Part 1: Accessioning

Part 1: Accessioning

Author: Clifford M. Chapman, BS, MS, HTL (ASCP), QIHC

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The primary goal of preventative maintenance is to prevent the failure of your laboratory equipment before it actually occurs, ensuring that the specimen workflow through your histology laboratory never stops. A welcome corollary to preventative maintenance is that employee health and safety is never compromised and that you are always prepared for any unannounced inspection. In addition, it’s not just laboratory equipment that you have to be concerned about. Any computer printers, scanners, etc. involved in the laboratory process are included as well.

Beginning with the accessioning of specimens, printers have become ubiquitous in the histopathology laboratory setting. More and more laboratories utilize bar code tracking systems. These systems require printers that can print requisition labels, specimen bottle labels, microscope slide labels and tissue processing cassettes. Requisition and specimen bottle labels are straightforward. They consist of adhesive labels measured to your laboratory’s specification and will be used on a flat surface.

Microscope labels are more complex. They must have a final surface print that is unaffected by laboratory solvents used in slide staining, and they must fit exactly on the slide. These printers, and the ribbons and labels that go into the printers, are unique. The printers must function reliably and consistently, without the labels and/or ribbon jamming. This is also true of slide printers that print directly onto the slide. It is paramount that this equipment receives preventative maintenance, and that you have a back-up printer just in case.

Similarly, cassette printers are unique in that they must print on a plastic tissue processing cassette surface. Some printers are similar to the slide printers mentioned above. Others use a laser printer. The laser printer uses a filter to collect fine particles. It is important for employee safety and the consistent operation of the printer to replace the filters at appropriate time frames and to make a record of the filter exchange for documentation.

A proactive vendor can provide both preventative maintenance on printer hardware and timely filter exchange. The vendor will also provide the correct documentation for both tasks, which you can keep on site. In the event that the documentation is misfiled and cannot be located at the time of inspection, the vendor can send over a copy of any documentation via email or fax. This can provide much needed peace of mind at the time of an inspection.

Additionally, printer failures can affect daily operations. Any failure “up front” at the time of accessioning can delay specimen entry into the laboratory. If the specimen involved is a “rush”, this could adversely impact patient care. Similarly, microscope slide printing failures can result in a delay in turnaround time. The faster you can provide slides to your pathologist, the more quickly diagnoses can be rendered.

Another aspect to be considered is that, during a preventative maintenance call, a vendor may be able to suggest a better slide, cassette or label which fits your printer properly. If slides and/or cassettes are jamming in your existing printers, it may be more efficient to change the manufacturer of the slides / cassettes (Reference: Avantik White Paper: Microscope Slides). The tolerances required for laboratory printers to work are very small. If the source material (i.e. slides and cassettes) are not manufactured to rigorous tolerances, it may be the cause of jamming. When slides and cassettes jam inside a printer, not only is it frustrating for the user, it causes a delay in operations, with a resulting increase in turnaround time.

Vendors should also perform a complete examination of the printer hardware during preventative maintenance visits. The service technician may be able to identify internal parts that are worn and may be in danger of imminent failure. It is better to fix this issue immediately, rather than wait for the unit to fail during use, resulting in unplanned delays.

When regular preventative maintenance is performed on the equipment used in the accessioning of specimens, it ensures that the specimen receipt is documented immediately in real time. It also ensures that specimens are delivered into the surgical grossing room as quickly as possible to begin the workflow through your histology laboratory, as we shall see in the next part in this series.

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