[Histonet] Long and short biopsy runs with one processor

Wed Apr 13 16:30:48 CDT 2005

Julia,

I agree with your philosophy about small runs.  We are a pathology
department supporting a large teaching hospital and an even larger area
pathology service.  However, we also do a considerable amount of private
work for several endoscopy clinics in our locality.
The scenario you describe is very similar to ours.
We have the usual overnight run, usually 450-600 blocks with the large
material in one processor and the smaller in another.  We receive the
endoscopy specimens anytime from 7:30am through to 3:00pm each day, with any
pick ups after 6:00pm being processed the next morning in a short run
2-2.5hrs.  This means we can have at least two runs per day of endoscopy
specimens.  The endoscopy specimens from the private clinics are about 30%
of our work and the TAT for these specimens is >2 days from pick-up to hard
copy result to the clinician.

We also process renal biopsies several times per day as well as the
occasional urgent specimen.

Bill Sinai
Laboratory Manager
Tissue Pathology, ICPMR
Westmead NSW 2145
Australia
Ph 02 9845 7774

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Julia
Dahl
Sent: Thursday, 14 April 2005 4:13 AM
To: Joyce.Rush <@t> sjmcmn.org; Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Long and short biopsy runs with one processor

Joyce -

First let me preface with my bias - I am a GI pathologist (read small biopsy
material is what I live and breathe).

Long processor runs are great for standard surgical material - but
absolutely overprocess small pieces of tissue, resulting in hard,
dehydrated, difficult to cut little brittle fragments.

The best approach that I've seen and used is to examine your "bottlenecks."
The main bottlenecks are the points at which you have lots to do in front of
you - with limited resource to do it (i.e. you have 150 cassettes to embed
coming off of the processor at one time and ONE embedding station.  That's a
bottleneck.)

What time do you usually start your processor?  Say your processor starts at
10:00 p.m. with a standard 6 hour process run.  Your pathologists or your
PAs close the grossing stations at 6:00 p.m. and load the processor - and
everything sits there for 4 hours (that's another bottleneck).

In this scenario - you can add a second processor run at virtually any time
that you are staffed that allows you to turn over the processor for the
standard run by 6:00 p.m. (when the standard next load is).

Since a small biopsy run usually takes about 2 hours on the Vitek:

0600 - Standard processor emptied - large surgical cases ONLY (about 2/3 of
your blocks)
0600 - 1000: Embed, cut, stain and coverslip surgicals
0700 - 0800:  Previous day's and early AM courier run of small biopsies
grossed in
0800 - 1000:   Small biopsy processor run
1000 - small biopsy processor emptied
1000 - 1230: Embed, cut, stain and coverslip biopsies.

If you wanted to do another biopsy run - to allow same day turnaround time -
the 2nd biopsy run could be scheduled at 10:30 each day with slides coming
out around 3:30.

I'm interested to hear other people's ideas.

Julia

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>We are a community hospital and last year processed 28,000 blocks.  We are
>being challenged by our Laboratory Director to run a long and short, biopsy
>run daily, M-F.  Currently we run everything together.  We have one
>processor, a VIP5.  I'd love to hear of ways people have handled this.
>Thanks so much!  I always get such good advice from this group!
>
>Joyce
>
>Joyce A. Rush, BS, MT(ASCP)
>Laboratory Manager
>St Joseph's Medical Center
>523 North Third Street
>Brainerd, MN  56401
>Office:218-828-7500   Fax:  218-828-7510
>
>
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