Surgical Pathology Specimen Collection

SPECIMEN SUBMISSION

Identification of Patient and Specimens

Properly completed requisitions must accompany any specimen sent to Anatomic Pathology for evaluation. See "Requisitions" section below. Patient ID on the requisition must MATCH the patient ID on the sample container(s). Two unique patient identifiers (full name and date of birth are mandatory) must be present on both the specimen container and requisition. Specimen source, including laterality, and corresponding letter matching the specimen letter listed on the requisition must be written on each specimen container. Specimens submitted without correlating/positive patient/specimen identification will require:

• Corrective action by submitting physician or personnel involved in specimen collection, or
• Specimen re-collection if possible.
• Best practice suggestion: after specimen collection but before the patient leaves the examination room, ask the patient to confirm that the information on the container as well as the paperwork is correct.

Manual Requisitions

The type of specimen and/or the type of service requested will determine the requisition(s) needed. Any York requisition may be obtained from the on-line WellSpan Health Printing Services Digital Storefront or from the Translab Services Division of Laboratory Services at (717) 851-1417. Choose from the following list:

• WellSpan Health Surgical Pathology Requisition (York Hospital gold color), Form #3008, Revised 1/14
• WellSpan Health Surgical Pathology Requisition (Gettysburg Hospital blue color), Form #3008, Revised 1/14. May be obtained by calling 717-337-4120, ext 75122.)   
• WellSpan Health Breast Pathology Worksheet (light pink color), Form #817, 4/14
• York Hospital Intraoperative Consultation Requisition (two part white/yellow), Form #40236, Revised 8/13 (also send form #3008)
• Gettysburg Hospital Frozen Section Tissue Reoprt (two part yellow), Form #MR 120. (also send Pathology Tissue Request upon case completion) 
• WellSpan Health Hematopathology Requisition (green color), Form #825, Revised 12/13 

To ensure optimal diagnostic evaluation as well as appropriate billing, complete all the required information requested on the requisition(s). Failure to supply the full name of the submitting clinician will result in a delay in processing until the complete name is obtained. Multiple specimens submitted on the same patient in separate containers must be recorded sequentially in the area designated for specimens with a precise description/ location. Note: DO NOT abbreviate laterality. Record "right" or "left" as appropriate on the requisition.

Electronic Orders

For all inpatient surgical requests, please order the test in PowerChart using the mnemonic SURGICAL PATH SPECIMEN ORDER or PATHOLOGY TISSUE REQUEST and answer all the required questions. A specimen label and requisition should print out at the patient location, if not, use a manual paper requisition. Place the label on the specimen container and bring both the requisition and specimen to the laboratory. Please call the laboratory if you have questions. (York Hospital 717-851-5001; Gettysburg Hospital 717-337-4120) 

Containers

All routine surgical specimens should be submitted in 10% neutral buffered formalin with the formalin volume equal to at least 10 times the specimen volume in order for adequate fixation to be achieved. Pre-filled formalin containers may be obtained from Anatomic Pathology. Please call York Hospital Histology at (717) 851-5006 or Gettysburg Hospital Histology at (717) 337-4120, ext 75122 for ordering instructions.

Special Tissue Handling

Nerve, muscle, and/or kidney biopsies require the expertise of pathology to evaluate the adequacy of the specimen before it is immediately transported for evaluation. Pathology must be notified no less than 24 business hours prior to the procedure.

For lymph node biopsy for lymphoma testing, contact pathology for immediate sampling and placement in RPMI solution for testing.

Other special handling or special fixative requests require prior consultation with a pathologist at least 24 hours prior to the procedure.

SPECIMEN DELIVERY

Preserved Specimens:

All preserved specimens with the appropriate requisition(s) may be delivered to the York Hospital Anatomic Pathology specimen drop off room (APSDR) and placed in the refrigerator, or delivered to the Gettysburg Hospital Central Processing area. Pick up of preserved specimens may be arranged by calling York Hospital Translab Services at (717) 851-1417.  Specimens for Gettysburg Hospital Lab are routinely picked up by designated courier runs throughout the day. 

Unpreserved (Fresh Tissue) Specimens:

Unpreserved specimens with the appropriate requisition(s) may be delivered to the York Hospital APSDR and given directly to the AP receiving tech who will deliver to the appropriate pathologist's assistant. The York Hospital pathologist on-call needs to be notified for after hour deliveries of fresh specimens by calling (717) 851-2511. At Gettysburg Hospital the specimens are delivered to the Lab Central Processing area who will contact Anatomic Pathology during regular work hours. 

Intraoperative Consultation Procedure

SPECIMEN SUBMISSION

When an intraoperative consultation is requested (i.e. frozen section, touch preparation), ALL tissue should be submitted fresh - no preservative. The tissue should also be kept sterile if flow cytometry, drug resistance assays, or chromosome studies are being requested.

The fresh tissue should be placed on a blue surgical towel or into a sterile specimen container that is labeled with the patient name, tissue site, and appropriate specimen letter, if more than one specimen is being submitted. The tissue should be accompanied by a surgical pathology requisition (Form # 3008), and an intraoperative consultation requisition (Form # 40236) at York Hospital or a Power Order generated requisition and the yellow Frozen Section Tissue Report  (Form #MR 120)provided by the Operating Room at Gettysburg Hospital. The intraoperative consultation requisition should be filled out completely, and include the patient information (a patient sticker should be placed on both the white and the yellow copies of the requisition), the ordering physician, date, pre-op diagnosis, operating room number or extension, and the specimen number and location. The diagnostic mission box should also be checked appropriately depending on the reason for the consultation.

SPECIMEN DELIVERY

The fresh tissue and an empty container large enough to hold the tissue should be brought to the York Hospital frozen section room by either the circulating nurse from the operating room or via York Hospital security if the specimen is arriving from Apple Hill Surgical Center. For Gettysburg Hospital the fresh tissue should be delivered directly to the Gettysburg Hospital Histology lab. A notification call must be placed to York Hospital Anatomic Pathology at (717) 851-5001 stating that a fresh specimen has been or will be delivered to the frozen section room. If it is after 4:30 p.m. or over a weekend, the on-call pathologist should be notified by calling (717) 851-2511. Gettysburg Hospital Anatomic Pathology should be notified at (717) 337-4120.