[Histonet] Re: Frozen section turnaround time

[Bill Sinai]

Dear All,

Hello from Sydney, Australia,

In my laboratory most of the pathologists sign the F/S worksheet with both
the start and finish times for each Frozen Section block.  They tend to use
it as a measure of how efficient they are when the TAT audit figures appear
at their Medical Staff meetings.  Admittedly most of the time the specimen
is selected by a pathology registrar and the pathologist only arrives to
read the report with the registrar towards the end.

Our TAT for each single block has averaged 15mins from time of arrival to
report issue for the last 15 years.  This often includes the F/S pathologist
referring the case to a pathologist within whose specialty the specimen
falls.  We have in the F/S area a Cryostat, Biohazard Cabinet, staining
solutions and a double head microscope for the Pathologist and Registrar to
use to diagnose and a telephone so that the report can be issued directly to
the theatre.



Bill Sinai 
Chief Hospital Scientist
Tissue Pathology ICPMR 
Westmead Hospital 
Westmead NSW 2145 
Phone 02 9845 7774 
Fax 02 9687 2330


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Smith Wanda
Sent: Wednesday, 15 August 2007 7:12 AM
To: RSRICHMOND <@t> aol.com; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Re: Frozen section turnaround time

Bob,
AMEN to getting the Pathologist to sign the worksheet!!!!  I have threatened
to break their legs is they walk off without signing.

Regarding the 20 minute TAT, Mr. Gruber at CAP told me that the 20 minutes
is from the time the Pathologist starts the frozen section to the time they
call the surgeon.  That makes sense if the Pathologist are responsible for
frozen sections at a remote site that they have to travel to.

In the narrative after the question in the checklist, it states:
"NOTE:  If 90% of frozen sections are not completed within 20 minutes, the
laboratory must document evaluation of the reason(s) for the delay.
This TAT is intended to apply to the typical single frozen section.  In
cases where there are multiple sequential frozen sections required on a
single specimen (e.g., resection margins), or in cases where additional
studies such as radiographic correlation are required, longer TAT may be
expected"
Hope this helps!!!
Wanda
Wanda G. Smith, HTL(ASCP)HT
Trident Medical Center
Pathology Supervisor
ph:  843-847-4586
fx:  843-847-4296
email:  wanda.smith <@t> hcahealthcare.com
-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
RSRICHMOND <@t> aol.com
Sent: Tuesday, August 14, 2007 3:32 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Re: Frozen section turnaround time

Allison Scott (where's LBJ Hospital - is that the LBJ I think it is?) asks
about turnaround time for frozen sections. That's the time from when you
receive the specimen in the laboratory until the time when the pathologist
phones the report to the surgeons.

If I understand it aright, CAP's requirement is 20 minutes for a single
frozen section, but there are no CAP guidelines for multiple frozen
sections. The problem is getting the pathologist to record the time on the
frozen section work sheet - it's a real nuisance, and a lot of fudging of
records can be expected, but the Herrn Inschpektors have no way of knowing
that.

Bob Richmond
Samurai Pathologist
Knoxville TN


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