[Histonet] Work flow, quality issues

[Steven Coakley]

I have worked in several HT labs and as expected most differ in individual technique.  Most are very good as far as work flow from grossing, processing, embedding and sectioning.  I work in a lab now where the grossing and processing of "like specimens" are in case order until there embedded.  Embedded totally out of order, even within a case.  One person will rough cut the blocks on 1 microtome, approx 20 microns.  After all the embedding is done the  trimmed  blocks are put in order, placed  on ice in which about half are to be cut on another microtome.  Although the microtomes are adjusted close I have found that by the time I'm ready to section my blocks on the microtome not used for trimming I often have to go into the tissue 20-40microns,  5 microns at a time, to get a complete section.  This often makes it tough to get a good, rehydrated 2nd section not to mention often the 1st if the event the tissue is larger and or firm to start
 with.  Often I have to re-trim the blocks to match my microtome then rehydrate them again.  This all takes time and makes it impossible to section all my cases in order, waiting on blocks to rehydrate, hold slides sometimes leading to mistakes.

I have always, and in every lab I worked except this one, trimmed my own blocks for a specific microtome.  At the end of trimming, I always fine cut 4-5 microns 2-5 times to deminish the artifact often caused by too aggressive initial trimming.  Then I rehydrate and ice the tissue..   With this technique I use less knifes also.

I temped in this lab about 1/1/2 years ago and was asked by the Pathologist and Lab Director to address these very issues and section quality.  Now that I'm back nothing has changed.  The pathologist still has section quality issues.  What ever happen to the idea of Quality Improvement.  The works getting done I suppose, maybe thats all that matters these days.