[Histonet] 72644.18148.qm@web111105.mail.gq1.yahoo.com

Thu Apr 1 14:47:15 CDT 2010

Thomas

Just a question, what would you consider an unnecessary CAP regulation?

Liz

Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC
Manager
Premier Laboratory, LLC
PO Box 18592
Boulder, Colorado 80308
office (303) 682-3949 
fax (303) 682-9060
www.premierlab.com

Ship to Address:
1567 Skyway Drive, Unit E
Longmont, Colorado 80504

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Thomas
Jasper
Sent: Thursday, April 01, 2010 12:46 PM
To: Andrew Burgeson
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] 72644.18148.qm <@t> web111105.mail.gq1.yahoo.com

I'm inclined to agree with you Andrew.  Seems to me that CAP has become,
unintentionally (I'd like to believe) something of an unsavory, bullying
sort of entity.  I'm not certain about all the factors involved, but I
think a few things have definitely contributed to all of this CAP
negativity.

First of all - CAP was (is?) considered the accrediting "gold standard".
That's pretty heady stuff...possible ego inflation potential...high
horse attitude...elitism?  Not saying that was the plan, just an
unfortunate and unintended consequence.  I'm sensing a power trip here,
it's partly human nature (I guess) and it can definitely suck!

Secondly - as I recall, CAP got egg on their face a few years back in
the DC/Baltimore area I believe.  Someone can correct me if I'm wrong or
provide more specific details.  Anyway, the gist being - someplace
passed their CAP inspection and someone (an employee I believe)
contacted another regulatory agency because there was NO way this place
should've passed CAP.  When this all came to light CAP had to respond,
and as can often be the case, the response was overly compensatory.

I'm sure a lot of folks out there know what I mean.  Now CAP issues
confusing and sometimes unnecessary regulation changes and additions.
And of course we're all aware of the "super secret surprise"
inspections.  I'm not even sure of half the other hidden agendas and
possible ulterior motives.  Control issues, tarnished pride, bruised
egos and all conveniently cloaked in a drive for the best possible
patient care...who could argue with that standard?

During my previous employment, we "sweated" the details and worked
diligently to achieve our 1st CAP accreditation circa 2000.  I have to
admit, I did/do like the regulation format.  Having a question asked,
determining if it applies to your service, and then answering yes or no.
By taking it from there and doing things on the up and up, most any lab,
that's honest and conscientious should have the realistic expectation of
passing CAP.  That was then, it seems to longer be that way.  As I
mentioned, confusing language and reg. additions/changes, along with CAP
inspectors and their agendas have all been to the detriment of the
accreditation.

I was trained to look at CAP as "peer review".  In my experience, many
times this was not the case.  Many CAP inspecting "teams" wants to make
the "inspectees" (if that's a word) something of a clone, carbon copy or
version of the inspecting team's service.  This is another huge problem
and causes a lot of strife, hard feelings and red tape at and after the
summations.  The regulations, ideally, should be interpreted in the most
objective way possible.  Again, maybe it's human nature, but it seems
that people can't help being overly subjective re: interpretations of
any number of CAP regs.

I used to work with a pathologist that regularly attended the CAP
committee meetings.  At times I would bring issues to him I thought
relevant to CAP.  I don't recall the specifics but I do know they were
of a practical nature from a technical viewpoint.  I basically got the
brush-off and was led to believe that CAP wasn't interested in the
"technical" viewpoint and he wasn't going to bother with it.  This may
be a stretch in logic on my part...however, I can't help but think if
CAP would listen to technical folks as well as MDs, they'd be in a
better position right now.

I'm not inclined to throw the baby out with the bath water.  I think CAP
accrediting was established with good intentions. Somehow things have
gotten out of hand, and some have gone horribly wrong.  I think things
like QIP are good, although I've heard complaints about that as well.
I'm feeling lucky these days because CAP isn't in my life.  But my
attitudes and mind-set have most certainly been shaped by my CAP
experiences.  Please remember this is my opinion only, I am not perfect
and am only interested in practical application of sensible regulations
for optimal patient care.

Regards,
Tom Jasper
Histology Supv.
CORPS

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Andrew
Burgeson
Sent: Thursday, April 01, 2010 10:27 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] 72644.18148.qm <@t> web111105.mail.gq1.yahoo.com

Sheesh is right, J.

CAP is all politics as far as I am concerned. It is all about protecting
the careers and paychecks of the general pathology community.

I am thouroughly unimpressed with JCAHO, CAP et al.

If all you need to legally run a laboratory is to be CLIA inspected,
then WHY BOTHER with these subjective entities?

The BS I have heard over the last few months concerning MOHS surgery
specimens is one glaring example of the limitations CAP has in
understanding fully certain nuances of the lab trade.

Ridiculous. Unless you want the marketing and potential "perception"
that you are better covered from a legal standpoint, CAP certs are
worthless. 

The more I hear about CAP certifications, the more I see it as a certain
community of individuals who are protecting their perceived "TURF." 

In the end, the pathologists in the group and in the facility in which
you are working have to take responsibility for these matters. If the
docs think a CAP cert is necessary, then do it and live with it. If not,
then consider yourself lucky to not have to see these people in your
lab.

I have been through MANY CAP inspections in and out of the military. For
the most part, though, I see people paying this organization to inspect
their lab as the same thing as "burning a pinch of incense in honor of
great Caesar, ruler of Rome." It will get you some kudos, but tangibly
not change much at all if your pathologists or HR $ hiring hands want to
pocket more $ as a result of hiring "pregnant out of wedlock 16 year
olds" to gross tissue and cut slides.

Seen it.

AB

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