[Histonet] Work flow, quality issues

[Cheri Miller]

What is the gain??? I am confused by their methods. I also face(rough cut)
and section on the same microtome. I noticed over the years that cuts on the
same microtome and block, one tech can get a thin section just by the way
they turn the flywheel. A heavy handed cutter can make the section thicker
on the same instrument and block. 

Cheryl Miller HT (ASCP)
Histology Supervisor
Physicians Laboratory,P.C.
Omaha, Ne. 
402 738 5052

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Steven
Coakley
Sent: Wednesday, January 14, 2009 2:53 PM
To: Histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Work flow, quality issues

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.






      
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