[Histonet] Two Patient Identifiers on slides

Wed Jul 31 13:35:37 CDT 2013

Due to legal issues, if we have a cassette mislabeled we request a cassette with the correct patient information immediately and re-embed the block.  Biopsies are a concern as it is sometimes difficult to re-embed a small tissue, so we do our best.  We have had times when we cross out the barcode as we could not reliably re-embed and carefully make notes for any future legal problems (no matter how unlikely the case may be) to establish the identity clearly.  If the slides were cut and we cannot go back to the block due to tissue size or disease state we use the same procedure as cassettes and a paper label.  The real issue is training everyone to double check the name and case number with the paperwork as the cassettes and slides are printed and have no mistakes.  We are human and has been proven difficult at times.  

Pam Marcum

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Pratt, Caroline
Sent: Wednesday, July 31, 2013 1:14 PM
To: Joe W. Walker, Jr.; Michelle Moore; Jean Wood; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Two Patient Identifiers on slides

My understanding was the same as Joe's and at least to date, that is what we have presented during survey and it has been deemed acceptable.  However, we are accredited by TJC not CAP.  My question to those of you who are providing 2 patient identifiers on blocks?  How do you make it fit?  If anyone could scan an image to Caroline.Pratt <@t> uphs.upenn.edu I would greatly appreciate it!  As of now, we have the unique patient accession number and a barcode with the accession number as well.  We are in our survey window I would like to be sure we are compliant.  

One more question, if you label slides and blocks with a name and DOB from the requisition and find out during insurance validation that the name is misspelled or the DOB is inaccurate, how do you handle that?  Thanks for your help.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Joe W. Walker, Jr.
Sent: Tuesday, July 30, 2013 4:31 PM
To: Michelle Moore; Jean Wood; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Two Patient Identifiers on slides

I don't think this is technically correct according to the CAP.  The question in the most recent checklist states:

**REVISED** 07/11/2011

ANP.52000 Specimen ID                           Phase II
The identity of every specimen and image, including blocks, slides, and electron micrographs, is maintained through each step in processing.

NOTE: Each block of tissue must be individually labeled with unique patient identifier(s), e.g.
accession number etched onto the block or embedded into it. Storage of unlabeled blocks in separate containers that are labeled with patient number or name does not meet this requirement.
Evidence of Compliance:

✓ Written procedure describing system for maintaining specimen identity

This question does not state that 2 identifiers must be on the slides and blocks, etc.  It states it must be a unique identifier throughout the process.  A specimen accession number would technically suffice.  You can add additional identifiers if that helps in your process but they are not required.

I believe that this is often confused with the General lab question GEN.40491 which requires that any specimen that is collected and submitted to the lab must have 2 unique identifiers on it.  Once the specimen is in the lab, the unique accession number would suffice.

Now, if you are utilizing the 2 identifiers to help prevent mislabeling, then I think it is a good idea as an extra precaution step.  We are fortunate to have a xylene resistant label and printer that allows us to label the slides prior to processing.

My two cents as a manager,

Joe W. Walker, Jr. MS, SCT(ASCP)CM
Anatomical Pathology Manager
Rutland Regional Medical Center
160 Allen Street, Rutland, VT 05701
P: 802.747.1790  F: 802.747.6525
Email joewalker <@t> rrmc.org    www.rrmc.org

Our Vision:
To be the Best Community Healthcare System in New England

Rutland Regional…Vermont’s 1st Hospital to Achieve Both ANCC Magnet Recognition® and the Governor’s Award for Performance Excellence

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Michelle Moore
Sent: Tuesday, July 30, 2013 3:46 PM
To: Jean Wood; histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Two Patient Identifiers on slides

We are writing path #, date of birth & patient initials as identifiers. Michelle

________________________________
From: Jean Wood <jwood <@t> fairchildmed.org>
To: "histonet <@t> lists.utsouthwestern.edu" <histonet <@t> lists.utsouthwestern.edu>
Sent: Tuesday, July 30, 2013 2:37 PM
Subject: [Histonet] Two Patient Identifiers on slides

Hello Histonetters,

      Recently we started utilizing a slide labeling component that is built into our AP Easy LIS system and has accession number, levels and patients first and last name when labels are printed out. Dymo does not have a chemically resistant label (we have a Dymo 450 printer) and we have been putting the labels on AFTER the slides are stained and cover slipped.

In the meantime, the HT is writing in pencil the accession # and levels on the slide which is then covered up with the permanent label after cover slipping. Our Lab Manager is worried that we are not compliant as we do not have two patient identifiers on throughout the whole process (she wants us to write patient names on slides in pencil (before staining) and then cover that up with the pre-printed label after staining.

1. What is everyone else doing?
2. Have any of you found a chemically resistant label compatible with the Dymo labeler?

Jean Wood BS, HT
Fairchild Medical Center Pathology Dept.
Ph:530.841.6243 Fax:530.841.6232
jwood <@t> fairchildmed.org<mailto:jwood <@t> fairchildmed.org>
_______________________________________________
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
This message (and any included attachments) is from Rutland Regional Health Services and is intended only for the addressee(s). The information contained herein may include privileged or otherwise confidential information. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or have reason to believe you are not authorized to receive it, please promptly delete this message and notify the sender by e-mail.

Thank You

The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message.

----------------------------------------------------------------------
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.