[Histonet] Unregistered HT testing

[Dessoye, Michael J]

Just to be clear, I wholly agree with your comments...I am not
downplaying registration by any means, and I think that IHC and ISH
should fall under high complexity.  I think this issue gets downplayed
because in many cases one can 'get by' by putting slides on a stainer
and running it, and that doesn't 'appear' to be high complexity...but
without the background knowledge and understanding that you talked
about, these folks can't troubleshoot issues when they come up or
understand the principles behind the procedures.
 
To get back to the original question, I do know labs that have this
testing performed by unregistered techs...however, they all have degrees
and on-the-job training, so I imagine most would fall into the
'registration eligible' category, and be qualified for high-complexity
testing.  In my opinion, that would meet the CAP requirement.
 
Michael J. Dessoye, M.S. | Histology Supervisor | Wilkes-Barre General
Hospital | An Affiliate of Commonwealth Health |
mjdessoye <@t> commonwealthhealth.net | 575 N. River Street | Wilkes Barre,
PA 18764 | Tel: 570-552-1432 | Fax: 570-552-1526 
 
________________________________

From: joelle weaver [mailto:joelleweaver <@t> hotmail.com] 
Sent: Wednesday, April 18, 2012 1:17 PM
To: Dessoye, Michael J; nkonop <@t> chw.org;
histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Unregistered HT testing


CLIA does stipulate education requirements though for high complexity( I
don't have it handy, but I do recall it is quite specific).
Yes "interpretation" differs from performance. But we are not
interpreting for diagnosis anyhow, but we do have to make technical
assessments, corrections,  and I think you need some insight to do that
effectively.  As I recall from CLIA, IHC/ISH is clearly under high
complexity. But I can think of some histochemical staining ( such as
enzyme muscle histochemistry) that might also be considered high
complexity. I know for grossing, it is also an issue. 
 
Even if ASCP certification is not specifically stipulated in CLIA ,  I
think that is is implied , in that the education stipulations are
roughly equivalent to the criteria for HT certification- (associates
with qtr. hours needed in science, chemistry etc). So yes I guess anyone
can learn to put on and take off slides on a stainer and execute any
process or procedure when trained to do so. The "rub" for me though is
that I personally have observed that when people don't have training or
education in histology ( formal or informal), they don't know how the
stain works, or what it should show,  so they are not adept at review of
stained slides, and are not able to troubleshoot stain problems etc. I
think that this should be part of the expectation, but that is an
opinion,  not I guess actually regulated as a requirement. I do think
that CAP pretty much stipulates this expectation via competency
requirements, but that is how I interpret it. Certification is just a
means to communicate that you have satisfied the criteria, which should
say that you have this underlying knowledge and understanding- knowing
science just forms the basis for this understanding.  I think good in
house laboratory training and competency assessment could be an
alternate route to that goal in places where more academic training
opportunities are scarce. 


Joelle Weaver MAOM, HTL (ASCP) QIHC
 

> Date: Wed, 18 Apr 2012 10:43:22 -0400
> From: mjdessoye <@t> commonwealthhealth.net
> To: NKonop <@t> chw.org; histonet <@t> lists.utsouthwestern.edu
> Subject: RE: [Histonet] Unregistered HT testing
> CC: 
> 
> Our interpretation of special stains/IHC/ISH is that it is the
> 'interpretation' of these stains that is 'high complexity'. I believe
> that CLIA is the place where 'high complexity' is defined (although
CAP
> may expand on this) and CLIA does not recognize ASCP registration.
> 
> Michael J. Dessoye, M.S. | Histology Supervisor | Wilkes-Barre General
> Hospital | An Affiliate of Commonwealth Health |
> mjdessoye <@t> commonwealthhealth.net | 575 N. River Street | Wilkes Barre,
> PA 18764 | Tel: 570-552-1432 | Fax: 570-552-1526 
> 
> 
> -----Original Message-----
> From: Konop, Nicole [mailto:NKonop <@t> chw.org] 
> Sent: Tuesday, April 17, 2012 3:37 PM
> To: 'histonet <@t> lists.utsouthwestern.edu'
> Subject: [Histonet] Unregistered HT testing
> 
> Hello everyone!
> 
> I'm just curious to know if anyone is allowing unregistered HT's to do
> special stains in their CAP accredited lab? I have been involved in
> discussions regarding high complexity testing. From the feedback I
have
> received, special stains and IHC stains are considered high complexity
> testing. I beg to disagree. I can understand IHC/ISH as high
> complexity but I don't think routine special stains fall under that
> category. I'd appreciate any feedback or literature you can reference
> for me to review. Thank you!
> 
> Nicole Anne Konop BS, HTL(ASCP)
> Histology Team Lead
> Children's Hospital of Wisconsin
> (414)266-6580 Direct Line
> (414)907-0366 Pager
> (414)266-2524 Histology Department
> 
> 
> 
> 
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