[Histonet] Checks and balances for specimen accessioning

Fri Feb 25 12:48:49 CST 2011

One quick clarification:  If the OR or whomever collects the specimen would
put a barcoded label on the specimen container at collection time, all of
this would be avoided.

That just seems to be a difficult thing for those departments to do.  I know
that it's not a technical issue.  It's something more than that.

..but it can be done and in what appears to be a small percentage of
facilities, is indeed done.

Michael Mihalik
PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369

-----Original Message-----
From: Finley, Sue [PH] [mailto:SFinley <@t> providencehealth.bc.ca] 
Sent: Friday, February 25, 2011 10:08 AM
To: 'Michael Mihalik'; 'Mahoney,Janice A'; 'Nita Searcy'; 'Allison D'
'Scott'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Checks and balances for specimen accessioning

Hi All
We too receive samples from our OR clinics and wards, referred-in etc.  The
example that you have illustrated in this e-mail thread is a very common
occurrence and as Michael states bar coding cannot control the initial point
of entry into the lab.  It is the responsibility of the person preforming
the task of accessioning to diligently check sample information is correct
on both the container and the requisition.  We too have implemented LEAN
concepts throughout our AP flow and have very strict SOPs to address how to
handle "external incidents" of this nature.  We do not process until the
sample has been corrected by the sender.

For us; LEAN concepts/management is the preferred tool and then
instrumentation selection is layered over our LEAN environment that
interfaces with our LIS.
Regards
sue

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Michael
Mihalik
Sent: February 25, 2011 9:47 AM
To: 'Mahoney,Janice A'; 'Nita Searcy'; 'Allison D' 'Scott';
histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Checks and balances for specimen accessioning

..but Janice, Vantage won't help with accessioning issues will it?  I'm just
going back to this issue because that was the initial point of the thread
and it's really, really important to get things right at accessioning.  

The other aspect of this is that accessioning is the point at which material
from outside the lab comes into the lab.  It's the 'interface' or the place
where the river water meets the ocean water if you follow my analogy.  We
have a lot more control over material once it enters the lab.  It gets
frustrating to spend so much effort and monies on improving practices inside
the lab, only to be subject to issues outside of the lab.  Yes, you can
check for them by manual processes (name verification), but in large volume
environments, that's gets tougher.

I just get frustrated that so many specimen still come down to the lab
without a patient id/order #/something barcode, so that I can ensure
positive identification.

This is important stuff.

Michael Mihalik
PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369

-----Original Message-----
From: Mahoney,Janice A [mailto:Janice.Mahoney <@t> alegent.org]
Sent: Friday, February 25, 2011 9:12 AM
To: 'Nita Searcy'; Allison D' 'Scott; histonet <@t> lists.utsouthwestern.edu;
Michael Mihalik
Subject: RE: [Histonet] Checks and balances for specimen accessioning

Allison and all,
As part of LEAN we use standard work.  This means we have best practice
written down, step by step and every person does it the same way on every
specimen. No matter what!  This gets "hard-wired" after a while. The
inspection of the requisition against the container is one of the steps in
the process.  Errors can be virtually eliminated using this practice.
There is also the wonderful innovation of using bar coding to assure things
match.  Check out the Vantage system by Ventana.  I highly recommend it for
eliminating the kind of mistakes you point out.
Jan
Omaha

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Nita Searcy
Sent: Friday, February 25, 2011 10:26 AM
To: Allison D' 'Scott; histonet <@t> lists.utsouthwestern.edu; Michael Mihalik
Subject: RE: [Histonet] Checks and balances for specimen accessioning

You are absolutely correct.

Nita Searcy, HT/HTL (ASCP)
Scott and White Hospital
Division Manager, Anatomic Pathology
2401 S. 31st. Street
254-724-2438
Temple, Texas, 76502
nsearcy <@t> swmail.sw.org

254-724-2438

>>> "Michael Mihalik" <mike <@t> pathview.com> 2/25/2011 10:22 AM >>>
To me, there is only one 100% solution -- barcodes.  I'm quite anxious to
hear other people's thoughts, though.

Michael Mihalik
PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Scott,
Allison D
Sent: Friday, February 25, 2011 8:01 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Checks and balances for specimen accessioning

Hello to all in histoland.  What types of checks and balances do you have in
place for specimen accessioning.  We had a incidcent where I was
accessioning a case and I did not catch that the name on the container was
different from the name on the requisition.  The resident grossing did not
catch it either.  They usually peel back the copath label and look at the
name on the label that came from the procedure area.  In my case the
resident did not do this. It was not until the pathologist saw a discrepancy
in the age on the requisition and what was written in the pertinent history,
that it was determined that it had been mislabeled from the beginning.  I
did a incident report and the area was cited.
Besides making sure that who ever is accesioning cases checks that the names
match, what else can be done?  Any help in this will be greatly appreciated.

Allison Scott HT(ASCP)
Histology Supervisor
LBJ Hospital
Houston, Texas
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