[Histonet] Two patient identifiers and handwritten blocks

Tue Aug 15 12:33:43 CDT 2006

I believe you need two human-readable identifiers. As some have mentioned,.
The technology may not be available to read a given barcode (this mostly
concerns linear "bar" codes verses 2D (grid) codes, some readers can read
only the bar codes, some both).  But it seems that the barcodes I've seen
also have a human-readable line showing what is in the barcode. It may be
small type, but it is usually there. If it is there that could be used as
the second identifier.

Tim

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jesus Ellin
Sent: Tuesday, August 15, 2006 10:20 AM
To: Victor Tobias; chiggerson <@t> memhosp.com
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Two patient identifiers and handwritten blocks

I know of this one as well Victor and you are correct.  But can a barcode be
used as a identifier.  Since it is unique to our system only, what if you
send it out for a consult and the only identifier is the Accession number
and barcode that is unique to what ever LIS or PIS you are using.  Will this
hold up on a  JACHO inspection.??  This is the question at hand that only
JACHO can answer I think.  But since CLIA and JACHO seem to be revamping we
need to look at what they are requiring inorder to see were we need to head.
It seems to me that there needs to be specific clarification one what is
acceptable and what isnt.  We do not need to be shooting in the dark.  What
happens if you are not automated and do not have the capability to add 2D or
1D barcodes to the blocks.  Then you are looking at the man hours that are
going to be spent on just writing blocks with not only accession number but
also either, MRN, SSN, or Name.  We are all already having wings clipped
because of budget issues and the most costly is wage.  So I see some serious
issues with this one. 

Jesus A. Ellin HT ASCP
Yuma Regional Medical Center
Histology Systems Technologist
Pathology Information Systems
928-336-7444 or 928-336-1144
Fax: 928-336-7319

-----Original Message-----
From: Victor Tobias [mailto:victor <@t> pathology.washington.edu] 
Sent: Tuesday, August 15, 2006 10:09 AM
To: chiggerson <@t> memhosp.com
Cc: Jesus Ellin; histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Two patient identifiers and handwritten blocks

In the presentation I saw for MGH, they have the accession number, block ID
and barcode.

Victor

Victor Tobias
Clinical Applications Analyst
University of Washington Medical Center
Dept of Pathology Room BB220
1959 NE Pacific
Seattle, WA 98195
victor <@t> pathology.washington.edu
206-598-2792
206-598-7659 Fax =================================================
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chiggerson <@t> memhosp.com wrote:
> Good question! I think the preferred solution is a barcode that is
> linked to the patient's information.  I am not sure if user 
> readability is required. I would think not if you are using bar code 
> readers at embedding and microtomy like some larger institutions are 
> doing.  I think MGH implemented such a system.  They scan their block 
> just before microtomy and the labels for that block print right at the

> microtome.  You can't get better positive patient ID than that! I
> assume that the accession number is also on the block because you 
> still have to file and retrieve it. It would be interesting to find 
> out if they are using just the bar code and acession number, or if
they also have patient name.
>
> Is there any one from MGH out there that can answer this?
>
> Thanks,
> Cindy
>
>
>
>
>
> "Jesus Ellin" <JEllin <@t> yumaregional.org>
> 08/15/2006 11:43 AM
>
> To
> chiggerson <@t> memhosp.com, "Richard Yeo" <ryeo <@t> wchosp.org>, "Blazek,
Linda" 
> <lblazek <@t> digestivespecialists.com>
> cc
> histonet <@t> lists.utsouthwestern.edu
> Subject
> RE: [Histonet] Two patient identifiers and handwritten blocks
>
>
>
>
>
>
> Could one of the Identifiers be a 2D barcode or just a plain barcode. 
> This is generted specificly for this block with this patients 
> information.  That could be used as a identifier, or does it have to 
> be something that is a readable identifer to everyone that is handling

> that case.??
>
>
> Jesus A. Ellin HT ASCP
> Yuma Regional Medical Center
> Histology Systems Technologist
> Pathology Information Systems
> 928-336-7444 or 928-336-1144
> Fax: 928-336-7319
>  
>  
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
> chiggerson <@t> memhosp.com
> Sent: Tuesday, August 15, 2006 9:22 AM
> To: Richard Yeo; Blazek, Linda
> Cc: histonet <@t> lists.utsouthwestern.edu
> Subject: RE: [Histonet] Two patient identifiers and handwritten blocks
>
> Okay, so I do not receive any more "flaming" and vicious e-mails, let
> me clarify.
>
> JCAHO requires two patient identifiers when collecting specimens,
> administering meds, etc. JCAHO recommends and encourages laboratories 
> to use two patient identifiers on all aliquots (this includes blocks 
> and slides). Our institution has implemented a two patient identifier 
> policy before taking any action with a patient, patient specimen, or 
> patient record (NOT just specimen collection).  This is institution 
> wide. In addition, the laboratory has implemented the two patient 
> identifier policy for all testing phases including preanalytical, 
> analytical and postanalytical for both specimens and records. This is 
> not only recommended by JCAHO but also recommended by CAP. Please note

> it is currently a recommendation, not a requirement. If you need a
> reference, refer to CAP's publication "Quality Management in Anatomic
Pathology".
> Recommendations for including two patient identifiers on both frozen
> section slides and on all blocks and slides is located in the chapter 
> "Strategies for Error Reduction and Prevention in Surgical Pathology".
> More and more institutions are taking these recommendatioins seriously

> and implementing policies both institution wide and laboratory wide. 
> Mine is such a place. We have always used two patient identifiers, 
> except on the blocks. Therefore, for those that are taking this 
> seriously, I would like to know which two patient identifiers are used

> and how you implemented it.
>  I NEED to comply with my institutional and laboratory's policies.
>
>
> Thanks,
> Cindy
>
>
>
>
>
> "Richard Yeo" <ryeo <@t> wchosp.org>
> 08/15/2006 10:31 AM
>
> To
> <chiggerson <@t> memhosp.com>
> cc
>
> Subject
> RE: [Histonet] Two patient identifiers and handwritten blocks
>
>
>
>
>
>
> SPECIMENS COMING INTO THE LAB REQUIRE TWO PATIENT IDENTIFIERS,
> NAME/DATE OF BIRTH/SSN#...
> NOT PARAFFIN BLOCKS/SLIDES. 
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
> chiggerson <@t> memhosp.com
> Sent: Tuesday, August 15, 2006 9:37 AM
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] Two patient identifiers and handwritten blocks
>
> For those of you that are still handwriting accession numbers on your
> blocks:
>
> 1.      Do you require both the accession number and the patient's
name
> to
> be handwritten on the cassettes to meet the two patient identifier
> patient safety requirement?
>
> 2.      If so, do you require the patient's full name? Or last name,
> first
> initial?
>
> 3.      If not using the patient's name as the second identifier, what
> are
> you using? Medical Record Number?
>
> 4.      If not using two patient identifiers (accession number only),
> how
> are you justifying not using two identifiers to meet the patient
> safety requirements?
>
> 5.      For those that have implemented adding a second handwritten 
> identifier to blocks, how did your staff react?
>
> The obvious solution is a cassette labeler, however it just is not
> going to happen soon.  Thank you in advance for your response to this 
> very important issue.
>
> Thanks,
> Cindy
>
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