Surg Path Meeting 11-1-16

This Month:

  • We introduced subspecialty slide boxes last month to facilitate weekly hand-offs of cases. New cases should be delivered by histology to the supspecialty slide boxes rather than your individual boxes. Continue checking your personal box because additional slides, recuts, special stains, or improperly accessioned cases may still go to your box!
  • While grossing, make sure the case is assigned to the appropriate subspecialty in CoPath (Subspecialty ID field present in Histology E/E and Final Diagnosis E/E). Part type changes will clear the subspecialty field, so if you change a part type, re-enter the subspecialty. Also double check that the appropriate attending and resident are assigned to the case.
  • If a Subspecialty is accessioned incorrectly, 1) make the change and 2) notify Charlene of the case #, the initial incorrect Subspecialty, and the new correct Subspecialty.
  • Resident Subspecialty services that are issued to Subspecialty boxes are:
    • BR Breast
    • BST Bone & Soft Tissue
    • ENT Head & Neck
    • THO Thoracic
    • GU Genitourinary
    • GYN Gynecologic
    • GI Gastrointestinal
  • Other Subspecialty services that are issued to Personal boxes are:
    • HL Heart & Lung Biopsies (Dr. Husain fellow)
    • LIV Liver Biopsies & Explants (GI fellow)
    • REN Medical Renal (Renal fellow/attending)
    • NP Neuro (Neuro attending)
    • PED Pediatric (rare usage, should still go to resident)
  • Please notify histology lab if major protocol changes are made in CoPath as they may not be reflected in Ventana (i.e. changing from multiple levels / unstained sections to 1 H&E).
  • In Dr Lingen's consult oral biopsies: Please remember to dicate the PreOp and PostOp diagnoses either 1) into your clinical history or 2) into the Preop / Postop Diagnosis fields in CoPath. 

Ongoing Reminders:

  • Update your dictation templates if you have not been on surg path in recent months.
  • PGY1s - please continue to fill out your SMALL and BIG specimen checklists. Feel free to ask a senior resident on how to track the specimens you've grossed in CoPath.

General Grossing:

  • At the end of the day, grossing resident should email the list of assigned bigs as well as any leftover bigs to all residents on surg path, PAs, and Dr. Cipriani.
  • The grossing resident is responsible for switching the surg path pager coverage OFF the LMROC resident each morning at 8 am and back ON the LMROC resident each evening. Remember to send a page to the LMROC resident to notify them on the status of any pending frozens and which attending is on frozen coverage that evening.
  • "Number of Containers": Remember to state the Number of Containers received at the top of your gross description if it is not already in the part type. Dragon command is "Container".
  • "Received": Be mindful of whether specimens are truly received in formalin (large white sticker if specimen is coming from the OR) or if formalin was placed in the gross room (red biohazard/formalin sticker). Your dictation should read "received in formalin", "received fresh and placed in formalin", "received fresh", or "received fresh for intraoperative consultation". See Initial Specimen Evaluation page for details.
  • "Cassette Summary": Remember to state whether you are submitting Representative or Entire specimen.
  • For specimens that are transferred to a different container for appropriate fixation, make sure the original label stays with the specimen at all times. 
  • Gross-only cases should have a final diagnosis entered and be sent to the attending. Use CoPath quick text: HARD for "Surgical hardware (gross examination only)" or FOBJ for "Foreign object (gross examination only)".
  • At the end of the day, make sure all specimens are placed in formalin if appropriate. 

Frozens: 

  • On the frozen section worksheet, remember to include your initials if you traiged the specimen. Also indicate who reported the diagnosis (resident or attending) and to whom the diagnosis was reported.
  • Intra-op consultations that are gross only still require a diagnosis on the frozen section worksheet, an attending signature, and pertinent reporting information at the bottom. Also inform the techs to modify the part type to appropriately reflect a gross only intra-op consultation.
  • While grossing complex specimens on which a frozen was performed, DO NOT FORGET to describe what was done during frozen (i.e., which part of the specimen was sampled for frozen).
  • Refer to the Intraoperative Consultation page for details.