[Histonet] High Complexity Testing

[Weems, Joyce]

Honey... Estrogen won't do a thing!!! j:>) 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Victoria Baker
Sent: Tuesday, February 08, 2011 11:59
To: O'Donnell, Bill
Cc: Dawson, Glen; histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] High Complexity Testing

The performance of ISH/IHC is in many laboratories considered high complexity testing - however - as the technologist doing the work does not make the diagnosis it is considered to be a part of specimen processing.
(How's that for political double talking!)   Use of automation in these
procedures provides standardization of the protocols, but it is still a 'machine' it would not know how to recognize a staining or processing issue along with other possible faults.  The purpose of automation was to provide standardization and consistent reproducibility of protocols, reduce antibody/reagent amounts, free the technologist for other needs in the lab and reduce turn around time required for this procedure.  In essence it is hands off BUT not brains off.

Short history is that when CLIA and CAP first started doing these ratings of low - high complexity testing Histology was a grey/special area in that the staff performed the technical aspect of the work, but did not sign off or make the diagnosis.  Since then we have had revisions in CLIA and even with CAP guidelines there is still an aspect of subjectivity based upon the inspector's interpretation of the guidelines.  It's frustrating, infuriating at and at times totally exasperating as you are trying to comply with all the requirements and regulations that are supposed to be clear.

If your pathologist is considering all Histology work as low complexity I would wonder why they thought that?  Is the lab participating in any of the CAP QA/QI programs?  Does he/she participate in doing any In services with the staff?  Do they interact with the staff and share anything  with them in regards to the work or any specific concerns they may have?  Does the department have reference material available to the staff for further study or understanding of the work they do and how important it is to patient care?  Is the department willing to assist with $$'s for in-house CE courses or local Histology societies to further the laboratory staff development?
One thing that I would wonder most is if they think that what you do is 'low complexity' could they go into the lab and perform the work themselves?

Okay my morning rant is complete --- now I guess I should take my Estrogen
;-)

If I have offended anyone, I apologize in advance.  Hope everyone has a nice day.

Vikki
On Tue, Feb 8, 2011 at 10:06 AM, O'Donnell, Bill < billodonnell <@t> catholichealth.net> wrote:

> I don't actually have an answer, but rather an observation.
>
> How many med techs are still doing glusoses in test-tubes, or manual 
> drug screenings or hcg's? It would seem, by deduction that an 
> automated glucose, if only because who it performing it, is a complex 
> test. If measuring a bowel biopsy is now "complex", why should the 
> critical judgements and skills needed to cut a section, place it 
> correctly on a slide and load the machine be considered not complex.
>
> If it comes down to "who" is doing it, then all of our efforts to 
> elevate the field, gain higher and more competative wages and 
> education requirements have done little except in isolated regions or 
> laboratories.
>
> Morning rant.... Need to start getting more sleep.
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Sheila 
> Fonner
> Sent: Tuesday, February 08, 2011 6:45 AM
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] High Complexity Testing
>
>  Hello All,
>
>
>
> I would really appreciate it if anyone has information on whether 
> IHC/ISH are considered high complexity testing for histotechs.  Our 
> pathologist believes that ALL histology low complexity testing since a 
> "machine" is doing the work.  Can anyone help me out with some 
> guidelines, literature, etc. that says otherwise?  I would really 
> appreciate it.  We just want to know which one it is.
>
>
>
> Thanks so much Histoland!
>
>
>
>
>
>
>
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