[Histonet] Histonet] TAT for frozens?

[Stephen Peters M.D.]

Pathologist point of view. I think most of us can easily, embed, freeze cut and stain a 
single slide of a small simple piece of tissue some where between 5 and 10 minutes. 
Each additional block will add another few minutes. The real time consumer for the 
pathologist comes in grossing the tissue and reading the slide. Given a large specimen  
that requires careful inking, detailed dissection,  meticulous slicing,  and thorough 
gross examination of each piece the time can add up quickly. In reading the micro, 
many cases can be obvious in a glance, however some take meticulous screening to 
find minute clues.  Wading through books and asking for intradepartmental consultation will also consume time. 
I have no problem with following turn around times in order to identify weak pathologists or techs in a department who may benifit from education. It may also help point out that it is
 time to modernize equiptment and may be a nice piece of data to show your administrators 
when you are looking for that new cryostat or additional staff.
 
The point I would like to make is that perfoming a thorough gross and a careful micro 
are extremely important and should not be rushed. A careful gross is our best defense
 against sampling error. A careful micro will avoid any embarrasing surprises on 
permenents. Whether your a tech preparing the slides or a pathologist grossing and
 reading them it is very important that we avoid letting anyone make us feel rushed. None of 
us can do our best under pressure and I urge anyone in this business to make believe you
 are working on the tissue of a family member. The patients surgery is costing an a great
 deal and often totally hinges on what we say on frozen. An if we are wrong 
that same surgeon who rushed us will be puting the blame on us the next day when we 
have given a wrong diagnosis or find out we really don't have enough tissue for the 
special studies the patient went to surgery for. 
My suggestion: Worry about TAT stats for the simple ones and do them all as carefully as
 you can. If it is complicated it will take more time. These can be documented 
as comlicated for TAT records. When a surgeon calls to speed me up me in the middle of 
a case I like to tell them " Now you made me nervous and I have to go to the bathroom. It will take another 10 minutes"
 
Stephen