Date sent:      	Thu, 09 Aug 2001 09:06:56 +0100
From:           	"Coaker, Terry" <Terry.Coaker@nuth.northy.nhs.uk>
Subject:        	Quality-right first time?
To:             	"'Histonet'" <histonet@pathology.swmed.edu>

> What is the most reliable, economical way of ensuring section quality
> with no transcription errors or recuts?
> Is it necessary to check every slide microscopically before issue?  

I would say yes to the latter question. In an ideal world we would 
produce the perfect section first time, every time, but this is not 
always possible or obvious until viewed microscopically. I actively 
encourage my staff to use the microscope to assess their work, 
this gives them a better knowledge of Histology and Pathology (and 
makes my life easier).Ultimately I look at all the slides as I have to 
report or discuss most of them, but have found that the number of 
recuts/rejects have become less and less.
As for economy, what is the cost of checking slides 
microscopically. This should be considered an invaluable teaching 
aid.
Transcription errors/section quality, do you mean putting the wrong 
name/number on the slide? 

> staff are trained to pick up only the best sections at the water bath
> and you control your staining, can you be confident in the quality and
> remove microscopic checking? 
No, this may not pick up any of those artefacts associated with 
fixation, processing etc which need to be identified rapidly or 
indeed staining problems.
 
Remember the pathologists provide the
> final check. 
Yes, but I am sure their time is better suited to reporting rather 
than requesting recuts. Better you sort these things out before the 
work gets to the Pathologist.

> Are there other ways e.g checking all slides off against the paraffin
> block
Is this not standard procedure in quality control? 

> or using a stereo microscope to check quality at the water bath.

This will give some indication of section quality/level etc. but this 
would not really be adequate in the final analysis.
As with much in Histology, results can be very subjective as could 
ones perception of quality, although there is not much room for 
compromise here.
Terry.
Terry Hacker,
Head of Histopathology and Electron Microscopy
Medical Research Council,
Harwell,
Didcot,
Oxfordshir