[Histonet] Forwarded post for a histonet member: Subject: CLIA 24-hour gross review.

[Sandy Cope-yokoyama]

I am the sole histologist in a gastroenterology laboratory situated in a GI clinic. Complying with the 24-hour grossing review by the pathologist is a challenge because my slides travel by courier across town to the pathologist to read. I receive specimens throughout the day and perform grossing in the early AM then again at 11 AM.  My pathologist signs copies of the requisition that I fax over that contains the gross and sends them back to me.  On a daily basis this works just fine. Fridays and holidays are a pickle but we manage.
My question is the intent of the 24-hour review. The inspector cannot tell me why this was put in place, what the pathologist is supposed to do with this information and/or how to tell if it is accurate because he does not receive the slides until the following day which would be outside of the 24-hour review rule.
Can anyone tell the intent of the rule? How does this rule improve patient care? Even in a hospital laboratory, once a biopsy is grossed and placed in a cassette, how on earth does looking at the written gross of how big the specimen is or what color it is impact further actions that can take place?  What remedial action does CLIA expect?

Thanks for your input, Gastro Gal



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