Complete case = gross description corrected, slides correctly labeled, slides matched to report, prioritized/organized, essential clinical history checked, and slides pulled from patient’s prior pathology.
Preview the slides and make your presumptive diagnosis in writing.
Review cases with the attending pathologist.
Document any changes in the report and clinical information from clinician.
Follow up on incomplete or pending cases:
Resubmit tissue, submit tissue from decalcification solution, order special stains/levels/unstained slides, complete immunohistochemistry request forms, collect/organize pending slides, preview special stains, collate additional clinical information, show consults, review the pending cases with the attending pathologist.
Keep your turn-around time at or above the average.
Triage problematic cases to appropriate upstream personnel.
You are not obligated to solve problems created by others, but you should assist the person responsible in taking appropriate action.
Sequence of Actions
Preview day:
Collate, proofread, and correct your dictations. Pick up slides and correct requisition forms.
Check on necessary clinical history/lab results in the computer.
Contact MH histology lab by 2:00 pm if slides don’t show up.
Correlate cases received with those on your grossing list.
Double-check matched slides with corresponding reports.
Review the slides and compose your presumptive diagnosis in writing.
Fill out special order forms (levels, special stains, immunohistochemistry) and synoptic forms when necessary.
Organize cases by priority (urgent/stat/rush first, tonsils/tubes/hernia sacs last).
If necessary, order deeper levels to show complete sections and submit additional tissue.
Brief the staff of any problems. Schedule a sign-out time.
Sign-Out day:
Meet with staff at scheduled time (otherwise 9:15 am).
Review/sign-out cases with your attending.
Compose a list of cases to follow up.
Further work-up: recuts/levels, special stains/immuno’s, and re-sampling must be done on the same day. Additional history, consults, and references from the literature should be obtained as soon as reasonably possible.
Case follow-up: inform clinician about certain findings as instructed by attending, collect recuts/levels and special stains/immuno’s, review with attending pathologist.
Document in writing any changes in the report: additional blocks from resampling, gross description, clinical information including the source (e.g. Dr. John Smith).