[Histonet] Standardizing staining/IHC protocols by case or tissue type

[Walter Benton]

Brandon,

In my experience there generally isn't a set SOP for ordering patterns. However, there are exceptions for breast cases, melanoma cases etc..., but those are the minority, not the majority. However, you can approach the cost effective process with them. Given most antibodies have a relatively long shelf life 2-3 years, I would recommend running a report and determining how many times an antibody was ordered of the course of year. In many cases as I experienced new antibodies replaced older antibodies and thus were not being ordered. As a result we removed those antibodies from the antibody offering. You'll need to reach an agreed upon number of tests that need to be ordered, which remove any bias that may result from presenting the numbers prior to that being discussed. In addition, it may be beneficial for you to work with you reference lab that performs IHC or Specials that you routinely do not perform to get firm TAT that will entice the pathologist to utilize that source instead of in-house. I hope this helps. We had to do this when I managed a large university lab with well over 125 antibodies. In the end we eliminated around 20 or so and brought on 5-10 new antibodies that were being sent out frequently and ultimately were more cost effective in-house and had a better TAT in-house.

Hope this helps!

Walter Benton HT(ASCP)QIHC
Histology Supervisor
Chesapeake Urology Associates
806 Landmark Drive, Suite 126
(All Deliveries to Suite 127)
Glen Burnie, MD 21061
443-471-5850 (Direct)
410-768-5961 (Lab)
410-768-5965 (Fax)
wbenton <@t> cua.md
________________________________________
From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Pohl, Brandon J [bpohl <@t> swedishamerican.org]
Sent: Friday, October 07, 2011 1:07 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Standardizing staining/IHC protocols by case or tissue      type

I am having trouble getting my pathologists to understand that their lack of standardization or consistency in ordering special stains and IHC is resulting in such low volumes that many of the stains or antibodies are not cost effective for us to run.  They seem to think that the way they each individually order certain stains based on preference or comfort level in reading is a norm amongst all pathologists.  I am hoping to get some feedback from anyone willing in order to find out if they are correct or if my point of standardizing their methods is valid.  For anyone willing to share, could you please let me know what types of protocols or panels you have established for different types of tissues or different types of cancers that are SOP for each of those cases.  I know some cases require flexibility and variation, but we have very little in terms of standardization that each pathologist follows.  Thanks!


Brandon Pohl MAT, HTL (ASCP)
Histology Supervisor
Swedish American Hospital
Rockford, IL 61104
815-489-4279
bpohl <@t> swedishamerican.org
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