[Histonet] RE: Embedding process improvement and competencyassessment

Thu Aug 25 12:16:26 CDT 2011

This point is well taken- I agree that our experience and knowledge often goes unrecognized. In my humble opinion , it takes all components, theory knowledge,  extended practice and  forthcoming technical mastery... some of this can come with academic study, some comes with actual "doing" . No doubt we are not there yet in having the best system for training new people coming in, it has been an ongoing industry challenge. Some managers seem to understand the components needed, some do not. Certainly helps to be a histologist in any case, for any type of management of this lab section. Do to our lack of recognition in some markets I guess, we often have MT people as supervisors and managers, they bring some things to the table, but lack some insights it seems. But what I am suggesting that we can try to do, is to get those willing and already in those positions,   to an understanding for what is particularly needed for histology. Some MT managers I have had have in the past, have been pretty good and are open to this, some unfortunately have demonstrated the dissappointing attitude that "anyone can do histology"...and seem to try  to fill the need with any "warm body". In my experience, with few exceptions, I have never seen the "warm body" method of filling staffing needs work out very well. 
Joelle

Joelle Weaver MAOM, BA, (HTL) ASCP

> Date: Thu, 25 Aug 2011 12:39:16 -0400
> From: NHeath <@t> Lifespan.org
> To: JMacDonald <@t> mtsac.edu
> Subject: RE: [Histonet] RE: Embedding process improvement and competencyassessment
> CC: histonet <@t> lists.utsouthwestern.edu; histonet-bounces <@t> lists.utsouthwestern.edu; SDattili <@t> stormontvail.org
> 
> Regardless of wether there were 8 blocks or eighteen blocks taking the
> practical taught me to be precise with all of the hands on aspects of
> Histology. Shame on the older techs from the "practical days" of not
> keeping on top of their game with embedding. My comment was geared more
> towards the newbies coming out of histo schools who can pass the exam
> with flying colors but sit them in front of an embedding center or
> microtome and they are all thumbs! As far as a manager, I myself would
> rather have someone who has experience with histology over seeing my
> work. Just once again the lack of respect of having the HT/HTL behind
> your name.
> 
> ________________________________
> 
> From: Jennifer MacDonald [mailto:JMacDonald <@t> mtsac.edu] 
> Sent: Thursday, August 25, 2011 10:58 AM
> To: Heath, Nancy L.
> Cc: Histonet Listserv (E-mail);
> histonet-bounces <@t> lists.utsouthwestern.edu; D'Attilio, Shelley;
> Podawiltz, Thomas
> Subject: RE: [Histonet] RE: Embedding process improvement and
> competencyassessment
> 
> 
> 
> I fail to see the correlation of a non HT person supervising the
> Histology lab and the lack of a practical exam for HT/HTL staff. One of
> the issues that Shelley brought up was the staff lost or did not develop
> their embedding skills. Submission of a practical exam is not proof of
> highly developed embedding skills. For the HT exam there were 8 blocks
> that were submitted (9 slides). I know of cases where the blocks were
> not even embedded or cut by the applicant. 
> 
> 
> 
> 
> "Heath, Nancy L." <NHeath <@t> Lifespan.org> 
> Sent by: histonet-bounces <@t> lists.utsouthwestern.edu 
> 
> 08/25/2011 07:11 AM 
> 
> To
> "D'Attilio, Shelley" <SDattili <@t> stormontvail.org>, "Podawiltz, Thomas"
> <tpodawiltz <@t> lrgh.org>, "Histonet Listserv (E-mail)"
> <histonet <@t> lists.utsouthwestern.edu> 
> cc
> Subject
> RE: [Histonet] RE: Embedding process improvement and
> competencyassessment
> 
> 
> 
> 
> 
> 
> This is exactly why the powers that be should have NEVER gotten rid of
> the practical portion of the HT/HTL board certification! 
> 
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
> D'Attilio, Shelley
> Sent: Thursday, August 25, 2011 9:45 AM
> To: Podawiltz, Thomas; Histonet Listserv (E-mail)
> Subject: [Histonet] RE: Embedding process improvement and
> competencyassessment
> 
> Hi Tom,
> Thank you for your kind words. I am off the bench almost completely. I
> can work in the gross room in a pinch and my counting skills are
> excellent, so I can always file slides and block if an emergency
> arises:) I occasionally cover a bench in Chemistry as well, but my
> staff is all pretty glad that I mostly stay in my office. 
> 
> Thanks so much for the embedding information. The main problem we are
> tackling at the moment is tissue orientation. I have written a pretty
> detailed embedding procedure that is being reviewed by the new histology
> supervisor. Our plan is to refresh the training of everyone on staff in
> conjunction with this procedure, then add specific embedding
> competencies to our checklist. I will make sure that the procedure
> incorporates the first 6 elements that you listed below.
> 
> Currently we have a QA sheet that is given to the pathologist with each
> batch of slides. Pathologists provide us with feedback on the slide
> quality by filling out the form. Slides with sub-standard
> quality--whether in orientation, cutting, staining, whatever--our
> reviewed by every histotech in the lab with an aim to education and
> improvement of performance. We have a form called the "Slide Quality
> Review Form" that details the quality issue. Techs are directed to
> review the slides and comment. Difficult cases or those where people
> disagree are discussed in our department meetings. 
> 
> One of our difficulties over the years has been how the work was divided
> between the histotechs. One histotech loved to embed and was very good
> at it, so he did most of the embedding. He eventually moved to an
> overnight shift, which resulted in him embedding even more than he was.
> Consequently, other staff people either lost their skills or never fully
> developed them. It was introduction of rapid processing that really
> brought this issue to the forefront, since different people were
> embedding at different times of the day.
> 
> Unfortunately, I let my NSH membership lapse this year for budgetary
> reasons. I have purchased quite a few resources over the years from
> NSH, and even attended the NSH annual meeting a few years ago when it
> was in Phoenix. I will reconsider my decision to drop my membership. 
> 
> For those on the list, here is Tom's response to my question:
> 
> Hi Shelley, 
> 
> I would suggest you join NSH, they have all kinds of reference material
> for this type of work. 
> 
> Please tell me you are off the bench, you have a lot to monitor and if
> you are working the bench on top of your management duties my prayers go
> out to you. 
> 
> Embedding: 
> 
> 1. Proper size of mold in relation to specimen size. 
> 2. Proper orientation of tissue, example 5 skin biopsies, dermis must
> face the same direction, and be at an angle to the blade so when you cut
> the section cuts smoothly and doesn't roll up. 
> 3. Multiple pieces all on the same plane. If one piece is deeper than
> the others you must re-embed, or you will cut through the other pieces
> before you reach it. 
> 4. Make sure that the embedding unit is wipe down between each case as
> are the forceps, this will avoid tissue floaters. 
> 5. Never open more than one cassette at a time. 
> 6. Verify that the piece count on the work sheet matches what is in the
> cassette when it is opened.
> 7. Never hound the staff about speed, accuracy is more important, speed
> comes with experience. If its embedded wrong, it will be cut wrong and
> this will effect diagnosis. 
> 8. What do you do for QA on the slides?I have a work sheet that the
> Pathologist fills out each day about the slides, which is the end
> product of embedding. 
> 
> I hope my tips help you and feel free to contact me if you need
> anything. 
> 
> Tom Podawiltz, HT (ASCP)
> Histology Section Head/Laboratory Safety Officer LRGHealthcare
> 603-524-3211 ext: 3220
> ________________________________________
> 
> 
> 
> NEED A DOCTOR? Stormont-Vail's Health Connections can help you find a
> doctor accepting new patients. Call (785) 354-5225.
> 
> ************************************************************************
> ******************************************
> 
> 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.
> 
> ************************************************************************
> ******************************************
> _______________________________________________
> Histonet mailing list
> Histonet <@t> lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
> 
> _______________________________________________
> Histonet mailing list
> Histonet <@t> lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
> 
> 
> _______________________________________________
> Histonet mailing list
> Histonet <@t> lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet