[Histonet] Re: Basis for Quality Work in a Histotech

Thu Dec 20 13:20:31 CST 2012

We have a QC sheet but it is only used when the pathologist/resident sees something out of whack. We don't QC every single slide or even case.  Remember also that someone has to review all those forms or it's a waste of time so the fewer the better! 

The result is we have about one QC sheet every other day (1500 hundred slides/day between H&E, IHC and SS). Fully half are submitted by one pathologist. That pathologist is also the ONLY one who submits them for good as well as poor slides (though in about a 10:1 ration bad:good). 

I keep track of them on a spreadsheet and do a review with the tech involved (f there is one). It is pretty random as to which techs have "errors,"  and all have at least one during a year's time, but we have picked up a few sectioning and stain problem trends over the years. It seems to work ok and it does not seem to be a burden. 

I also talk regularly with individual pathologists and just randomly ask them if they have seen any problems they want me to work on.  I pick up a few issues that way.

Of course if it is something they feel is really a problem I get the phone call...

Tim Morken
Department of Pathology
UC San Francisco Medical Center

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Lynette Pavelich
Sent: Thursday, December 20, 2012 11:06 AM
To: Bob Richmond; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Re: Basis for Quality Work in a Histotech

Dr. Richmond,
It's always refreshing to hear what the "other shoe" has to say! I'm sure seeing those required quality control sheets coming in everyday is tiring, and then especially frustrating when small to none results are seen in a timely manner. I can empathize with you as change/improvement can sometimes take a long time!! 

I also realize.......after being in the field 40+ years (ouch!), that verbal communication seems to work faster than all those required sheets of paper you have to fill out. Like the pathologist who comes through the door saying; "HEY.......what happened with this slide??" (LOL) will get a much faster response/correction than those papers I receive back everyday to collate! It's just more personal, and shows the techs more of the pathologist's side of the hardships of diagnosing after receiving less than lovely slides.

Equally refreshing, is a pathologist who remembers to thank the tech who does a great job! And I thank you for that! A genuine complement is really appreciated!

Lynette

Lynette Pavelich, HT(ASCP)
Histology Supervisor
Hurley Medical Center
One Hurley Plaza
Flint, MI 48503

ph: 810.262.9948
mobile: 810.444.7966

________________________________________
From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet-bounces <@t> lists.utsouthwestern.edu] on behalf of Bob Richmond [rsrichmond <@t> gmail.com]
Sent: Thursday, December 20, 2012 1:42 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Re: Basis for Quality Work in a Histotech

From: Kim Donadio <one_angel_secret <@t> yahoo.com>
Subject: Re: [Histonet] Basis for Quality Work in a Histotech
To: "O'Donnell, Bill" <billodonnell <@t> catholichealth.net>,        Maria Mejia
        <mbmphoto <@t> gmail.com>,   "Morken, Timothy"
        <Timothy.Morken <@t> ucsfmedctr.org>
Cc: "histonet <@t> lists.utsouthwestern.edu"
        <histonet <@t> lists.utsouthwestern.edu>
Message-ID:
        <1355948250.57406.YahooMailNeo <@t> web112302.mail.gq1.yahoo.com>
Content-Type: text/plain; charset=utf-8

Kim Donadio (where?) comments:
>>I'd like to add my two cents to the measuring "Quality" topic. I'll 
>>make it short. - You should have a "Quality Management" program. It's 
>>vital to track errors, types of errors, frequency and who etc. This is 
>>NOT a tool for blame as we are all adults or we should be. It is 
>>however a tool for tracking trends, making improvements and yes if you 
>>did see someone making a mistake often, you would have the data to 
>>educate particular personnel. - There are QM tools out there from 
>>various organizations. And yes, there are standards of deviations such 
>>as the TAT for frozens. There are standards for other things as well. 
>>Set Standards of excellence with your Pathologist. Make goals. Track 
>>them. Follow improvement.<<

I'm going to add a sour and cynical rejoinder. As most of you know, I'm an elderly pathologist who's spent the last 30 years as a locum tenens, working maybe 60 pathology services in my "career". Sometimes in a pathology practice I'll be asked to fill out daily "quality whatever" (the patter changes with the years) reports about the slides. I always dread having to do this, because I know that the more of this paperwork I have to do, the worse the slides will be. The worst was one that required several square inches of scribbling a day.
They couldn't mount a coverslip correctly.

Any meaningful system would require daily feedback from pathologist (or other end user) to histotechnologist. I've never encountered a pathology service that accomplished this.

Dang - now I'm remembering that this morning duodenal biopsy sections were the best I'd ever seen here, and I forgot to tell the histotech before she slipped out the door!

Bob Richmond
Samurai Pathologist
Maryville TN

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet
_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet