PREVENTATIVE MAINTENANCE SERVICE PART 1:
Unannounced Lab Inspections
You just arrived to work in the lab, and the phone is ringing already. You pick it up. It is the front desk calling down to the lab to let you know that the state inspectors are there. They want to speak to the supervisor. That is you.
You proceed upstairs to the office to greet the inspection team. They want to get started right away. They hand you a list of information that they want to see. At the top of the list is: records of equipment maintenance. Your mind races: do we have all of that documentation? Did it make it into the final log books?
Sound familiar? Anyone who has ever worked in a histopathology laboratory has experienced the “unannounced inspection”. This experience is stressful enough without having to worry about equipment maintenance documentation. However, it is a regulatory requirement and someone has to be responsible for it. And it’s not just laboratory equipment. Any computer printers involved in the laboratory process are included.
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 laboratories 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 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 cheaper and 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 remedy this issue immediately, rather than wait for the unit to fail during use, resulting in unplanned delays.
As the inspection laboratory walk through tour gets under way, your mind is still racing. The inspection team seems content with the accessioning space and procedures. However, as they enter the processing room you think: did the tissue processors receive their preventative maintenance service last month? Are the service records in the equipment log book? What about the activated charcoal filters? When is the last time they were changed? Did we file those records as well?