[Histonet] a question on ethics

[Janice A Mahoney]

Ron,
I'm sorry for your situation.  It seems to me that something you must do immediately, to protect your patients and yourself, is to do exactly what your manager is suggesting.  Get an internal quality program into place.  I'm assuming as supervisor you have that authority.
One suggestion is to have a person check the slides against the blocks before they go out to the Pathologists.  Start a log sheet or some kind of documentation to track the errors.  Decide on an acceptable number of errors for your techs. (hopefully less than .1%).  
I would do this before I went to your administration or any other source.  Explain to your techs that this is for the patient and for them.  Everyone is liable. 
Another thing you can do is to look at the process of each tech cutting slides.  If possible, standardize the way they check the numbers and transcribe them.  Include in this standardization a minute to inspect the slide against the block before they put it in a staining rack. 
I applaud your dedication to quality.  Do what you can now.
Good Luck.  
Jan Mahoney

Janice Mahoney
Histology/Cytology Coordinator
Alegent Health Laboratory
Phone (402)717-2889
Fax (402)717-5231

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>>> "Greg Dobbin" <dobbin <@t> upei.ca> 08/13/2004 9:18:42 AM >>>
Ron,
You have Risk Managers? Meet with them right away! Today, not 
tommorrow! Unless the whole system there is corrupt, they will take 
care of you (job security) and you will rest easier knowing someone 
else is helping you "manage" the risk!! You owe it to the patients to 
make this situation right. Very serious consequences are 
inevidable in that current situation. Good luck. And keep us posted 
on new developments.
Greg

From:           	"Ron Martin" <pathrm35 <@t> adelphia.net>
To:             	<histonet <@t> lists.utsouthwestern.edu>
Date sent:      	Fri, 13 Aug 2004 04:27:14 -0500
Subject:        	[Histonet] a question on ethics 

> Fellow techs,
> I am in a difficult situation and need some serious advice. I recently (4 months ago) accepted a technical supervisor position in a dermatology lab. I went from a bench tech at my old job to this position. I also walked away from a raise at my old position so I could step into a supervision 
position. I took the new position because I was told by my manager that she would teach me some supervision, management and financial skills that I currently do not have as well as the growth potential of the company.This position is not what I was told it would be. Part of my "duties" include 
emptying the trash, clean the bathroom  (not happening) and taking her personal and professional calls. The question on ethics is the high volume of mistakes made by our technician, our offices and also by my manager herself.
> I caught a mistake made by our tech a few weeks ago.She put the wrong tissue on the wrong slides as she inverted the two cases. I caught her mistake before it went out. One time she assigned the same number to two different cases. She then sent the correct case out for a consult (which wasn't 
needed) and put the wrong patient name on the slide. Every other day there is something different.My manager will not terminate her as she knows I am seeking employment elsewhere and she cannot afford to lose a tech.
> One day my manager gave three cases the same accession number.She caught her mistake on one of the cases but I still ended up with two cases with the same number. When I first started there my manager had a case in which there " was no tissue in the container". She said that she notified the 
office about the situation however up to six weeks later the office was still calling looking for results.At that point she wrote up an incident report and dated it six weeks prior to coincide with the surgery date.
> Our offices are not any better. One case came in with the wrong patient information. It took about 7 weeks for the office to realize that they sent the wrong patient information with the biopsy as the names were close in spelling.  The offices continually send mistakes with incorrect spelling 
of patients names and incorrect anatomical locations.
>  I have tired to document everything but there are too many mistakes and I don't have enough time or energy to keep up with them.My manager wants us to do our own "internal quality control". My interpretation of this is that she doesn't want our physician and risk manager to know of these 
mistakes. Are these becoming common problems or is it just my situation?
> I want to emphasize that I hope I am not being unethical myself for revealing this information but I really need some advice and support.I have very high standards and they are not being met in this current situation. I am currently seeking a new position but I need employment and cannot resign 
until another position becomes available. I would like to stay in Florida and if anyone knows of any positions please inform me as I am at my wits end. Thanks in advance.
> 
> Ron  
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~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Greg Dobbin
Pathology Lab
Atlantic Veterinary College, U.P.E.I.
550 University Ave.
Charlottetown, P.E.I.
Canada,  C1A 4P3
Phone: (902)566-0744
Fax: (902)566-0851
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Making a living is getting; making a life is giving.

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