Subject: [Histonet] Recuts/deepers

[Terri Braud]

We, too, had an excess of recuts and deepers.   After careful study, it
was found the majority were due to a preference for certain
pathologists, but many were due to poor grossing / poor processing, and
a few were due to tech error with tech error being the least number of
the categories  
We tackled the reduction one group at a time.
Previously, we cut GI's at 2 levels, but a slight majority of the
pathologists preferred more.  To keep the number of slides low, but give
the extra levels desired, we now cut 3 levels of all small biopsies,
mounted on one slide.
For LEEPs, we upped the number of original levels, too. 
The pathologists also agreed to cut and fix any large specimen
overnight, since there was no negative impact on patient care.  Now, our
larger specimens gross more easily, and consequently embed and cut
better.
To correct the grossing problem, the techs and PA had a an inservice
during embedding so that the PA could see the effects of the grossing
issues we were dealing with.
Out techs and PA came up with a new inking system that not only
identified skin margins as needed, but also indicated "tips up with a
red dot" for the techs, eliminating all incorrectly embedded skins. The
techs were also able to demonstrate to the PA, the importance of
thickness consistency for serial sections embedded together.
Our effort was a group effort for the pathologists, the PA, and the
technical staff all cooperating and our recut/deepers orders were
reduced by over 70%, much greater than our original target.
This was 6 months ago, and our numbers are still holding.
Best of Luck

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Holy Redeemer Hospital Laboratory
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3676
Fax: 215-938-3874

***********************
---------------------------------------------------------------------------------



CONFIDENTIALITY NOTICE:

This E-Mail is intended only for the use of the individual or entity to which
it was sent. It may contain information that is privileged and/or confidential,
and the use or disclosure of such information may also be restricted under applicable
federal and state law. If you received this communication in error, please do not
distribute any part of it or retain any copies, and delete the original E-Mail.
Please notify the sender of any error by E-Mail.

Thank you for your cooperation.