[Histonet] Clarification-interfacing the IHC bond andCassettelabelers to Co-Path

Fri Oct 22 15:00:53 CDT 2010

Our LIS specialists built a template into the pathologist screen for
each case where they simply check off the boxes of the IHC they want on
a case.  It took them a little while to get used to not using post it
notes for their orders but once they got used to it, they like it.  It
only takes them a second or two to check what they want.  Once they
click the "send order" box, the order goes directly to the IHC worksheet
for that day.  When the stains are done and the qc tech scans their bar
codes, the "finished cases" icon will appear in the pathologists queue.
The interface itself saves us tech time since most pathologist are going
to simply fill in a form or use a post it to convey their orders.  A
tech then has to enter this info into a worksheet and into the Bond
prior to running the IHC.

We built our lab (only opened since Jan 19, 2010) and equipped it based
on LEAN processes.  In some areas the LIS supported LEAN, in other areas
we needed to use work arounds (like connecting each slide and cassette
labeler to it's own CPU so that to the system, they appear as another
printer with an IP address).  I am a firm believer that any lab (brand
new or a retrofit) can be adapted to LEAN through process changes,
equipment adaptations, and/or using existing software more fully. 

Steve

-----Original Message-----
From: Rathborne, Toni [mailto:trathborne <@t> somerset-healthcare.com] 
Sent: Friday, October 22, 2010 1:57 PM
To: Feher, Stephen; Akemi Allison; Walter Benton
Cc: Histonet
Subject: RE: [Histonet] Clarification-interfacing the IHC bond
andCassettelabelers to Co-Path

I'd be interested in knowing how this has impacted your pathologists.
Were they resistant at first? The extra time inputting requests would
now fall on them.  And there is still a chance of keystroke errors with
pathologist entry.
I'm not disagreeing with the comments you made, only wondering since you
were able to save .7 FTE, where the .7 pathologist came from. Or is it
the interface itself that saves the time, and not who enters it?
Also, did you have the slide printers before the LEAN process was
implemented? or was it done because of LEAN and is part of the FTE
savings?
I'm very interested in this process, but know the types of questions
I'll need to have answers for. We're a Cerner facility, so some things
will be different but the principal will be the same.

Toni

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Feher,
Stephen
Sent: Friday, October 22, 2010 1:32 PM
To: Akemi Allison; Walter Benton
Cc: Histonet
Subject: RE: [Histonet] Clarification-interfacing the IHC bond
andCassettelabelers to Co-Path

We have interfaced our Bonds with Soft Path LIS system.  My
justification for this started with using it for LEAN processes in that
the orders for IHC went directly from the Pathologist to the Bond and
eliminated the need for my techs to have to input individual orders for
IHC by hand.  Since we have set up our slide labelers to be recognized
as just another printer as far as the LIS is concerned, we do not use
paper labels at all but have 2d barcodes printed directly on our slides.
When an order is put in by the pathologist for IHC, my techs can see the
order, cut the section and print the slide with the correct bar code.
Bond recognizes the barcode and initializes the tests that have been
ordered and transferred from the pathologist.

This has accomplished the following:

No tech time lost in printing labels for slides to go on the bond.  No
ambiguity or lost IHC orders due to hand writing orders by the
pathologist.  No chance of keystroke errors on the part of my IHC tech
while putting manual orders into the Bond.  In addition to eliminating
hand writing and manual keystrokes, which are distinct patient safety
issue, I have calculated that having the interface has saved me
approximately 0.7 FTE.  Instead of having to hire extra staff to cover
increased workloads or wasting existing staff on extraneous tasks (hand
labeling, manually entering orders, etc), I can utilize them in other
areas.

The patient safety aspect of eliminating extra tasks involving manual
data entry is huge.  A majority of the lawsuits against pathology labs
involve some aspect of human error resulting from manual tasks in
labeling or data entry.  In addition to being able to market my lab as
patient safety focused, we have eliminated a major source of potential
lawsuits.  It's hard to put a price tag on what that saves other than to
say that the costs are sometimes much more than the dollar figures paid
out. 

Steve

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Akemi
Allison
Sent: Thursday, October 21, 2010 4:01 PM
To: Walter Benton
Cc: Histonet
Subject: Re: [Histonet] Clarification-interfacing the IHC bond and
Cassettelabelers to Co-Path

Hi Walter and Histo-subscribers,

Ist I want to thank Walter for his quick reply.  I appreciate your
answer!  2nd, I appreciate any and all replies, but does anyone have an
"article" that addresses issues that can occur such as:

Efficiency
Omitting Duplication of Tests ordered: Additional Slides, Special
Stains, IHC, FISH, CISH, Cost effectiveness due to omission of errors
Patient Safety

Thanks

Akemi Allison BS, HT (ASCP) HTL
Director
Phoenix Lab Consulting
Tele: 408.335.9994
E-Mail: akemiat3377 <@t> yahoo.com

On Oct 21, 2010, at 11:38 AM, Walter Benton wrote:

> Efficiency
> Patient Safety
> Orders for the Bond come directly from the LIS and can not be 
> misunderstood due to poor handwriting, since they are interfaced with 
> the LIS.
>
>
> Walter Benton HT(ASCP)QIHC
> Histology Supervisor
> Chesapeake Urology Associates
> 806 Landmark Drive, Suite 126
> (All Deliveries to Suite 127)
> Glen Burnie, MD 21061
> 443-471-5850 (Direct)
> 410-768-5961 (Lab)
> 410-768-5965 (Fax)
> wbenton <@t> cua.md
> ________________________________________
> From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet- 
> bounces <@t> lists.utsouthwestern.edu] On Behalf Of Akemi Allison 
> [akemiat3377 <@t> yahoo.com]
> Sent: Thursday, October 21, 2010 2:33 PM
> To: Histonet
> Subject: [Histonet] interfacing the IHC bond and Cassette labelers to 
> Co-Path
>
> Hi out there in Histo Land!
>
> I would like your assistance in answering a question that was proposed

> by a friend who is not a histonet member.  I don't have the answer, 
> but know that one of you would.  Below is the question:
>
> Could you help me justify the importance of interfacing our IHC bond 
> and Cassette labelers to Co-Path? A simple paragraph,  or if you have,

> a white paper, that would be great.  I am attempting to get the 
> interfaces approved through our IT Department and running up against 
> some roadblocks.
>
> Thank you in advance for your assistance,
>
> Akemi Allison BS, HT (ASCP) HTL
> Director
> Phoenix Lab Consulting
> Tele: 408.335.9994
> E-Mail: akemiat3377 <@t> yahoo.com
>
> _______________________________________________
> Histonet mailing list
> Histonet <@t> lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet

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