[Histonet] Embedding process improvement and competency assessment

Thu Aug 25 08:30:41 CDT 2011

Shelley:
I fully understand your position and I am sure that you sometimes may have felt as a "stranger" in histology. I also understand that you have been able to do things that had benefit the histology work flow..
My general point is that I think that promotions, in all fields of the medical laboratory, should come from "within" as a reward for a good job. It is the same thing as if somebody from outside the ranks of the Chemical Laboratory is promoted to run it. The same thing has happen in your case when you became the manager for histology coming from outside histology.
You have pointed out to a key component of this whole equation: the salary differences and, more deep than that even, is the fact that histotechs are "looked down" from many members of the medical lab. There is still the perception, encouraged by many a pathologist, that "even a monkey can make a tissue section".
The fact that histology is 80% still manual compared with the chemical lab that is almost 90% automated, projects an image that "histology is a less than technical activity", when it is not.
This missperception and some disdain the histotechs are perceived, is the core cause why the promotions in histology usualy do not come from its ranks. And it is also why when that happens, like in your case, you find yourself at a miss about how those tasks "wordy of a monkey" are done.
I hope that now you understand why my first "rant". This is my second "rant".
Under separate cover I am sending you the competencies you need.
René J. 

--- On Wed, 8/24/11, D'Attilio, Shelley <SDattili <@t> stormontvail.org> wrote:

From: D'Attilio, Shelley <SDattili <@t> stormontvail.org>
Subject: RE: [Histonet] Embedding process improvement and competency assessment
To: "Rene J Buesa" <rjbuesa <@t> yahoo.com>, histonet <@t> lists.utsouthwestern.edu
Date: Wednesday, August 24, 2011, 5:14 PM

Rene',
I agree with many of the points you make about a non-histotech managing a histology laboratory, especially since the decision could be seen to devalue the special training and knowledge of a histotech.  Every bit of knowledge I have gained along the way has been hard-fought, to say the least, and I'm quite sure that I have made mistakes.  

My experience in the clinical lab did give me an outside perspective on our procedures and processes in our Histology lab.  In my tenure, I have introduced slide and cassette labelers that are interfaced with our AP information system and rapid tissue processing technology.  In addition, I am a great proponent of specimen tracking systems, particularly as a way to improve patient safety.  I hope to implement a tracking system in the next 2-3 years.   So while I struggle with the many things that I do not know, I am proud of the changes I championed in our laboratory.

I think the original idea for my position (and I'm not the first to have this position) was as an "administrative" manager--budget, new equipment, personnel matters, etc. with the histotechs themselves functioning as a self-directed team for technical matters.  Because our volumes have grown and the technology become more complex, I was able to justify the addition of a bench-level supervisor.

And I agree with you that medical technologists/clinical laboratory scientists could make excellent histotechs.  It is a shame that in many labs the rate of pay for the two positions is not equivalent.

It is very generous to offer your embedding competencies, and I humbly accept.  

Regards,

-----Original Message-----
From: Rene J Buesa [mailto:rjbuesa <@t> yahoo.com]
Sent: Wednesday, August 24, 2011 2:18 PM
To: histonet <@t> lists.utsouthwestern.edu; D'Attilio, Shelley
Subject: [Histonet] Embedding process improvement and competency assessment

Shelley: 
Please do not miss-understand what I am going to write you but I still find extremely difficult to wrap my mind around the fact that somebody without practical knowledge of histology can become a manager of a histology laboratory. 
You will have a very hard time going about your tasks and you will probably make some judgment mistakes.
I have proposed many times that medical technologists are the answer to the shortage of histotechs, but because I think MT can be trained and add to their theoretical knowledge of the lab the skills to become good histotecha.
Your question is an example of the difficulties you are encountering because one of the responsibilities of the histology manager is to develop and write the competencies for each task based on his/her experience. 
Since you do not have such experience your only solution will be to rely on others and if your select the wrong one, you will end with "soft" competencies that will adversely affect the overall work flow of the lab.
Excuse for this rant. Now, if you want, I can send you the embedding competencies I developed for my lab.
René J.

--- On Wed, 8/24/11, D'Attilio, Shelley <SDattili <@t> stormontvail.org> wrote:

From: D'Attilio, Shelley <SDattili <@t> stormontvail.org>
Subject: [Histonet] Embedding process improvement and competency assessment
To: histonet <@t> lists.utsouthwestern.edu
Date: Wednesday, August 24, 2011, 1:55 PM

Hi all,
I'm looking on ways to assess competency on embedding skills.  I am a medical technologist managing histotechnologists, so I don't actually know how to embed anything.  Luckily, I have been able to promote a registered histotech to a front-line supervisor position in the lab and improving our techs' embedding skills, particularly on skins, is a process improvement project for the coming year.

I would love some tips on how you assess competency on this important skill.  Is direct observation the only way, or do you use other techniques in conjunction with direct observation?  Any good resources out there that has lots of photos of actual specimens?  Any ideas for measuring improvement?

Thanks in advance for your help,

Shelley D'Attilio MT(ASCP)
Manager, Chemistry, Cytology and Histology
Dept. of Pathology and Laboratory Medicine
Stormont-Vail HealthCare
Topeka, Kansas

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The information transmitted in this e-mail and in any replies and forwards are for the sole use of the above individual(s) or entities and may contain proprietary, privileged and/or highly confidential information. Any unauthorized dissemination, review, distribution or copying of these communications is strictly prohibited. If this e-mail has been transmitted to you in error, please notify and return the original message to the sender immediately at the above listed address. Thank you for your cooperation.