[Histonet] Checks and balances for specimen accessioning

Fri Feb 25 13:03:08 CST 2011

But you have to hope the whom ever is putting the barcode label on uses the correct patient barcode. That has been the problem that I have seen.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Michael Mihalik
Sent: Friday, February 25, 2011 12:49 PM
To: 'Finley, Sue [PH]'; 'Mahoney,Janice A'; 'Nita Searcy'; 'Allison D' 'Scott'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Checks and balances for specimen accessioning

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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