CAP Pro Course - Histology - Quality Management in the Histology Laboratory (2025 & 2026)

Author: Carla Shoffeitt, MSM, HT(ASCP)
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • Explain the requirements that promote quality in specimen identification and tracking throughout the workflow path.
  • Outline procedures to ensure the quality of specimens submitted for histological testing, including appropriate handling and documentation of suboptimal specimens.
  • Discuss quality control (QC) procedures for histological processing and staining, including actions taken when QC results are not acceptable.
  • Identify acceptable methods to ensure stain quality.
  • Discuss requirements for storage, retention, and release of histology specimens to ensure postexamination quality of specimens if required for later testing.
  • Discuss the use of quality management initiatives in the histology laboratory.

Course Outline

  • Explain the requirements that promote quality in specimen identification and tracking throughout the workflow path.
      • Positive Patient Identifiers
      • Acceptable Labeling of Specimen Containers
      • Accessioning and Tracking of Specimens
      • Appropriate Labeling of Tissue Cassettes and Glass Slides
      • Multiple specimens are dropped off in the gross room. Upon receipt, the histologist assigned to the gross room attempts to confirm positive patient id...
      • What information should be compared before sectioning a block to ensure proper patient identification?
  • Outline procedures meant to ensure the quality of specimens submitted for histological testing, including appropriate handling and documentation of suboptimal specimens.
      • Specimen Processing Requirements Based on Fixative
      • Specimen Processing Requirements Based on Fixative, continued
      • Handling Suboptimal Pathology Specimens
      • Procedures for Maintaining Specimen Integrity During Processing: Verification of Blocks
      • Procedures for Maintaining Specimen Integrity During Processing: Embedding Standards
      • Cason has completed the embedding for the morning shift and is comparing the embedded blocks with the log generated by the grossing staff last evening...
      • For breast specimens that may be subject to estrogen receptor (ER), progesterone receptor (PR), and/or HER2 testing, the College of American Pathologi...
      • Anna is working in histology accessioning and receives a phone call from the operating room (OR). The OR associate explains that a large section of in...
  • Discuss quality control (QC) procedures for histological processing and staining, including actions taken when QC results are not acceptable.
      • Process and Instrumentation Controls
      • Hematoxylin and Eosin (H&E) Control for Routine Staining and Tissue Processing
      • Special Stain Control Tissues and Quality Control (QC)
      • Immunohistochemistry (IHC) Controls
      • John is replenishing alcohols and filtering stains on the automated staining instrument in his laboratory. Upon completion, John documents his actions...
      • You are preparing to perform a special stain on a liver biopsy. Your co-worker reminds you not to forget to use an appropriate control slide when you ...
      • Lauren stains the designated hematoxylin and eosin (H&E) control prior to staining patient samples. After reviewing the slide microscopically, Lau...
  • Identify acceptable methods to ensure stain quality.
      • Special Stain Quality
      • Troubleshooting Special Stains to Ensure Quality
      • Validation of Immunohistochemistry (IHC) Antibodies, Detection Kits, and Ancillary Reagents
      • Troubleshooting Immunohistochemistry (IHC) Stains to Ensure Quality
      • The immunohistochemistry (IHC) specialist in your laboratory has received new lots of antibodies. Which of the following best describes the action tha...
      • Dr. Wells has requested a TTF-1 immunohistochemistry (IHC) stain on a thyroid biopsy, as well as the correlating fine needle aspirate (FNA) cytology s...
  • Discuss requirements for storage, retention, and release of histology specimens to ensure postexamination quality of specimens if required for later testing.
      • Required Retention Times for Wet Tissues, Paraffin Blocks, Glass Slides, and Reports
      • Storage Considerations for Formalin-Fixed Specimens
      • Filing and Storage Considerations for Glass Slides and Paraffin Blocks
      • Release of Materials for Consultation or Legal Review
      • Sam receives a request for a paraffin block on a patient enrolled in a research treatment trial. Upon further review, Sam realizes the block is five y...
      • Specimen storage and retention are important components of quality management. Which of the following is true when storing wet tissue that has been fi...
      • You have been asked to work on a project that involves reorganizing the gross room to include wet tissue storage. Which of the following would be the ...
  • Discuss the use of quality management initiatives in the histology laboratory.
      • What is Quality Management?
      • Participation in Quality Assessment (QA) Programs
      • Document Control System
      • Documentation of Instrument Function and Maintenance
      • Specimen and Data Tracking in the Histology Laboratory
      • Upon checking the temperature of the paraffin dispenser, you discover that the dispenser is not functioning properly and the paraffin is beginning to ...
      • You have been notified that your laboratory recently enrolled in the Histology Quality Improvement Program (HistoQIP). Your immediate supervisor has e...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for HT, HTL, MLS, MT, MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: Carla J. Shoffeitt, MSM, HT(ASCP), is the System Director of Anatomic Pathology for Emory Healthcare in Atlanta, Georgia. She holds a Master of Science Degree in Healthcare Management as well as a Bachelor of Science degree in Biology from Troy University, Troy, Alabama. She is certified as a Histotechnician and has 29 years of experience in the field of Histology.
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is currently an Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.

This course is part of the CAP Competency Assessment Hub.

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