[Histonet] Work flow, quality issues

[Rene J Buesa]

Steven:
Are you just complaining to vent some sort of frustration, or can you actually do something about it?
If venting, my sympathies go to you. What you describe could become the nightmare of anybody with the slightest idea about histology good practices, not to mention somebody that tries to take the flow into a "more or less" Lean semblance. The "muda" is astonishing.
 
If you can do something about, what you describe you are used to do is just what has to be done. Use your knowledge and credentials to try to solve the mess you describe.
You know how to do it and good luck. I am sure that "somebody" in that lab has done it that way for years and will be difficult to made to change.
René J.

--- On Wed, 1/14/09, Steven Coakley <sjchtascp <@t> yahoo.com> wrote:

From: Steven Coakley <sjchtascp <@t> yahoo.com>
Subject: [Histonet] Work flow, quality issues
To: Histonet <@t> lists.utsouthwestern.edu
Date: Wednesday, January 14, 2009, 3:53 PM

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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