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<div class=Section1>
<p class=MsoNormal><span class=SpellE><font size=2 color=navy face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial;color:navy'>Shiela</span></font></span><font
size=2 color=navy><span style='font-size:10.0pt;mso-bidi-font-family:Arial;
color:navy'>, <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'>That's what QA programs are
for.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'>The problem is that even if you
can document one or more mistakes you can't really say for sure if it is
because of sequential grossing of like specimens unless you have data showing
that. It could just be coincidental. You would have to show that such mistakes
happen predominately when like specimens are grossed sequentially. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'>If you have a QA program you can
make this potential problem part of that as a QA monitor in order to document
the problem. <span class=SpellE>Followup</span> on all <span class=SpellE>mis</span>-identification
mistakes (and be sure to document those that are caught in the lab - not just
those that reach a pathologist) and determine their place in the grossing order
(is that possible with your methods?). Then follow trends of mistakes and try
to assign the trend to specific practices. That is the only way to show the
magnitude of any problem. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<div>
<p class=MsoAutoSig><font size=3 color=navy face="Courier New"><span
style='font-size:12.0pt;font-family:"Courier New";color:navy;mso-no-proof:yes'>Tim
Morken<o:p></o:p></span></font></p>
<p class=MsoAutoSig><font size=3 color=navy face="Courier New"><span
style='font-size:12.0pt;font-family:"Courier New";color:navy;mso-no-proof:yes'>Lab
Vision / NeoMarkers<o:p></o:p></span></font></p>
<p class=MsoAutoSig><font size=3 color=navy face="Courier New"><span
style='font-size:12.0pt;font-family:"Courier New";color:navy;mso-no-proof:yes'>www.labvision.com<o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;mso-bidi-font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'>-----Original Message-----<br>
<b><span style='font-weight:bold'>From:</span></b> Tague, Curtis
[mailto:CTague@ahs.llumc.edu] <br>
<b><span style='font-weight:bold'>Sent:</span></b> </span></font><st1:date
Month="11" Day="19" Year="2003"><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'>Wednesday, November 19, 2003</span></font></st1:date><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> </span></font><st1:time
Hour="11" Minute="40"><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>11:40 AM</span></font></st1:time><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'><br>
<b><span style='font-weight:bold'>To:</span></b> Tapper, Sheila<br>
<b><span style='font-weight:bold'>Cc:</span></b> Histonet (E-mail)<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Histonet] embedding
like specimens sequentially</span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=3 face=Arial><span
style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal style='margin-left:.5in'><font size=2 color=blue face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial;color:blue'>I'd have your
pathologist put the hammer down. He or she would no doubt be happy to see
you're desire to improve quality control and reduce the chance any mix up that
could lead to legal problems. Explain to them the risks and I'm sure they'll
back you. </span></font><font face="Times New Roman"><span style='font-family:
"Times New Roman"'><o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal style='margin-left:.5in'><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-family:"Times New Roman"'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal style='margin-left:.5in'><font size=2 color=blue face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial;color:blue'>curt</span></font><font
face="Times New Roman"><span style='font-family:"Times New Roman"'><o:p></o:p></span></font></p>
</div>
<blockquote style='margin-top:5.0pt;margin-right:0in;margin-bottom:5.0pt'>
<p class=MsoNormal style='mso-margin-top-alt:0in;margin-right:0in;margin-bottom:
12.0pt;margin-left:.5in'><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>-----Original Message-----<br>
<b><span style='font-weight:bold'>From:</span></b>
histonet-admin@lists.utsouthwestern.edu
[mailto:histonet-admin@lists.utsouthwestern.edu]<b><span style='font-weight:
bold'>On Behalf Of </span></b>Tapper, Sheila<br>
<b><span style='font-weight:bold'>Sent:</span></b> </span></font><st1:date
Month="11" Day="19" Year="2003"><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'>Wednesday, November 19, 2003</span></font></st1:date><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> </span></font><st1:time
Hour="10" Minute="21"><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>10:21</span></font></st1:time><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'><br>
<b><span style='font-weight:bold'>To:</span></b>
histonet@lists.utsouthwestern.edu<br>
<b><span style='font-weight:bold'>Subject:</span></b> [Histonet] embedding like
specimens sequentially</span></font><font face="Times New Roman"><span
style='font-family:"Times New Roman"'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial'>Can anyone give me a
literature reference that delineates the reasons and process for embedding
non-like specimens sequentially?<span style='mso-spacerun:yes'> </span>We
are trying to address our PA's ordering cervical biopsies followed by
endocervical curettage biopsies, and breast masses followed by breast core
biopsies, etc..<span style='mso-spacerun:yes'> </span>The only thing that
seems to drive change is documented literature, not histotechs telling them
that this is poor practice, and potential a legal problem.<span
style='mso-spacerun:yes'> </span>I don't need case studies - <i
style='mso-bidi-font-style:normal'><u><span style='font-style:italic;
mso-bidi-font-style:normal'>WE </span></u></i>all know them - I need hard
and fast rules.<span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial'>Thank you in advance!<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial;mso-no-proof:yes'>Sheila
Tapper HT(ASCP)<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial;mso-no-proof:yes'>St.
Luke's Hospital<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 face=Arial><span
style='font-size:10.0pt;mso-bidi-font-family:Arial;mso-no-proof:yes'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=3 face=Arial><span
style='font-size:12.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></font></p>
</blockquote>
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