[Histonet] RE: Process Improvements

[joelle weaver]

Getting into this thread a little late...but I like the ideas so far and agree that error rates such as mislabels are a good variable to monitor ( blocks, slides etc). Other quality issues too such as rework due to poor embedding, improper orientation, tissue "floaters", sectioning repeats as recuts due to poor sectioning, incomplete secctions or general ( microtomy). But if they wanted you to use the 6S model you have to get the VOC data ( Rene touched on this). Your QA data is one source for this reported feedback errors/ problems,  and a good place to look first( someone mentioned this). But I would add to do RCA to determine common cause error sources. I would also consider a process phase analysis to track at least one monitor through the whole testing cycle, preanalytic, analytic and postanalytic. This is the model that is used for clinical, and also something that is ISO -centric and the CAP likes to see the specimen travel. Then build the target and process "in control" specifications, and corrective action documentations, and you are pretty set up. 




Joelle Weaver MAOM, HTL (ASCP) QIHC
 > Date: Fri, 5 Oct 2012 08:17:17 -0700
> From: rjbuesa <@t> yahoo.com
> To: trathborne <@t> somerset-healthcare.com; Fawn.Bomar <@t> HalifaxRegional.com; histonet <@t> lists.utsouthwestern.edu
> Subject: Re: [Histonet] RE: Process Improvements
> CC: 
> 
> Fawn:
> First of all, before you start wondering, ask your pathologists what they want to know. It is not enough for them to ask for indicators "like other areas in the lab" because the histology lab is an "unique area of the medical laboratory".
> If they do not know what they want, then you can prepare some indicators that will allow you to measure productivity and quality.
> For instance:
> 1- total time it takes from the moment the lab receives an specimen to the moment you send the finished slides to the pathologists. That would be a partial Turn Around Time (TAT) and will measure the histology "gross productivity".
> 2- if you want to involve the pathologists and the office, then you can extend that partial TAT to the moment the reports (hard copy) are sent to the referring physician.
> 3- you could also keep a record when the first batch of slides (usually the "rushes") are ready for the pathologists to read, and when the last bath of the day reach the pathologists. Keeping a record of both times you can improve the "slides production" productivity
> 4- you can keep a record of how many quality complaints you receive from the pathologists and which histotechs they correspond to. By doing so you can develop a retraining program.
> In the same way you can start keeping track of your work, but please always remember that you can never will be able to have a faster TAT than, for example, the chemical lab. It is in "the nature of the beast".
> The only procedure in histology than can compare with some chemical procedures is the the Frozen Section that has been defined by CAP as "being ready within 20 minutes after the specimen is received". You can also keep track of those times and find out how you rate
> There are many tasks you can use, but first ask your pathologists, and your manager, for those they would like to know.
> René J.
> 
> 
> ________________________________
> From: "Rathborne, Toni" <trathborne <@t> somerset-healthcare.com>
> To: Fawn Bomar <Fawn.Bomar <@t> HalifaxRegional.com>; "histonet <@t> lists.utsouthwestern.edu" <histonet <@t> lists.utsouthwestern.edu> 
> Sent: Friday, October 5, 2012 10:48 AM
> Subject: [Histonet] RE: Process Improvements
> 
> How about mislabeled specimens (blocks or slides), number of repeated stains (specials or ihc), floaters, TAT, or correlations? Just look at the CAP checklist for ideas, you will be surprised at how many ideas you can get from that!
> 
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Fawn Bomar
> Sent: Friday, October 05, 2012 10:40 AM
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] Process Improvements
> 
> Hi everyone,
> 
> 
> 
> My new manager would like me to come up with a list of process/performance improvements in the pathology department that can be measured on a monthly/quarterly basis, such as they do for other departments in the hospital, i.e. the ER measures the number of patient falls with <5 per quarter being their goal.  I need advice on what to measure for our histology/pathology/cytology departments.  Does anyone have any suggestions?
> 
> 
> 
> Thank you
> 
> Fawn
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