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

[O'Donnell, Bill]

I agree that the verbal approach is swiftest. I remember one lab that I
worked in where we did daily QA sheets for overall quality. Specifics
might be noted, but since I didn't always get the sheets back the same
day - they weren't of much real help. Anyway, one day the pathologists
tells me he thinks I need to look at the hematoxylin as it was staining
"funny". Sure enough, it was. 

I inquired when he first noticed it and he said "oh, it's been several
days". I looked at the sheets and everything was marked satisfactory. I
got rid of the sheets, documented my own daily checks, and simply asked
the paths how they thought things looked each day. They reviewed and
signed off on the sheets at the end of the month, but I got first hand
feedback which actually meant something and problems got solved in a
more timely manner. I'm sure this experience is not unique, but since
that event I have always insisted that the pathologist come directly to
the lab when they have a problem with any aspect of the work. It's
amazing what a little communication will do.



-----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 1:06 PM
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

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