[Histonet] Help on Workload - CAP

[Janice A Mahoney]

Hello Katia and All,
I have been amazed at what the HT's at my institution have been able to accomplish over the past year.  We have implemented LEAN in our laboratory.  I'm presenting a workshop at the National meeting in Ft. Lauderdale next month on how we accomplished reducing our TAT, space, cost etc.
The main impact has come form implementing "single piece flow" of specimens.  It is amazing the difference it makes to eliminate "waste".  This "waste" includes, excess walking, blocks/slides just sitting with nothing being done with them, techs waiting for work and getting rid of unnecessary steps in the process.
These are just a few thoughts on how to help with your issue.  
Good Luck.
Jan,
Omaha  

>>> "Katia Cristina Catunda" <kccatunda <@t> terra.com.br> 08/10/2005 7:57:50 PM >>>
Searching for a workload parameter to analyse if we do have many or less 
histotechnicians as necessary for our routine I found one "Q & A" answer in 
CAP (cited in the end of the email). Our slide-average per histotechnician 
is about 40 slides per day and I don't see how I can reduce our staff to get 
the 50 slides suggested by CAP.

We do have at the same time 2 technicians on embedding (starting at 6 am), 4 
techinicians on microtomy (starting on 7 am) and 2 technicians on staining 
and mounting (starting on 7 am). We don't have any automatization on 
staining neither mounting. We release our firsts slides at 8h20 and they are 
continuously liberated until the end of the routine (about 12 pm).

The technicians who does embedding does special stains and all the 
processor's battery-change. The technicians that stain and mount the slides 
does the archivation of the cassettes. And at 12pm we start our microwave 
routine with the same technicians that processed the morning-routine.

Can anyone give me some tips... are we so away from the average workload of 
the other labs? How can I evalue it precisely? Pleeeeassseee... 
heeeelllpp!!! lol

Thanks you all,



Katia



__________________________________________________________________________

Q.  How many cassettes should be processed by a histotechnologist during an 
eight-hour shift?

A.  No established comprehensive standard addresses histology workload. 
Previously published CAP workload guidelines for histopathology, based on 
data from the Laboratory Management Index Program, say "each well-trained 
HT/ HTL can be expected to produce approximately 3,000 slides per quarter, 
or 12,000 slides per year. Included in these totals are 2,500 H&E slides and 
500 common special stains, or 10,000 H&E slides and 2,000 common special 
stains. If only rare special stains are requested, more set-up time is 
required. Twelve thousand slides per year is equivalent to 50 slides per 
day. These are average numbers for a lab where much of the work is not 
automated."

In practice, a uniform standard across laboratories may be an unrealistic 
goal because many factors influence the number of blocks a 
histotechnician/technologist can cut in a given period. These include:

  a.. The experience level of the technician. A new employee or student 
would be expected to cut at a slower rate.
  b.. The case complexity. Biopsies, which require multiple levels and 
careful trimming, require considerably more time than routine cases (for 
example, uterus).
  c.. The number of interruptions. Smaller laboratories, in which the 
cutting technician may be answering the phone or receiving special stain or 
recut requests, or both, will have lower productivity.
The most useful standard for employees in a given laboratory is set by the 
supervisor or senior technologists, or both, based on past productivity 
levels.
To address productivity in a more global sense, it is necessary to assign 
work units to each of the varied tasks in histology, including loading and 
maintaining processors, embedding, cutting, routine staining, special 
stains, and immunohistochemistry. It is then possible to benchmark units 
worked per hour. As with routine cutting, however, the assignment of work 
unit values to a given task can only be done realistically by the histology 
supervisor and pathologist at a given site, taking into account economies of 
scale and levels of automation.

Richard W. Brown, MD
Medical Director,
Core Histology Laboratory
Memorial Hermann Healthcare System
Houston

Member, CAP
Surgical Pathology Committee

With members of the
CAP/National Society
for Histology Committee:

Freida L. Carson, PhD, HT(ASCP)

Lena T. Spencer,
MA, HT(ASCP)HTL, QIHC

Vincent Della Speranza,
MMS, HT(ASCP)HTL

Sue E. Lewis, HTL(ASCP)




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