Cel Rutledge wrote:
>
Besides refusing to accept the specimen and sending it back (which
several other people have suggested) and/or doing training so that
the couriers (?sp) understand the danger to themselves of
formaldehyde exposure, there are a couple of other things we have
tried. It has also helped with mismatched specimens and paperwork
being written wrong.

1. Have the person delivering the specimen sign in their name and
time. We have a clip board by the drop off point, and they have to
sign in. This is especially helpful when a lone container comes
down when no one was at the desk (everyone running around taking
care of 6 zillion other things). So it isn't as big as a suprise, as
in "When did this come down?"

It also helps because we can call up and report any problems, and
state specifically that so-and-so dumped the jars and they spilled.
We also kept a QC log, listing the problems, and sent this back to
the supervisor (?monthly at first, now I think quarterly). Seeing
an official QC log seems to help also.

2. We did not return the specimen if there was a problem (leaking,
paperwork, etc.) We also were concerned about it becoming lost,
or no one fixing it so it would be returned in the next load
without being fixed. Plus, if it leaked on the way down to our
area, it was going to leak on the way back, exposing more
people and areas.

So we would call the OR, or the courier service, or the outpatient
clinic, whatever, and someone had to come down (pathology is in
the basement, of course) and fix the problem. This was also
recorded on the QC sheet - who fixed it and the time.

Trust me, when they  have to walk all the way back to our
area to fix something, they quit making mistakes as often.
And if it was the OR head nurse who had to do it (like paperwork
mixups), this was soon in THEIR reports and training sessions.

It was also recorded on the QC what time they fixed it and who
fixed it. So if the clinician called, they could be told why there
was a delay, and how long it took for someone to come down to fix it.
This also helped motivate people to not make so many mistakes, and to
fix it fast when there was a problem.

Mistakes still happen, but they seem to be fewer. Thankfully.

Just some different ideas on how to try to fix the problem. And
as someone said, you HAVE to have the complete backing of the
pathologist in charge of this area, and the pathologist in charge
of the entire department. The legal aspects of formaldehyde
exposure (or mislabeled specimens) is a good point, and hopefully
can override their concern for turn-around time.

Good luck.

> We have been having a problem with the condition of surgical specimens
> that are delvered to pathology.  We have a central messenger center that
> collects specimens from the clinics and surgery on a regular time
> schedule.  They pick up specimens and then deliver them to pathology.  The
> immediate problem is the careless with which they are handled.  They
> "toss" them into a plastic or paper bag and then empty them on the
> receiving desk.  To ones complete amazement-they leak. The clinics,
> surgery and messenger supervisors have been contacted, warned, threatened,
> verbally abused, begged and pleaded with, but still no end in sight to the
> problem.
>
> We have explained the problem with contamination, having to redo the
> paperwork, and the time consuming effort involved in  handling this
> problem, but nothing.  It is a double headed problem, but I feel that if
> the messengers would not turn them every which way then the containers
> that were not sealed correctly would not leak.
>
> The clinics are furnished bags with special pockets for paperwork on the
> outside of the bag while the specimen goes inside, unfortunately the put
> the paper inside with the leaky specimen.
>
> I would like some suggestions as to how other hospitals receive their
> specimens.  Is this common?  Or, are we just lucky?
>
> Cel Rutledge
> San Francisco General Hospital

--
Peggy A. Wenk, HTL (ASCP)
Anatomic Pathology
Wm. Beaumont Hospital
3601 W. 13 Mile Rd.
Royal Oak, MI 48073-6769