April 24, 2015

CAP and NSH Release New Guideline to Improve Patient Safety

BY Dr. Keith J. Kaplan

Pathologists and histotechnologists team to provide recommendations to standardize block and slide labeling practices

Recently the College of American Pathologists (CAP) and the National Society for Histotechnology (NSH) released the first evidence-based guideline to ensure patient safety through the uniform labeling of paraffin blocks and slides. The guideline, “Uniform Labeling of Blocks and Slides in Surgical Pathology,” is now available in the online edition of Archives of Pathology & Laboratory Medicine.

The new guideline includes 12 guideline statements to assist pathology laboratories in developing standardized block and slide labeling practices. In developing the guideline, an expert panel of pathologists and histotechnologists with expertise in histology laboratory quality practices, addressed the over-arching question, “What are the essential elements for proper labeling of paraffin blocks and microscopic slides in the routine practice of surgical pathology?”

Key points of the recommendations include:
• Laboratories should ensure that all blocks and slides are clearly labeled using two patient identifiers.
• Laboratories should ensure that the accession designation used on the surgical pathology report and all blocks and slides from that accession, includes the case type, year, and a unique accession number.

“Careful and consistent labeling of paraffin blocks and microscopic glass slides is essential in the practice of surgical pathology to ensure patient safety and to reduce the potential risk of pre-analytic error,” said Richard W. Brown, MD, FCAP, co-chair of the guideline representing the CAP and a pathologist at Memorial Pathology Consultants, Houston, Texas. “We encourage pathologists and histology laboratory professionals to implement the new guideline in their individual practice settings as an additional quality assurance measure.”

Adoption of standardized practices additionally will improve patient care by facilitating interpretation of histologic sections when they are referred in consultation to a second institution.

“Because the guideline was developed by a panel of pathologists and histotechnologists with expertise in histology laboratory quality practices, we believe that the recommendations will be a valuable resource for laboratory professionals,” said Vincent Della Speranza, MS, HTL (ASCP), guideline co-chair representing NSH. “The recommendations offer examples for labeling procedures to aid with this process.”

The panel conducted a systematic review of more than 400 articles, examined evidence from 10 articles that met specific inclusion criteria, and participated in a considered judgment process to develop the recommendations. Recommendations were derived from strength of evidence, open comment feedback, and expert panel consensus. The guideline will be updated as new evidence becomes available.

The CAP and NSH encourage pathologists and laboratory professionals to implement the new guideline recommendations in order to improve patient care. The CAP offers tools and resources, including a summary of the recommendations and frequently asked questions (FAQs) for further implementation and understanding.

About the College of American Pathologists
As the leading organization with more than 18,000 board-certified pathologists, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. The CAP’s Laboratory Improvement Programs, initiated 65 years ago, currently has customers in more than 100 countries, accrediting 7,600 laboratories and providing proficiency testing to 20,000 laboratories worldwide. Find more information about the CAP at cap.org. Follow CAP on Twitter: @pathologists.

About National Society for Histotechnology
The National Society for Histotechnology (NSH) represents professionals from the Histotechnology discipline who practice in clinical, research, pharmaceutical, veterinary, marine sciences, and forensic laboratories. The NSH is the global leader in professional development of practitioners in the discipline. The NSH is recognized as a resource to professional standards and accreditation organizations as a partner in developing quality programs and documents that are utilized in the anatomic pathology laboratory. The NSH is actively represented in numerous health care professional societies and participates in an advisory role as a voice in regulatory issues that impact health care. Find more information about NSH at nsh.org.

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