[Histonet] Re: Quality Assurance for Histology
rsrichmond <@t> gmail.com
Mon Oct 11 11:51:13 CDT 2010
Quality Assurance for Histology: I've been a locum tenens pathologist
for nearly 30 years, and have worked on more than 60 pathology
services in my "career". I'll make some melancholy observations on
The more "quality assurance" paperwork I have to do, the worse the
quality of the slides.
I always get a lot of angry response when I say this on Histonet, but
I assure you that the great majority of small pathology service
histotechs take great pride in not having a microscope and never
looking at a slide.
The most common problems I see are excessive variability of staining,
and venetian-blind artifact in Gi biopsy sections. (I don't see
problems with inadequate processing, because I don't overload
cassettes and I insist on adequate time for fixation.)
If I ran the zoo, I would want to review some selected slides with a
senior histotech at the end of every day, using a double-headed
microscope. Some written record would need to be generated, I imagine.
I have NEVER seen this sort of review done.
Pathologists bear the ultimate responsibility for solving these
problems. Residency programs have been completely ineffective in
training pathologists how to do this.
I wish I knew more about how radiology services do quality assurance.
I notice that I don't see out-of-focus X-ray films.
The MBA's drove Edwards Deming to Japan more than half a century ago
rather than adopt it, but effective feedback is necessary in any
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