RE: [Histonet] RE: Embedding process improvement and competencyassessment
I recall being told that one reason for the practical discontinuation, was that there were not enough well qualified judges for the practical work available at the ASCP, mostly populated with MT trained people in these roles? ..not sure if that is true.I am not offering that this is valid for a reason, just that this was the information I was given when I questioned the wisdom of that decision. I do think that if you cheat, this will catch up with you,but unfortunately not immediately most of the time. Sadly I think it does serve to dilute the perception of, and respect for, those that had put forth the effort to acheive their best , and submit their best slides(closest to perfection) by their own efforts. I can see it might be hard to prove cheaters, given the geographic area and number of people involved, but anyone who signed off on someone's misrepresented work, well they have to live with themselves and whatever the potential results to patients, colleagues et al. Joelle Joelle Weaver MAOM, BA, (HTL) ASCP From: joseph-galbra...@uiowa.edu To: bdebrosse-se...@isisph.com; jmacdon...@mtsac.edu; nhe...@lifespan.org Date: Thu, 25 Aug 2011 18:07:26 + Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment CC: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu; sdatt...@stormontvail.org How disgusting to hear about cheating. I recall that someone was supposed to sign off as a witness that the applicant had done the work themselves. I spent months acquiring tissue, processing, embedding, cutting and staining a set of blocks and slides and was rewarded with a high score for the effort. It was something I could be proud of. As I recall we had to submit 25 or so slides back then only some of which were graded and the grading was really strict (but did vary with the grader). Joe Galbraith HTL (and also MT by the way) University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Thursday, August 25, 2011 12:14 PM To: 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new
RE: [Histonet] RE: Embedding process improvement and competencyassessment
How disgusting to hear about cheating. I recall that someone was supposed to sign off as a witness that the applicant had done the work themselves. I spent months acquiring tissue, processing, embedding, cutting and staining a set of blocks and slides and was rewarded with a high score for the effort. It was something I could be proud of. As I recall we had to submit 25 or so slides back then only some of which were graded and the grading was really strict (but did vary with the grader). Joe Galbraith HTL (and also MT by the way) University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Thursday, August 25, 2011 12:14 PM To: 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I
Re: [Histonet] RE: Embedding process improvement and competencyassessment
Ditto Joe! I did it twice! Once for HT, then again for HTL!!! Paula K. Pierce, HTL(ASCP)HT President Excalibur Pathology, Inc. 8901 S. Santa Fe Oklahoma City, OK 73139 405-759-3953 Lab 405-759-7513 Fax www.excaliburpathology.com From: Galbraith, Joe joseph-galbra...@uiowa.edu To: Bea DeBrosse-Serra bdebrosse-se...@isisph.com; Jennifer MacDonald jmacdon...@mtsac.edu; Heath, Nancy L. nhe...@lifespan.org Cc: Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley sdatt...@stormontvail.org Sent: Thu, August 25, 2011 1:07:26 PM Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment How disgusting to hear about cheating. I recall that someone was supposed to sign off as a witness that the applicant had done the work themselves. I spent months acquiring tissue, processing, embedding, cutting and staining a set of blocks and slides and was rewarded with a high score for the effort. It was something I could be proud of. As I recall we had to submit 25 or so slides back then only some of which were graded and the grading was really strict (but did vary with the grader). Joe Galbraith HTL (and also MT by the way) University of Iowa -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Thursday, August 25, 2011 12:14 PM To: 'Jennifer MacDonald'; Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details
RE: [Histonet] RE: Embedding process improvement and competencyassessment
This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure that the embedding unit is wipe down between each case as are the forceps, this will avoid tissue floaters. 5. Never open more than one cassette at a time. 6. Verify that the piece count on the work sheet matches what is in the cassette when it is opened. 7. Never hound the staff about speed, accuracy is more important, speed comes with experience. If its embedded wrong, it will be cut wrong and this will effect diagnosis. 8. What do you do for QA on the slides?I have a work sheet that the Pathologist fills out each day about the slides, which is the end product of embedding. I hope my tips help you and feel free to contact me if you need anything. Tom Podawiltz, HT (ASCP) Histology Section Head/Laboratory Safety Officer LRGHealthcare 603-524-3211 ext: 3220 NEED A DOCTOR? Stormont-Vail's Health Connections can help you find a doctor accepting new patients. Call (785) 354-5225. ** The information transmitted in this e-mail and in any replies and forwards are for the sole use of the above individual(s) or entities and may contain proprietary, privileged and/or highly confidential information. Any unauthorized dissemination, review, distribution or copying of these communications is strictly prohibited. If this e-mail has been transmitted to you in error, please notify and return the original message to the sender immediately at the above listed address. Thank
RE: [Histonet] RE: Embedding process improvement and competencyassessment
I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure that the embedding unit is wipe down between each case as are the forceps, this will avoid tissue floaters. 5. Never open more than one cassette at a time. 6. Verify that the piece count on the work sheet matches what is in the cassette when it is opened. 7. Never hound the staff about speed, accuracy is more important, speed comes with experience. If its embedded wrong, it will be cut wrong and this will effect diagnosis. 8. What do you do for QA on the slides?I have a work sheet that the Pathologist fills out each day about the slides, which is the end product of embedding. I hope my tips help you and feel free to contact me if you need anything. Tom Podawiltz, HT (ASCP) Histology Section Head/Laboratory
RE: [Histonet] RE: Embedding process improvement and competencyassessment
Regardless of wether there were 8 blocks or eighteen blocks taking the practical taught me to be precise with all of the hands on aspects of Histology. Shame on the older techs from the practical days of not keeping on top of their game with embedding. My comment was geared more towards the newbies coming out of histo schools who can pass the exam with flying colors but sit them in front of an embedding center or microtome and they are all thumbs! As far as a manager, I myself would rather have someone who has experience with histology over seeing my work. Just once again the lack of respect of having the HT/HTL behind your name. From: Jennifer MacDonald [mailto:jmacdon...@mtsac.edu] Sent: Thursday, August 25, 2011 10:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley; Podawiltz, Thomas Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction
RE: [Histonet] RE: Embedding process improvement and competencyassessment
That is unfortunate that people will resort to dishonesty, only cheating themselves in my humble opinion... According to NAACLS, since the discontinuation of the practical component of the HT exam( per Zoe) it is the responsibility of the program directors to require practical blocks and slides in HT training programs. Couldn't a histology supervisor or lead person create a similar process in their lab, if they wished to do so, for those who did not complete a formal program? Maybe something like a technincal proficiency from their procedures and competency standard that includes demonstration of manual execution and technical quality and mastery ? I also think this plays in with quality control documentation and assessment, ( which could be considered as a MGMT function) i.e. documenting versus execution of theory understanding and technical task(s) . Personally, I know that I have always included this technical execution in the proficiency any time that I have been involved or responsible for assessment, training and evaluation, since there is theory and practical execution to be considered...but once the method and means are in place, it should be applicable in many situations with persons at different places in their learning, experience and training, in my opinion. I have seen this applied in several histology labs successfully, and included with the QMS and procedures. I know that having a histologist involved in this development process, could be crucial, as already pointed out in this discussion thread, but I think given the shortage of trained people, with the right attitude many high level managing activities could be supported or performed by an otherwise trained administrator . Joelle Weaver MAOM, BA, (HTL) ASCP To: nhe...@lifespan.org From: jmacdon...@mtsac.edu Date: Thu, 25 Aug 2011 07:57:46 -0700 Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment CC: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu; sdatt...@stormontvail.org I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most
RE: [Histonet] RE: Embedding process improvement and competencyassessment
I heard of a lot of cheating as well. People paid others to do the blocks and staining. How good does it do? In the end, these people are cheating themselves. Very sad! Beatrice DeBrosse-Serra HT(ASCP)QIHC Isis Pharmaceuticals Antisense Drug Discovery 1896 Rutherford Road Carlsbad, CA 92008 760-603-2371 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald Sent: Thursday, August 25, 2011 7:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form. Slides with sub-standard quality--whether in orientation, cutting, staining, whatever--our reviewed by every histotech in the lab with an aim to education and improvement of performance. We have a form called the Slide Quality Review Form that details the quality issue. Techs are directed to review the slides and comment. Difficult cases or those where people disagree are discussed in our department meetings. One of our difficulties over the years has been how the work was divided between the histotechs. One histotech loved to embed and was very good at it, so he did most of the embedding. He eventually moved to an overnight shift, which resulted in him embedding even more than he was. Consequently, other staff people either lost their skills or never fully developed them. It was introduction of rapid processing that really brought this issue to the forefront, since different people were embedding at different times of the day. Unfortunately, I let my NSH membership lapse this year for budgetary reasons. I have purchased quite a few resources over the years from NSH, and even attended the NSH annual meeting a few years ago when it was in Phoenix. I will reconsider my decision to drop my membership. For those on the list, here is Tom's response to my question: Hi Shelley, I would suggest you join NSH, they have all kinds of reference material for this type of work. Please tell me you are off the bench, you have a lot to monitor and if you are working the bench on top of your management duties my prayers go out to you. Embedding: 1. Proper size of mold in relation to specimen size. 2. Proper orientation of tissue, example 5 skin biopsies, dermis must face the same direction, and be at an angle to the blade so when you cut the section cuts smoothly and doesn't roll up. 3. Multiple pieces all on the same plane. If one piece is deeper than the others you must re-embed, or you will cut through the other pieces before you reach it. 4. Make sure
RE: [Histonet] RE: Embedding process improvement and competencyassessment
This point is well taken- I agree that our experience and knowledge often goes unrecognized. In my humble opinion , it takes all components, theory knowledge, extended practice and forthcoming technical mastery... some of this can come with academic study, some comes with actual doing . No doubt we are not there yet in having the best system for training new people coming in, it has been an ongoing industry challenge. Some managers seem to understand the components needed, some do not. Certainly helps to be a histologist in any case, for any type of management of this lab section. Do to our lack of recognition in some markets I guess, we often have MT people as supervisors and managers, they bring some things to the table, but lack some insights it seems. But what I am suggesting that we can try to do, is to get those willing and already in those positions, to an understanding for what is particularly needed for histology. Some MT managers I have had have in the past, have been pretty good and are open to this, some unfortunately have demonstrated the dissappointing attitude that anyone can do histology...and seem to try to fill the need with any warm body. In my experience, with few exceptions, I have never seen the warm body method of filling staffing needs work out very well. Joelle Joelle Weaver MAOM, BA, (HTL) ASCP Date: Thu, 25 Aug 2011 12:39:16 -0400 From: nhe...@lifespan.org To: jmacdon...@mtsac.edu Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment CC: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu; sdatt...@stormontvail.org Regardless of wether there were 8 blocks or eighteen blocks taking the practical taught me to be precise with all of the hands on aspects of Histology. Shame on the older techs from the practical days of not keeping on top of their game with embedding. My comment was geared more towards the newbies coming out of histo schools who can pass the exam with flying colors but sit them in front of an embedding center or microtome and they are all thumbs! As far as a manager, I myself would rather have someone who has experience with histology over seeing my work. Just once again the lack of respect of having the HT/HTL behind your name. From: Jennifer MacDonald [mailto:jmacdon...@mtsac.edu] Sent: Thursday, August 25, 2011 10:58 AM To: Heath, Nancy L. Cc: Histonet Listserv (E-mail); histonet-boun...@lists.utsouthwestern.edu; D'Attilio, Shelley; Podawiltz, Thomas Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment I fail to see the correlation of a non HT person supervising the Histology lab and the lack of a practical exam for HT/HTL staff. One of the issues that Shelley brought up was the staff lost or did not develop their embedding skills. Submission of a practical exam is not proof of highly developed embedding skills. For the HT exam there were 8 blocks that were submitted (9 slides). I know of cases where the blocks were not even embedded or cut by the applicant. Heath, Nancy L. nhe...@lifespan.org Sent by: histonet-boun...@lists.utsouthwestern.edu 08/25/2011 07:11 AM To D'Attilio, Shelley sdatt...@stormontvail.org, Podawiltz, Thomas tpodawi...@lrgh.org, Histonet Listserv (E-mail) histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] RE: Embedding process improvement and competencyassessment This is exactly why the powers that be should have NEVER gotten rid of the practical portion of the HT/HTL board certification! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of D'Attilio, Shelley Sent: Thursday, August 25, 2011 9:45 AM To: Podawiltz, Thomas; Histonet Listserv (E-mail) Subject: [Histonet] RE: Embedding process improvement and competencyassessment Hi Tom, Thank you for your kind words. I am off the bench almost completely. I can work in the gross room in a pinch and my counting skills are excellent, so I can always file slides and block if an emergency arises:) I occasionally cover a bench in Chemistry as well, but my staff is all pretty glad that I mostly stay in my office. Thanks so much for the embedding information. The main problem we are tackling at the moment is tissue orientation. I have written a pretty detailed embedding procedure that is being reviewed by the new histology supervisor. Our plan is to refresh the training of everyone on staff in conjunction with this procedure, then add specific embedding competencies to our checklist. I will make sure that the procedure incorporates the first 6 elements that you listed below. Currently we have a QA sheet that is given to the pathologist with each batch of slides. Pathologists provide us with feedback on the slide quality by filling out the form
