The “Specimen Processing, Anatomic Pathology” protocol provides instructions for handling of specimens received at Pathology Associates (PA)/United Clinical Laboratories (UCL).
1. Specimen Receiving:
A. Surgical specimens are recorded in the Hospital Surgical Log Books located in the Finley and Mercy Pathology Gross Rooms by the hospital surgical (OR) staff. The OR staff will indicate the date and time the specimen was brought to the gross room, the patient name, specimen(s) and the name/initials of the person transporting the specimen(s) in the log book.
MMC: Disposition of Surgical Specimens ORPP 512
B. Specimens received from outside clients via UCL courier will not be logged into a surgical log.
a. TriState Surgery staff provides a specimen log that is delivered with the specimens collected at the surgery center.
b. Midwest Medical Center-Galena staff provides a specimen log that is delivered with the specimens collected at their facility.
2. Specimen Verification:
The AP personnel verifies the patient identification listed on the requisition with the identification on the specimen container.
A. Verify the patient name, date of birth, specimen type and date of collection.
a. If the requisition does not match the specimen bottle, reject the specimen.
b. If time permits, contact the office to verify the information, make sure to indicate who in the office was contacted.
B. Verify the specimen is in the labeled container and in the appropriate preservative, generally 10% neutral buffered formalin.
3. Specimen Accessioning:
A. Accession the case into CoPath under the appropriate patient identifier (medical record number or history number). If an identifying number is not sent with the specimen, check CLICS to see if the patient has an “X” number created.
a. If there is an “X” number currently on file for the patient, use this for the patient identification number.
b. If there is no “X” number on file, then create one and indicate this “X” number on the requisition received for the patient. Refer to the CLICS procedure “Patient Registration, Manual Entry”, using the Generate Patient ID function.
c. Two patient identifiers are required to create a case; patient name with medical record number, social security number or date of birth.
B. Accession the case into CoPath:
a. Enter all information into the mandatory fields assigning the grossing Pathology Assistant or Pathologist upon primary accession entry.
b. Indicate the CoPath case number on the requisition and bottle and label in order (i.e., A, B, C).
c. Label the cassette(s) with the CoPath case number and place with the specimen and requisition for grossing station.
d. “Gross only” cases not requiring microscopic exam will not require cassettes.
e. Fresh specimen handling for intra-operative interpretations:
These cases will be examined directly by a pathologist.
1. Enter the part type for the specimen and the description that is located on the requisition for the case. The pathologist (on the bench) is called for all fresh specimens received for intra-operative exam including frozen section diagnosis. Fresh specimens and frozen sections are accompanied by the green pathology sheet with appropriate specimen information: pre-op diagnosis, requesting physician, OR#, patient medical record number, patient name and patient date of birth.
2. The intra-operative interpretation results are written by the pathologist on the green pathology sheet. A photocopy of this form is scanned into CoPath image gallery for the case and the original intra-operative diagnosis is placed in the routing envelope to be delivered to the appropriate nursing unit by Mercy courier.
4. Place the specimen, a copy of the requisition and cassettes for the case on the grossing station for sectioning.
5. Secondary Accessioning:
A. The requisitions are placed in the tray to be taken to secondary accession entry.
B. The secondary accessioner then verifies the patient identity listed in CoPath with the patient identification listed on the requisition, as well as the specimen description and all other information entered for the case.
C. The secondary accessioner looks up the case by medical record number in order to catch duplicates.
D. The secondary accessioner also enters the clinical history, pre-op, post-op, insurance and billing information, encounter fields for patient any-type and order identification number.
6. After the gross evaluation of the specimens has been performed, the cassettes are transported to Cathedral Square for overnight processing at the end of the day.
7. Wet tissue specimens (residual) are stored on site for at least 2 weeks. Refer to separate procedures for stored specimen; i.e. POC, Breast Implants, Autopsy specimens.
8. Blocks are cut in Histology and stained slides are returned to the pathologist by the UCL courier the following working day.
9. A pathologist reviews the slides and enters the diagnosis in CoPath and electronically signs the case out.
10. Reports are batch printed at scheduled times and distributed twice daily from Mercy and Finley Pathology Depts. In addition to the paper reports:
A. Results from Mercy cases cross electronically to Cerner PowerChart upon sign-out.
B. Results ordered by Medical Associates physicians cross to EMAC.
C. Results of all cases are available for look-up in CLICS Web Inquiry.
i. October 2009 C. Leigh
ii. June 2010 K. Kalish (Revised: II.3.B.d.2., II.6., 10.)
Interim review: June 2011 A. Kass (Revised: II.2.A., 4., 5.B.)