[Histonet] Work flow, quality issues

Tue Jan 27 07:41:12 CST 2009

Steven,

It would be my suggestion that the Histology team get together to
include the supervisor to facilitate and address the quality issues that
you, your labs Pathologist (s) and Director are experiencing since there
has been questions raised in this arena. The "team" needs to come up
with a plan to meet the needs to demonstrate increased quality and/or
productivity. If all are on board and "bought in" to a change, the
results and plan will happen much more quickly and smoothly. The
Supervisor/Manager should be in a  position to take this responsibility,
motivate staff as well as personal initiative.

  Steven, It appears from what you explained the Supervisor/Manager
need to step up to the plate to understand your concern of all your
associates/coworkers and that your methodology may increase quality
and/or productivity with demonstrating by example. (what you explained,
sounds like a nightmare)!

You do know what its like to be in a new vehicle, the technology, the
feel, the looks the smell...? 
Every Histologist has a certain talent and if it should be ignored by
the Supervisor/Manager/Director/Pathologist, it may be time to give your
seat up on that old bus and get on a much newer model to allow you the
opportunity to feel good at what do what you do best...fortunate for us
in histology /pathology there are plenty of new vehicles out there !   

Your current employer is fortunate to have an employee that
demonstrates care and compassion for high quality expectations for the
patient!

Michael

Michael R. LaFriniere
Executive Director
Cytology Services of Maryland (CSM)
301-206-2555 ext 27      301-206-2595 fax
michael.lafriniere <@t> csmlab.com

>>> On 1/15/2009 at 12:29:16 PM, Rene J Buesa <rjbuesa <@t> yahoo.com>
wrote:
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, trimm
ed 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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