[Histonet] Work flow, quality issues

[Jan Shivers]

I have my techs be the only person who handles a block from facing off to 
finished microtomy.  They put their initials on the slide label, so if that 
block needs recuts in the following days, the same tech and microtome will 
be used.  That way, the least amount of tissue is lost off the block face.

Jan Shivers
UMN Vet Diag Lab


----- Original Message ----- 
From: "Steven Coakley" <sjchtascp <@t> yahoo.com>
To: <Histonet <@t> lists.utsouthwestern.edu>
Sent: Wednesday, January 14, 2009 2:53 PM
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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