[Histonet] Checks and balances for specimen accessioning

Victoria Baker bakevictoria <@t> gmail.com
Fri Feb 25 13:16:04 CST 2011

Do you recall the source of pick up for the specimen?  If it is picked up by
Histology either in the OR or a lab site the pick up person should be
checking the name on requisition, container and label in the book or ledger
prior to initialing and dating.  Also the person bringing the specimen to
these sites has to initial and date when they put the pt. label in the
ledger.  I would go back to the source - as a starting point.  Once the
specimen is received into the lab, the person accessioning is checking the
container against the requisition.  Once a patient is registered either in
the hospital or at the site they are assigned a medical record number or
another unique identifier.  When you accession this patient by one of these
identifiers the descrepancy should (I stress should) show up and be caught.
Another check is to see if the specimen on the container matches what is on
the requisition.  Something which should be done from pick up point.
It varies by site how the specimen is dictated in regards to specimen ID.
Some read from the bottle while looking at the requisition and dictate from
that, but I've found it isn't always the rule.

The original label (source label) has to be clearly visible and not covered
with another label at any time in the process.  If you are using a barcode
label in the Histology lab the barcode needs to be placed way from the
source label.

The LEAN process does indeed standardize a lot of the work process, but it
is also based on the lab volume, work flow which is individual to each lab.
Also the use of computer systems and how fully they are utilized within each
lab.  I've worked in several labs that are LEAN and they still had issues
with specimen handling/verification  for different reasons.

In your situation you would have to follow the paper trail at this point,
but it would be a very strong reason to work towards getting a unified
system in place that tracks specimens from the source to final sign out.  I
know that there are companies out there that do this one is PathCentral they
provide software and support.

Have a great weekend.


On Fri, Feb 25, 2011 at 11:00 AM, Scott, Allison D <
Allison_Scott <@t> hchd.tmc.edu> wrote:

> 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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