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Visuals to the fore in new histology labeling guideline

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Anne Paxton

June 2015—Like laboratorians, filmmakers split their workflow into three phases. In film, they are pre-production, production, and post-production. When flubs occur on a movie set, “We’ll fix it in post,” often said sardonically, is the fallback game plan to keep things on schedule and use visual and sound effects to cover up mistakes.

But you’ll never hear “We’ll fix it in post” in a laboratory, where errors have to be stemmed in the preanalytical phase, if not before. The mantra has to be “We’ll fix it in ‘pre.’” And that’s exactly the purpose of the new guideline that the College’s Pathology and Laboratory Quality Center and the National Society for Histotechnology have developed for accurate and consistent labeling of blocks and slides in surgical pathology (Brown R, et al. Arch Pathol Lab Med. Epub ahead of print April 21, 2015. doi:10.5858/arpa.2014-0340-SA).

Dr. Brown

Dr. Brown

In a quest to increase accuracy of patient identification and make labeling more standardized, the CAP and the NSH jointly convened an expert panel to produce the guideline. The panel’s main conclusion: Two human-readable, visual checks are needed. Titled “Uniform Labeling of Blocks and Slides in Surgical Pathology,” the guideline has as its major recommendation that histology laboratories use two unambiguous patient identifiers, one of which includes the accession number and case type, on tissue samples and the products made in the histology lab, including all tissue blocks and microscopic slides.

For decades, the accession number has typically been the only identifier on all histology materials, says Richard W. Brown, MD, CAP co-chair of the panel. With this guideline, “We’re basically saying to use the lab-assigned accession number and then a second data point—the patient’s name or a medical record number or something else.” Added expert consensus opinions in the guideline address the order and format in which identifying elements should appear.
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Key components of CAP/NSH labeling guideline for blocks and slides

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