Subject: [Histonet] Recuts/deepers

[Donna Millard]

I have actually had some success in reducing recuts, and attribute to a couple of things.

1.       Are pathologists are now measured on a case TAT without any exceptions. (before they could exclude cases for additional work/stains-(including recuts), held for fixation, decal...). They are ordering fewer recuts.

2.       I do a monthly report on Recuts, and look at the number of recuts by part-type, sectioning tech and pathologist. I try to determine which recuts are due to tech error from the comment that populates with the order (i.e. the comment on the order says "need complete surface" vs "following atypical focus". I figure if it's levels over 2, the tech was not going to get it in one slide to begin with). Note there is a level of subjectivity here, and I probably err on the side of blaming the tech-but I do the best I can, and it does give information back. The techs get fed back this information and can see what the % of blocks they cut that require recuts, and what type of tissue. If a pathologist is consistently ordering an unusually high number of recuts (particularly compared to other pathologists doing similar work), that gets fed back to Chief Medical officer and Medical Director. We had a case where one pathologist was ordering 12% versus everyone else ordering about 3-4% or less and was responsible for 30-40% of all recuts-that has been dramatically reduced).
And yes, I do think a fair number of recuts may actually be due to embedding error-we are trying to put processes in place to capture this, and get techs to re-embed and note this to be fed back as well.

Donna Millard
Director of Anatomic Pathology
Physicians Reference Laboratory, LLC
7800 W. 110th Street,Overland Park, KS  66210
Direct: 913-339-0485
Fax: 913-319-4156

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