[Histonet] weekends in the small lab

[Terri Braud]

Garrey brings up an excellent point, cautioning carefulness when dealing with breast fixation times over the weekend. When we receive breast biopsies on Thursday, that do not have enough fixation time to load Thursday evening, we run them Friday morning as soon as a processor becomes available.  For breast cases received on Friday, they are processed as a routine specimen, coming off on Monday.  For the rare occasion that we have a Friday breast received before a 3 day weekend, we will ask for a volunteer to come in and remove it from a routine schedule before the 72 hour fixation time is exceeded. We just let the blocks sit at room temp in paraffin until embedded.  We have been operating this way for years with no problem.
Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


-----Original Message-----
From: Garrey Faller [mailto:garreyf at gmail.com] 
Sent: Friday, December 06, 2019 7:02 PM
To: Terri Braud
Cc: histonet at lists.utsouthwestern.edu
Subject: Re: [Histonet] weekends in the small lab

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Agree. As a pathologist, I’ve benefited from weekend coverage at a much smaller Hospital  lab. Now am at a much busier lab and we don’t have weekend coverage . Would I like it? Yes. But we function fine without it. One thing to always consider is cap/Asco time fixation guidelines for breast biopsies. Having a weekend run gives you more flexibility.
G

Sent from my iPhone

> On Dec 5, 2019, at 1:40 PM, Terri Braud via Histonet <histonet at lists.utsouthwestern.edu> wrote:
> 
> In my experience in 2 small hospital labs, weekend coverage is just not worth it.  If it is a major surgery, then the patient will be recuperating and if it is just a biopsy, the ordering physician is rarely available to correlate the Pathology findings with the clinical findings.  Most tell the patient that they will get their results in a week or two.
> The only exception that I have encountered was if you process non-gyn cytology.  On rare occasions, we found the need to process a fluid in order to look for organisms or to send for flow, though we seldom did more than one per year.  For those occasions, we usually just had someone volunteer to come in to process it in order to save our weekends free.
> Generally, at both hospital labs, we were closed when surgery was closed, even on 3 day weekends and we've never had trouble or complaints. The weekend cases you describe are not a rush.
> 
> Terri L. Braud, HT(ASCP)
> Anatomic Pathology Supervisor
> Laboratory
> Holy Redeemer Hospital
> 1648 Huntingdon Pike
> Meadowbrook, PA 19046
> ph: 215-938-3689
> fax: 215-938-3874
> Care, Comfort, and Heal
> 
> 
> Today's Topics:
>   1. Weekend Coverage for Small Pathology Labs (Lindrud, Scott)
> Message: 1
> Date: Thu, 5 Dec 2019 15:19:39 +0000
> From: "Lindrud, Scott" <Scott.Lindrud at carrishealth.com>
> Subject: [Histonet] Weekend Coverage for Small Pathology Labs
> 
> Hi Histonet,
> I apologize if this is being re-posted but I did not see this message on the daily Histonet Digest so I'm not sure if it ever got posted.....
> I was wondering if anyone would be willing to share their experience with weekend Histology coverage for smaller Pathology labs?  When I say small, I'm saying about 30,000-33,000 blocks per year (avg 130-140/day) with automated IHC and special staining.  Our lab is in a rural area where all but one of the histotechs live between 25-50 miles away.  Winter weather has played a role in numerous instances of trying to get a histotech to the lab on a bad weather Saturday.
> 
> Our lab currently has a histotech come in on Saturday morning to set up a gross for about 16-20 cases which will be put on processing run to come off on Monday morning.  The majority of the cases are from colonoscopies, colposcopies, skin excisions, gallbladder/appendix, and placentas.
> 
> I'm asking this to see if there is a necessity for the Saturday coverage for a lab our size.  If the industry standard is that most labs of smaller size have some sort of Saturday histology coverage, then we're good to go.  But if most smaller labs aren't providing some sort of weekend coverage, then I feel more confident talking to management for our histotechs about the necessity of providing the Saturday coverage.   I just don't know what other smaller labs are doing.
> 
> Thanks for any opinions or information!
> 
> Scott A. Lindrud, MLSCM(ASCP)CTCM | Histopathology Technical Specialist
> Phone: 320-231-4406
> Fax: 320-231-4305
> scott.lindrud at carrishealth.com<mailto:scott.lindrud at carrishealth.com>
> 
> 
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