial experience may be necessary for analytic test performance. (3) Reagents and materials preparation. Score 1. (A) Reagents and materials are generally stable and reliable; and (B) Reagents and materials are prepackaged, or premeasured, or require no special handling, precautions or storage conditions. Score 3. (A) Reagents and materials may be labile and may require special handling to assure reliability; or (B) Reagents and materials preparation may include manual steps such as gravimetric or volumetric measurements. (4) Characteristics of operational steps. Score 1. Operational steps are either automatically executed (such as pipetting, temperature monitoring, or timing of steps), or are easily controlled. Score 3. Operational steps in the testing process require close monitoring or control, and may require special specimen preparation,precise temperature control or timing of procedural steps, accuratepipetting, or extensive calculations. (5) Calibration, quality control, and proficiency testing materials. Score 1. (A) Calibration materials are stable and readily available; (B) Quality control materials are stable and readily available; and (C) External proficiency testing materials, when available, are stable. Score 3. (A) Calibration materials, if available, may be labile; (B) Quality control materials may be labile, or not available; or (C) External proficiency testing materials, if available, may be labile. (6) Test system troubleshooting and equipment maintenance. Score 1. (A) Test system troubleshooting is automatic or self-correcting, or clearly described or requires minimal judgment; and (B) Equipment maintenance is provided by the manufacturer, is seldom needed, or can easily be performed. Score 3. (A) Troubleshooting is not automatic and requires decision-making and direct intervention to resolve most problems; or (B) Maintenance requires special knowledge, skills, and abilities. (7) Interpretation and judgment. Score 1. (A) Minimal interpretation and judgment are required to perform preanalytic, analytic and postanalytic processes; and (B) Resolution of problems requires limited independent interpretation and judgment; and Score 3. (A) Extensive independent interpretation and judgment are required to perform the preanalytic, analytic or postanalytic processes; and (B) Resolution of problems requires extensive interpretation and judgment. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Courtney Pierce Sent: Wednesday, May 16, 2012 12:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP vs. CLIA Can someone help me with the High Complexity Test with CAP vs. CLIA. Thanks Courtney Pierce IHC Specialist Quintiles Translational RD - Oncology Innovation Navigating the new health 610 Oakmont Lane Westmont, IL 60559 Office: + 630-203-6234 courtney.pie...@quintiles.com clinical | commercial | consulting | capital ** IMPORTANT--PLEASE READ This electronic message, including its attachments, is COMPANY CONFIDENTIAL and may contain PROPRIETARY or LEGALLY PRIVILEGED information. If
[Histonet] RE: CAP vs. CLIA
I should have included grossing. Grossing is high complexity because the person has to use independent judgment when examining and sampling the specimen. They are essentially providing a result of a procedure to be used to get more results down stream. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, May 17, 2012 9:41 AM To: Horn, Hazel V; 'Blazek, Linda'; 'Jesus Ellin'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. The test is the interpretation of results - providing diagnostic decisions on stains. Histology staff perform the stains - apply reagents to a slide following a pre-determined protocol. The pathologist, or someone he delegates it to, does the interpretation. In the clinical lab the techs actually validate results. Most of these are machine-produced numbers so the tech is validating that the machine works correctly. But since they are signing out the result they are considered as doing the testing. Cytotechs interpret slides and produce an independent result that they sign off and report out. They are doing high complexity testing. A clin lab tech who reads micro slides, plates or whatever and provides a result that they alone sign off on before sending out the result are doing high complexity testing. Tim Morken 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 Horn, Hazel V Sent: Thursday, May 17, 2012 9:17 AM To: 'Blazek, Linda'; 'Jesus Ellin'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I certainly agree with you Jesus. I felt like my face had been slapped. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Blazek, Linda [mailto:lbla...@digestivespecialists.com] Sent: Thursday, May 17, 2012 9:27 AM To: 'Jesus Ellin'; Horn, Hazel V; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA You hit the nail on the head! Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jesus Ellin Sent: Thursday, May 17, 2012 10:24 AM To: 'Horn, Hazel V'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply
RE: [Histonet] RE: CAP vs. CLIA
TimI agree with your comments and the interpretation of the regulations( and these are regulations not value judgments). I still think however that CLIA should be updated to include all activities, in all potential settings, that well trained histology personnel may perform. I can think of several histology jobs where output was produced that stood on its own, but did get fed into later processes for clinical interpretation and decision-making. I just think the picture/definition is rather narrow. I think that if you use the testing phases, our just crosses over some but not all phases( preanalytic analytic), whereas other testing has post-analytic. Maybe the word should be oversight? Histology techs sometimes just get offended because emotionally, this feels like it is implied that we don't know or understand our activities or supply technical correction. I think there is similarity to grossing in application, and likewise, histology produces a result that moves to later in the process stream. Though admittedly there is wide variation of skill and experience and different types of roles out there, I do think most of us monitor and validate the technical quality of our output, and are very concerned about the patient and the impact of our technical performance has on their outcomes... Joelle Weaver MAOM, HTL (ASCP) QIHC From: timothy.mor...@ucsfmedctr.org To: timothy.mor...@ucsfmedctr.org; hor...@archildrens.org; lbla...@digestivespecialists.com; jel...@yumaregional.org; donna.wil...@baylorhealth.edu; courtney.pie...@quintiles.com Date: Thu, 17 May 2012 09:50:29 -0700 CC: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I should have included grossing. Grossing is high complexity because the person has to use independent judgment when examining and sampling the specimen. They are essentially providing a result of a procedure to be used to get more results down stream. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, May 17, 2012 9:41 AM To: Horn, Hazel V; 'Blazek, Linda'; 'Jesus Ellin'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA CAP does not consider us testing personnel. How they come by this is a mystery to me. The test is the interpretation of results - providing diagnostic decisions on stains. Histology staff perform the stains - apply reagents to a slide following a pre-determined protocol. The pathologist, or someone he delegates it to, does the interpretation. In the clinical lab the techs actually validate results. Most of these are machine-produced numbers so the tech is validating that the machine works correctly. But since they are signing out the result they are considered as doing the testing. Cytotechs interpret slides and produce an independent result that they sign off and report out. They are doing high complexity testing. A clin lab tech who reads micro slides, plates or whatever and provides a result that they alone sign off on before sending out the result are doing high complexity testing. Tim Morken 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 Horn, Hazel V Sent: Thursday, May 17, 2012 9:17 AM To: 'Blazek, Linda'; 'Jesus Ellin'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I certainly agree with you Jesus. I felt like my face had been slapped. Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Blazek, Linda [mailto:lbla...@digestivespecialists.com] Sent: Thursday, May 17, 2012 9:27 AM To: 'Jesus Ellin'; Horn, Hazel V; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA You hit the nail on the head! Linda -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jesus Ellin Sent: Thursday, May 17, 2012 10:24 AM To: 'Horn, Hazel V'; 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest
[Histonet] RE: CAP vs. CLIA
Jesus wrote: I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. Certainly the regulations limit the high complexity designation to interpretation of procedure results, but that does not mean a facility does not need very highly trained and competent technologists to do the protocols that lead to good interpretation. It simply highlights the difference between running slides through protocols vs looking at the result and determining a diagnosis. I'm sure most here will see the difference. Remember that CAP is a simply a deemed agency of CLIA - that is, CMS (Centers for Medicare and Medicaid, which administers the CLIA regulations) delegates to CAP (and Joint Commission) the authority to accredit laboratories. CAP cannot make up new regulations, only enforce existing CLIA regulations. However, the CLIA regulations are by necessity very general so they can apply to any kind of laboratory operations, current or future. CAP has the leeway to look at what labs are doing and determine if the CLIA regulations apply to those tasks. However, CAP must submit their proposals to CMS/CLIA and CMS/CLIA must pass off on them before they are implemented. CAP checklists are far more complex than they were 20 years ago. But the histo lab is far more complex as well, and regulators (as well as the public) are looking much more closely at histology because of some major mistakes that have happened largely due to lack of rigor in testing validation and implementation. A lot of that has to do with small labs doing complex testing (interpretation) with methods they were/are not fully competent to do primarily due to lack of experience and expertise. While the accreditation process is getting more onerous, it is also forcing labs to be much more professional in their operations - always a good thing, I think. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Willis, Donna G. Sent: Thursday, May 17, 2012 7:26 AM To: 'Jesus Ellin'; 'Horn, Hazel V'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Very well said Jesus. I agree. Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Thursday, May 17, 2012 9:24 AM To: 'Horn, Hazel V'; Willis, Donna G.; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree with this interpretation. The commentary in the 7/11/2011 checklists indicates that regulations apply to A laboratory must evaluate and document the competency of all testing personnel for each test system. A TEST SYSTEM is the process that includes pre-analytic, analytic, and post-analytic steps used to produce
[Histonet] RE: CAP vs. CLIA
I completely agree with you on this. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, May 17, 2012 10:46 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Jesus wrote: I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. Certainly the regulations limit the high complexity designation to interpretation of procedure results, but that does not mean a facility does not need very highly trained and competent technologists to do the protocols that lead to good interpretation. It simply highlights the difference between running slides through protocols vs looking at the result and determining a diagnosis. I'm sure most here will see the difference. Remember that CAP is a simply a deemed agency of CLIA - that is, CMS (Centers for Medicare and Medicaid, which administers the CLIA regulations) delegates to CAP (and Joint Commission) the authority to accredit laboratories. CAP cannot make up new regulations, only enforce existing CLIA regulations. However, the CLIA regulations are by necessity very general so they can apply to any kind of laboratory operations, current or future. CAP has the leeway to look at what labs are doing and determine if the CLIA regulations apply to those tasks. However, CAP must submit their proposals to CMS/CLIA and CMS/CLIA must pass off on them before they are implemented. CAP checklists are far more complex than they were 20 years ago. But the histo lab is far more complex as well, and regulators (as well as the public) are looking much more closely at histology because of some major mistakes that have happened largely due to lack of rigor in testing validation and implementation. A lot of that has to do with small labs doing complex testing (interpretation) with methods they were/are not fully competent to do primarily due to lack of experience and expertise. While the accreditation process is getting more onerous, it is also forcing labs to be much more professional in their operations - always a good thing, I think. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Willis, Donna G. Sent: Thursday, May 17, 2012 7:26 AM To: 'Jesus Ellin'; 'Horn, Hazel V'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA Very well said Jesus. I agree. Donna Willis, HT/HTL (ASCP) Histology Lab Manager Baylor University Medical Center-Dallas ph. 214-820-2465 office ph. 214-725-6184 mobile donna.wil...@baylorhealth.edu -Original Message- From: Jesus Ellin [mailto:jel...@yumaregional.org] Sent: Thursday, May 17, 2012 9:24 AM To: 'Horn, Hazel V'; Willis, Donna G.; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I am going to have to go there,, sorry all I know I am going to stir-up a hornets nest, but here it goes, don't we think that this is done in lue of the fact that CAP are representing the Pathologist interest and not the interest of the Technicians. Times have changed and the CAP is asking for more and more from Anatomic Pathology questions every year, not only to include technical, but also instrumentation (simple and complex), as well as information systems, predictive markers, Digital Pathology ( a huge one), etc. I think the CAP need to re-evaluate this and re consider what high complexity testing is, because CLIA defines it not the CAP. Remember CAP enforces CLIA regulation as well as their own. I would challenge this. I feel the staff under me do more than turn a wheel, or place tissue in a mold. With Passion comes a need to start to create change, we need this done. Jesus Ellin HT/PA ASCP, BSBE,MSBE Yuma Regional Medical Center Anatomic Pathology Supervisor -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V Sent: Thursday, May 17, 2012 7:05 AM To: 'Willis, Donna G.'; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: CAP vs. CLIA It was a CAP e alert dated April 2, 2012 Hazel Horn 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 | 501.364.1302 office | 501.364.1241 fax hor...@archildrens.org archildrens.org 100 YEARS YOUNG! JOIN THE PARTY AT ach100.org -Original Message- From: Willis, Donna G. [mailto:donna.wil...@baylorhealth.edu] Sent: Thursday, May 17, 2012 8:42 AM To: Horn, Hazel V; 'Courtney Pierce' Cc: histonet@lists.utsouthwestern.edu Subject: RE: CAP vs. CLIA I have to say I disagree
[Histonet] RE: CAP slides
Her-2 IHC Dana Settembre -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Coppin, Margaret Sent: Wednesday, August 31, 2011 5:53 PM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP slides Hello, A few months back, there was a discussion on the list about CAP Proficiency Test slides that weren't staining as expected. Some of you had even contacted CAP and they acknowledged that there had been an issue. Any of you whose PT was affected, do you mind jogging my memory as to which PT's were the problem batch? Thanks in advance as always. Margaret --- The information transmitted by this e-mail and any included attachments are from ARUP Laboratories and are intended only for the recipient. The information contained in this message is confidential and may constitute inside or non-public information under international, federal, or state securities laws, or protected health information and is intended only for the use of the recipient. Unauthorized forwarding, printing, copying, distributing, or use of such information is strictly prohibited and may be unlawful. If you are not the intended recipient, please promptly delete this e-mail and notify the sender of the delivery error or you may call ARUP Laboratories Compliance Hot Line in Salt Lake City, Utah USA at (+1 (800) 522-2787 ext. 2100 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP question ANP.22970
Martha, I spoke to Joan at CAP just yesterday regarding this question. I too, am getting ready for CAP, so I feel your pain! She said you can use the benchmarks in the notes under the question in the checklist or you can used other published articles that offer benchmark data. Just state what your reference is and where it is from. She also said you can use proficiency testing data. Hope this helps, Wanda WANDA G. SMITH, HTL(ASCP)HT Pathology Supervisor TRIDENT MEDICAL CENTER 9330 Medical Plaza Drive Charleston, SC 29406 843-847-4586 843-847-4296 fax This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha Ward Sent: Tuesday, February 01, 2011 12:57 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP question ANP.22970 We are having our inspection this spring and I am working to get all our procedures, etc. ready. I am having trouble finding benchmark information for comparison for HER2 to comply with this question - ...the laboratory at least annually compares its patient results with published benchmarks, We are using the Dako Herceptest. I spoke with Dako tech services and they did not have any information. What are other labs using for a benchmark. Thanks in advance for all your help. Martha Ward, MT (ASCP) QIHC Assistant Manager Molecular Diagnostics Lab Dept. of Pathology Wake Forest University Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP question ANP.22970
The published article we use is Hormone Receptor Status Survival in a Population-Based Cohort of Patients with Breast Carcinoma www.interscience.wiley.com April 20, 2005 Nita Searcy, HT/HTL (ASCP) Scott and White Hospital Division Manager, Anatomic Pathology 2401 S. 31st. Street 254-724-2438 Temple, Texas, 76502 nsea...@swmail.sw.org 254-724-2438 wanda.sm...@hcahealthcare.com 2/1/2011 12:42 PM Martha, I spoke to Joan at CAP just yesterday regarding this question. I too, am getting ready for CAP, so I feel your pain! She said you can use the benchmarks in the notes under the question in the checklist or you can used other published articles that offer benchmark data. Just state what your reference is and where it is from. She also said you can use proficiency testing data. Hope this helps, Wanda WANDA G. SMITH, HTL(ASCP)HT Pathology Supervisor TRIDENT MEDICAL CENTER 9330 Medical Plaza Drive Charleston, SC 29406 843-847-4586 843-847-4296 fax This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martha Ward Sent: Tuesday, February 01, 2011 12:57 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP question ANP.22970 We are having our inspection this spring and I am working to get all our procedures, etc. ready. I am having trouble finding benchmark information for comparison for HER2 to comply with this question - ...the laboratory at least annually compares its patient results with published benchmarks, We are using the Dako Herceptest. I spoke with Dako tech services and they did not have any information. What are other labs using for a benchmark. Thanks in advance for all your help. Martha Ward, MT (ASCP) QIHC Assistant Manager Molecular Diagnostics Lab Dept. of Pathology Wake Forest University Baptist Medical Center Winston-Salem, NC 27157 336-716-2104 ___ 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 BEGIN:VCARD VERSION:2.1 X-GWTYPE:USER FN:Nita Searcy TEL;WORK:4-2438 ORG:;Anatomic Pathology EMAIL;WORK;PREF;NGW:nsea...@swmail.sw.org N:Searcy;Nita TITLE:Manager, Pathology Division TEL;PAGER:633-2370 END:VCARD BEGIN:VCARD VERSION:2.1 X-GWTYPE:USER FN:Nita Searcy TEL;WORK:4-2438 ORG:;Anatomic Pathology EMAIL;WORK;PREF;NGW:nsea...@swmail.sw.org N:Searcy;Nita TITLE:Manager, Pathology Division TEL;PAGER:633-2370 END:VCARD ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP question for pediatric pathology labs
Dear Ronnie We at the Children's Medical Center, Dallas do a twice a year slide exchange of ten cytopathology cases with another Children's Hospital. We actually learn a lot from this exercise as they critique slide quality as well as diagnoses. All the Anatomic pathology faculty take part in case reviews and we meet as a group to hear about the results of the other program's review of our cases. It is also much more pertinent to the nature of our pediatric pathology material than the CAP program would be (and the price is negligible). We have never had a CAP inspector have a problem with this type of program. We are careful to keep it all well documented in our quality records. Linda M Histonet administrator -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Houston, Ronald Sent: Wednesday, December 29, 2010 8:13 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP question for pediatric pathology labs Importance: High CYP.00190 Phase I N/A YES NO For laboratories that perform non-gynecologic cytopathology, does the laboratory participate in a peer educational program in NON-GYNECOLOGIC cytopathology (e.g., CAP Interlaboratory Comparison Program in Non-Gynecologic Cytopathology NGC)? How are labs responding to this request for a peer-educational program in non-gyn cytopath, as there is no such program for pediatric cytopathology, and, in the opinion of our pathologists, the CAP program is useless as far as it pertains to pediatrics? We have had varying responses from inspectors which we have adopted and then the next inspector says this isn't good enough and you should be doing something else. There has been little to no direction from CAP. 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 - Confidentiality Notice: The following mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. The recipient is responsible to maintain the confidentiality of this information and to use the information only for authorized purposes. If you are not the intended recipient (or authorized to receive information for the intended recipient), you are hereby notified that any review, use, disclosure, distribution, copying, printing, or action taken in reliance on the contents of this e-mail is strictly prohibited. If you have received this communication in error, please notify us immediately by reply e-mail and destroy all copies of the original message. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Please consider the environment before printing this e-mail. This e-mail, facsimile, or letter and any files or attachments transmitted with it contains information that is confidential and privileged. This information is intended only for the use of the individual(s) and entity(ies) to whom it is addressed. If you are the intended recipient, further disclosures are prohibited without proper authorization. If you are not the intended recipient, any disclosure, copying, printing, or use of this information is strictly prohibited and possibly a violation of federal or state law and regulations. If you have received this information in error, please notify Children's Medical Center Dallas immediately at 214-456- or via e-mail at priv...@childrens.com. Children's Medical Center Dallas and its affiliates hereby claim all applicable privileges related to this information. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Cap Question: 2 identifiers for slides
Not yet -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Scott, Allison D Sent: Thursday, July 01, 2010 2:37 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cap Question: 2 identifiers for slides Is is a CAP requirement to have 2 identifiers on surgical slides? Allison Scott HT(ASCP) Histology Supervisor LBJ Hospital Houston, Texas 77026 713-566-5287 CONFIDENTIALITY NOTICE: If you have received this e-mail in error, please immediately notify the sender by return e-mail and delete this e-mail and any attachments from your computer system. To the extent the information in this e-mail and any attachments contain protected health information as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), PL 104-191; 45 CFR Parts 160 and 164; or Chapter 181, Texas Health and Safety Code, it is confidential and/or privileged. This e-mail may also be confidential and/or privileged under Texas law. The e-mail is for the use of only the individual or entity named above. If you are not the intended recipient, or any authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this e-mail and its attachments is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- CONFIDENTIALITY NOTICE: The information in this e-mail may be confidential and/or privileged. If you are not the intended recipient or an authorized representative of the intended recipient, you are hereby notified that any review, dissemination, or copying of this e-mail and its attachments, if any, or the information contained herein is prohibited. If you have received this e-mail in error, please immediately notify the sender by return e-mail and delete this e-mail from your computer system. Thank you. == ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Cap Question: 2 identifiers for slides
Joint Commission does... Use case number and name. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nails, Felton Sent: Thursday, July 01, 2010 16:10 To: 'Scott, Allison D'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Cap Question: 2 identifiers for slides Not yet -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Scott, Allison D Sent: Thursday, July 01, 2010 2:37 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cap Question: 2 identifiers for slides Is is a CAP requirement to have 2 identifiers on surgical slides? Allison Scott HT(ASCP) Histology Supervisor LBJ Hospital Houston, Texas 77026 713-566-5287 CONFIDENTIALITY NOTICE: If you have received this e-mail in error, please immediately notify the sender by return e-mail and delete this e-mail and any attachments from your computer system. To the extent the information in this e-mail and any attachments contain protected health information as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), PL 104-191; 45 CFR Parts 160 and 164; or Chapter 181, Texas Health and Safety Code, it is confidential and/or privileged. This e-mail may also be confidential and/or privileged under Texas law. The e-mail is for the use of only the individual or entity named above. If you are not the intended recipient, or any authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this e-mail and its attachments is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- CONFIDENTIALITY NOTICE: The information in this e-mail may be confidential and/or privileged. If you are not the intended recipient or an authorized representative of the intended recipient, you are hereby notified that any review, dissemination, or copying of this e-mail and its attachments, if any, or the information contained herein is prohibited. If you have received this e-mail in error, please immediately notify the sender by return e-mail and delete this e-mail from your computer system. Thank you. == ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet 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] RE: CAP cancer protocols and checklists
We have the Meditech Computer system and we have built a data section between Micro and Diagnosis namde Synoptic Tumor Protocol nd have canned texts available for all tumor types that pull in the required information needed. All the Pathologist's have to do is enter the information and hit enter and it goes to the next field needed to fill in. That way it is done consistently and within the CAP protocols. Dawn D. Schneider, HT(ASCP) Lead Histology Tech Howard Young Medical Center 240 Maple St. Woodruff, WI 54568 715-356-8174 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carol Bryant Sent: Tuesday, March 16, 2010 4:20 PM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] CAP cancer protocols and checklists I am interested in how you are implementing the CAP cancer protocols in your laboratory? Are you using synoptic reporting, dictating from the checklists, etc? Any information you can provide would be greatly appreciated. Thank you in advance for your comments and input. Carol Carol Bryant, CT (ASCP) Cytology/Histology Manager Pathology Services Lexington Clinic Phone (859) 258-4082 Fax (859) 258-4081 cb...@lexclin.com NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please call the sender immediately at (859)258-4000 and delete all copies of this message and any attachment. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) 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 the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: cap survays
Technologists can certainly be trained to do the scoring properly but our pathologists score them and are fully involved in the evaluations, as well as reviewing challenge slides for submission. There are also sometimes interpretation questions that have to be done on-line that the pathologists have to do, for instance for Her2. You have to ask the question of who is doing the interpretation in real life, the techs or the pathologist? The survey is supposed to be done the same way you do it in your lab in your daily work so take that as the starting point of the discussion. I think it defeats the purpose if the pathologists are not involved since it is a test of the total quality system. Are they or aren't they part of the system? Tim Morken Supervisor, Histology / IPOX UCSF Medical Center San Francisco, CA -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Gonzales, Edith Sent: Thursday, September 24, 2009 12:50 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] cap survays To all, I would like to know what everyone is doing with the cap survay now that it is scoring staining performance and not detremining a diagnosis. Our paths want us to score then and they not be involved. Is this what everone else is doing? Edie DISCLAIMER: This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP
-- Message: 6 Date: Mon, 10 Aug 2009 09:05:44 -0500 From: Vacca Jessica jessica.va...@hcahealthcare.com Subject: [Histonet] CAP ? To: Histonet@lists.utsouthwestern.edu Histonet@lists.utsouthwestern.edu Message-ID: 938d716cd445614abbb817517557b6f4c8476...@nadcwpmsgcms09.hca.corpad.net Content-Type: text/plain; charset=iso-8859-1 How does one gather this information in the lab? What are your steps? GEN.70550 Is there documentation that each of the chemicals in the laboratory has been evaluated for carcinogenic potential, reproductive toxicity, and acute toxicity; and does the policies and procedure manual define specific handling requirements for these chemicals - Thanks Jessica Vacca Histology Supervisor 119 Oakfield Dr Brandon Fl 33511 (813) 571-5193 (813) 571-5169 FAX We take this one step further than Mr. McNemar. We take the info from the MSDS and have prepared a chart of our toxic chemicals that is kept in the documentation of our Lab Safety. It lists for the chemicals involved the specific toxic dangers and any special handling. Joanne Clark, HT Histology Supervisor Pathology Consultants of NM Roswell, NM -- ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: CAP regs on Histonet
For ease of reference, if you are asking, replying, or quoting anything pertaining to CAP regs, PLEASE give the CAP checklist number that contains the information being discussed. For those of us trying to keep current, it makes it so much easier to check our own records. Just a suggestion - Terri Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Laboratory Holy Redeemer Hospital and Medical Center 1648 Huntingdon Pike Meadowbrook, PA 19046 (215) 938-3676 phone (215) 938-3689 fax - 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
