Histology workflow consultant

[Deucedano]

Anyone have any recommendations on a good one? Seems like there are alot out there for clinical lab, but not specifically AP/histology workflow and efficency.

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[Napoleon1801]

Anyone have any recommendations on a good one? Seems like there are alot out there for clinical lab, but not specifically AP/histology workflow and efficency.

Maybe find a Lean/Six Sigma black belt expert? There are a number of absolute bozos out there who masquerade as consultants.

 

[WEBB PINKERTON]

All the consultants I have seen are fine for the clinical lab but they have no understanding of AP. I can't even remember the name of the one we used one time. It was joke.

 

[caffeinegirl]

The best way to improve AP workflows is to implement bar code scanning and a good LIS. And have your grossing techs/PAs use voice dictation and macros.

 

[LADoc00]

Do NOT waste a ton of money on this. I did histo in grad school so I never thought I needed this. How big of a lab??

 

[Deucedano]

30K surgicals with a vast majority complex hospital based surgicals. 600-800 blocks per day (based on 5 days). I really just want someone to come in and tell the histotechs they need to come in earlier so we pathologists can have more than 1-2 cases when we come in at 8-9am. When we are at other sites we often get 3/4 of our work after 3pm which I think is unacceptable. My expectations my be too high in this post covid no work environment though. When do you all typically get your AP work?

 

[caffeinegirl]

The majority of AP work should be ready by 9am - last new case out by 11ish at the most. Do you have a good histo lab manager? I don't think a consultant will help here - you need to start with your own management team.

 

[KeratinPearls]

30K surgicals with a vast majority complex hospital based surgicals. 600-800 blocks per day (based on 5 days). I really just want someone to come in and tell the histotechs they need to come in earlier so we pathologists can have more than 1-2 cases when we come in at 8-9am. When we are at other sites we often get 3/4 of our work after 3pm which I think is unacceptable. My expectations my be too high in this post covid no work environment though. When do you all typically get your AP work?

Damn 3/4 of your work after 3 pm? How late do you stay until? So you come into work later then?

That sounds like a sucky situation.

 

[Guest8]

The majority of AP work should be ready by 9am - last new case out by 11ish at the most. Do you have a good histo lab manager? I don't think a consultant will help here - you need to start with your own management team.

I wish! We've had so much turnover the last few years and we just can't hire people to work the true early morning shifts needed to make this happen. We're not even getting 30% of our slides by 9am (literally just got my first trays of the day. Most come out well after 12 and closer to 3. Sigh.

 

[cmz]

30K surgicals with a vast majority complex hospital based surgicals. 600-800 blocks per day (based on 5 days). I really just want someone to come in and tell the histotechs they need to come in earlier so we pathologists can have more than 1-2 cases when we come in at 8-9am. When we are at other sites we often get 3/4 of our work after 3pm which I think is unacceptable. My expectations my be too high in this post covid no work environment though. When do you all typically get your AP work?

1. How many histotechs does your lab have?
2. What time are they coming in to embed? How many are embedding? How many are cutting? How many blocks can each tech cut/embed per hour?
3. Are your blocks/slides barcoded to track efficiency?
4. Manual cover-slipping or automated?
5. How are recuts/deepers/steps handled?
6. Do you have a dedicated set of techs that work on special stains/IHCs, etc?

 

[Med Director New England]

30K surgicals with a vast majority complex hospital based surgicals. 600-800 blocks per day (based on 5 days). I really just want someone to come in and tell the histotechs they need to come in earlier so we pathologists can have more than 1-2 cases when we come in at 8-9am. When we are at other sites we often get 3/4 of our work after 3pm which I think is unacceptable. My expectations my be too high in this post covid no work environment though. When do you all typically get your AP work?

As long as your TAT expectation is appropriate late arriving cases can be tolerated. A case out after a certain time just becomes a tomorrow case unless it is a true rush (and these should be prioritized to be cut first anyways).

A lot of labs are experiencing similar problems; I am finding good HTs and AP support staff very hard to find the theses days. Also seeing a little bit of a shift in HT preference for work hours. 15-20 years ago 4 am - noon schedule was typical (and preferred by many HTs) for first shift hours, now lost don’t want to come in this early.

Sometimes in AP we go too crazy over TAT. Derms demanding next day sign out of outpatient biopsies is ridiculous, path labs rushing breast biopsies and receptors into a 72 hr window after it took radiology 2+ weeks to do a follow up spot mammogram and another week to get the biopsy done, etc…

 

[Guest8]

Derms demanding next day sign out of outpatient biopsies is ridiculous

Even more ridiculous is that this only applies if they send their biopsies to a third-party dermpath. If they hire their own in-office dermpath they're fine with someone that comes in 1-2x a week to read the cases, because then they're keeping 2/3 of the charges. Money trumps turnaround time very obviously.

 

[caffeinegirl]

Completely agree with what others have said. If staffing and shifts are an issue, then change your TAT expectations. Have a "priority" or "rush" category that has to be done first (inpatient biopsies, marrows, etc). Everything else can be done later, and signed out by the next day.

 

[WEBB PINKERTON]

Sounds like you know what you want to do. Instead of a consultant telling them, you do it.