1. Quarterly Assessment, Armed Forces Institute of Pathology.
2. Cytology proficiency testing.
3. Peer review in surgical pathology.
4. Monitors: turnaroud time.
5. Communications.
6. Timeliness.
7. Daily surgical pathology QI conference.
8. Enrollment in pathology review programs.
9. ASCP VA-cytopathology QA instructions.
10. AFIP surgical pathology QA instructions.
11. Employee required training instructions.
12. Reviewing prior surgical/cytopathology cases.
13. Protocol for handling disparities, errors.
14. Policy for documenting intradepartmental consultations.
15. Policy for documenting extradepartmental consultations.
16. Policy for documenting extradepartmental consultation discrepancies.
17. Coding extradepartmental consultations.
18. Turnaround time pilot study.
3.1. All microscopic tissue examinations of surgical tissue are performed by a staff pathologist and all surgical tissue diagnoses are made by a staff pathologist.
3.2. Each day, all pathologists participate in our QA conference at the multi-headed microscope, and review 100% of the biopsy and rush cases received. This includes review of frozen section diagnoses where there are any discrepancies between intraoperative diagnosis and final diagnosis; and all new cancer diagnoses. An attendance record is kept. Unresolved differences of opinion are recorded and can be sent to an outside consultant for review (usually the AFIP).
3.3. Every surgical pathology and cytology report is reviewed for any errors (in identification or completeness) and delinquencies. This review occurs at the time of report release (to the VistA® Computer System) by the pathologist who signs the case, and by the CHIEF, SURGICAL PATHOLOGY SECTION , who issues a lateness monitor.
5.1. Notification of a new positive (for cancer) diagnosis, with the exception of basal cell carcinoma.In the case of a confirm/priority email, the subject line must contain the words URGENT PATHOLOGY REPORT, and the case-number, so that the case can be tracked for reporting to the monthly Invasive Procedures Review Committee.
5.2. Notification of unsatisfactory specimens.
5.3. Notification for clinically significant, unsuspected results, or any other issues of concern to the pathologist, such as unexpected positive margins in a resection; or unexpected infectious disease.
P-0650 .......... CONSULTATION, NOS P-0658 .......... CONSULTATION, BY EMAIL P-0659 .......... CONSULTATION, BY TELEPHONE
9.1. Click on: http://www.ascp.org/cpimages
9.2. Click on:Option 29.3. Inside the VA firewall, a security banner will appear. You may have to wait up to 30 seconds.
Download images in PowerPoint presentation (high-resolution):
Cytopathology - Quarter 1 (or other Quarter as appropriate).
9.4. Click on SAVE.
9.5. A SAVE AS box will appear. Again, click on SAVE (lower right corner of box).
9.6. Wait up to 20 seconds, and click on OPEN.
9.7. Click on the thumbnail slides on the left panel, so that the full slide will appear in the center.
9.8. Take the test on your paper document.
9.9. BE CAREFUL! Typically, the ASCP slides are placed out-of-order in the Powerpoint module, to test whether the pathologist is alert to the correct number for each case.
9.10. To end the session, click on the [X] on the upper right corner of the monitor-screen.
10.1. To begin or continue with a course, go to URL:http://www.afip.org
10.2. Click on: ONLINE PATHOLOGY SERVICES (tab at top right of screen).
10.3. Inside the VA firewall, a security banner will appear. You may have to wait up to 30 seconds. If a SECURITY ALERT box appears, click on: OK.
10.4. Enter your LOGIN ID and PASSWORD (lower right box), and click on LOGIN.
10.5. On the left side of the screen, and click on: ONLINE PATHOLOGY.
10.6. Click on: EDUCATION.
10.7. Within the Course Search Box (Gray box), Scroll down to Course Type.
10.8. Hit the drop down error, and select Virtual Slides Courses.
10.9. Then click search Select the Histopathology Quality Assessment Program.
10.10. Select Conference 2-2007, or whatever is appropriate.
10.11. For questions, contact:Nicole L. Jenkins
Office of Quality Assurance,
Armed Forces Institute of Pathology (AFIP)
Voice: 202-782-2649
Fax: 202-782-7347
email: jenkinsn@afip.osd.mil
10.12. Under VIRTUAL SLIDE COURSES, click on: HISTOLOGY QUALITY ASSESSMENT PROGRAM (HQAP) (bottom left).
10.13. At the bottom of the screen, SELECT A CONFERENCE BELOW:
10.14. Select CONFERENCE 1 (or other appropriate CONFERENCE, corresponding to the particular open season. That is, Conference 1 = February; Conference 2 = May; Conference 3 = August; and Conference 4 = November.
10.15. Each open season runs throughout the month, and you may change your diagnosis at any time up to the closing date. For example, the responses for Conference 1 may be entered or modified any time between February 1 and February 28.
10.16. Click on: CLICK HERE FOR VIRTUAL SLIDE. There may be a slight delay, due to slow transmission of the computer image during peak hours.
10.17. A separate slide image screen appears as a large image in the center with control buttons on the bottom; and as a smaller image in the upper left corner. Click [+] for increased magnification. The area of magnification appears as a [RED BOX] in the smaller image. You may manipulate the slide by left-clicking the mouse on the area of interest, and dragging the mouse around. You may drag either the small image or the large image.
10.18. Click [-] for decreased magnification. The CURSOR KEYS are: ← to move RIGHT; ↑ to move UP; → to move LEFT; ↓ to move DOWN. DO NOT USE √, as this action might back you out of the session. Click [↖] (leftmost button) to reset the image to its original appearance.
10.19. When you have examined all slides for a case, then enter your diagnosis in the DIAGNOSIS BOX, and click on SUBMIT DIAGNOSIS.
10.20. You have all month to submit a diagnosis, or modify an existing diagnosis. You may modify a diagnosis until February 28 for Conference 1, May 31 for Conference 2, etc.
10.21. When you have reached a stopping point, PRINT a copy of your work, for your records.
10.22. To obtain your CME records, repeat steps 10.1 through 10.4. On the left side of the screen, and click on MY CME. In the middle of the screen select REPORTING YEAR. Click on CME CERTIFICATE. PRINT the page for your records.
1. If you see a certificate or some document indicating completion, PRINT IT IMMEDIATELY. This may be your only proof that you completed the learning module. The systems are flaky, and the next page may be an annoying unintelligible error message. When all else fails, give copies of these documents to your departmental administrator.Here are the required modules:
2. Just because your password worked the last time, doesn't mean that it works now. The system even changes the rules for what works as a password, without notifying the user.
3. Different logons have different password rules. Some require a combination of upper/lower case letters, numerals, and/or punctuation; some require at least 8 digits, etc., etc.
4. The first page of the Carelearning solicits your email comments, but provides no email addresses.
Diversity Training:How to Contact Your VISN 5 Compliance & Business Integrity (CBI) Office:
http://vaww.vamhcs.med.va.gov/Departments/EEO/training/WhyDiversity.ppt
No password required. Certificate at end of presentation.
Sexual Harassment, Prevention:
http://vaww.vamhcs.med.va.gov/Departments/EEO/training/SexualHarassment.ppt
No password required. Certificate at end of presentation.
No FEAR:
http://vaww.vamhcs.med.va.gov/departments/eeo/training/nofear.ppt
No password required. Certificate at end of presentation.
Green Environmental Management System (GEMS):
http://vaww.vamhcs.med.va.gov/Training/gems/GEMS.ppt
No password required. Certificate at end of presentation.
VHA Privacy Policy:
https://vaww.ees.aac.va.gov/
Cyber login/password required. Certificate at end of presentation.
VA Cyber Security Awareness:
https://vaww.ees.aac.va.gov/
Cyber login/password required. Certificate at end of presentation.
Disaster & Emergency Preparedness:
http://vaww.vamhcs.med.va.gov/Training/carelearning.htm
Carelearning login/password required. Verification is automatically logged into TEMPO.
Fire Safety and Fire Extinguisher:
http://vaww.vamhcs.med.va.gov/Training/carelearning.htm
Carelearning login/password required. Verification is automatically logged into TEMPO.
General Safety:
http://vaww.vamhcs.med.va.gov/Training/carelearning.htm
Carelearning login/password required. Verification is automatically logged into TEMPO.
Hazard Communication (Hazardous Materials):
http://vaww.vamhcs.med.va.gov/Training/carelearning.htm
Carelearning login/password required. Verification is automatically logged into TEMPO.
Infection Control:
http://vaww.vamhcs.med.va.gov/Training/carelearning.htm
Carelearning login/password required. Verification is automatically logged into TEMPO.
Compliance:
http://vaww.vamhcs.med.va.gov/Training/carelearning.htm
Carelearning login/password required. Verification is automatically logged into TEMPO.
Affirming the Commitment: Opening Hearts to Veterans:
http://vaww.va.gov/atc/images/atc_intranet.asx
No password required. You have to have AUDIO on your computer, and turn up the VOLUME so you can hear the presentation.
SUMMARY OF CARELEARNING CLASSROOMS:
Abuse and Neglect Classroom.
Age Specific Care Classroom.
Blood Borne Pathogens Classroom REQUIRED.
Disaster Preparedness Classroom REQUIRED.
Electrical Safety Classroom REQUIRED.
Fire Safety (R.A.C.E.) Classroom REQUIRED.
Green Environmental Management System (GEMS) Awareness Classroom.
Hazard Communications Plan Classroom REQUIRED.
Moving and Lifting Classroom REQUIRED
Patient Rights Classroom.
Restraints & Seclusion Classroom.
Slips, Trips, and Falls Classroom REQUIRED.
Standard Precautions Classroom REQUIRED.
TB Prevention Classroom REQUIRED.
VISN 5, Compliance & Business Integrity Training Classroom REQUIRED.
Ms. Donna Custer.
Donna.custer@va.gov
1-800-759-8888 PIN: 1064942.
13.1. The final report must specify the disparity.
13.2. The clinician submitting the specimen must be notified of the disparity.
13.3. The final report must document that the clinician was notified of the disparity.
13.4. The disparity must be discussed at the daily QA conference.
13.5. The disparity must be documented in the monthly pathology monitor submitted to the CHIEF, PATHOLOGY AND LABORATORY MEDICINE.
15.1. The consultation is delivered to the Chief, Surgical Pathology Section.16. IF THERE IS A DISCREPANCY BETWEEN THE CONSULTANT DIAGNOSIS and the diagnosis rendered in our department, the case is reviewed at surgical pathology QA conference, and a supplemental report is written according to the consensus reached by all the pathologists.
15.2. One copy of the consultation is added to a loose-leaf-bound collection of consultations kept in the department.
15.3. One copy is attached to the copy of the report that is kept in the Department.
15.4. The findings of the consultation are summarized by the staff pathologist for the case, as a supplemental report.
15.5. If the results of the consultation are of consequence to the clinicians caring for the patient, or if the clinician is waiting for the results of the report for any reason, the clinician is notified of the result of the consultation and the notification is documented as a supplemental report.