[Histonet] Re: Quality Assurance for Histology

Weems, Joyce JWeems <@t> sjha.org
Mon Oct 11 12:02:52 CDT 2010

I wish more pathologists had your mindset... Sigh... J

Joyce Weems 
Pathology Manager 
Saint Joseph's Hospital 
5665 Peachtree Dunwoody Rd NE 
Atlanta, GA 30342 
678-843-7376 - Phone 
678-843-7831 - Fax 


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Robert Richmond
Sent: Monday, October 11, 2010 12:51
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Re: Quality Assurance for Histology

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 this subject.

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 manufacturing process.

Bob Richmond
Samurai Pathologist
Knoxville TN

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