First evidence-based guideline released to ensure patient safety

Today, 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.