We are a physician owned clinic and the number of frozen sections we do is 
small.   Occasionally we have a few skin biopsies that are done in the ASC 
surgery department.

I got a call from them today and they have a problem that they encounter every 
time they do a frozen section.  When the surgeon takes the biopsy a nurse has 
to hold the specimen in surgery until the tissue order (requisition) is put 
into the computer.   With staffing in ASC this may take fifteen minutes after 
the biopsy is removed and given to the nurse, especially if the surgeon is 
asking the nurse to do other things in the meantime.

Of course when the specimen then is received by Histology it may take another 
15-20 minutes before the surgeon gets a frozen section diagnosis.  This morning 
the surgeon said this needs to get fixed.   Of course it's easy for me to say 
to the ASC department that  someone needs to put in the information immediately 
and not take fifteen minutes.  I even asked why can't the order be put into the 
computer before the frozen is done.  My other response to ASC was that we can 
do the frozen section but we can't assign a number not print barcoded slides 
and blocks until the order has been entered into the computer.

I do recall that organizations with less robust IT systems than CoPath  
sometimes use a written Frozen section order form and report.   Can anyone 
share with me a form they use currently that I could modify for our purposes?
I know the basics but don't want to have to reinvent the wheel if someone 
already has a form that they use for this purpose.

Of course once the nurses have had time to put the order into the computer  
histology would have to enter the case into the pathology system, assigning a 
surgical number.   The pathologist would have to in turn take the diagnosis 
etc. off of the written sheet and enter the diagnosis and gross into the 
computer system.  The written form would in turn have to be kept for 
documentation which can include scanning into the electronic health record  and 
would include things like time surgeon is called, site, patient sticker with 
patient identifiers, clinical history, etc.

I realize that this might seem like a step backward however given staffing 
issues I understand where the ASC nurse manager is coming from and if it helps 
the patient and surgeon I think we can live with the inconvenience.

Your thoughts and examples of forms or frozen section requisitions?


Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com<mailto:jvick...@springfieldclinic.com>



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