The Laboratory of Pathology supports the clinical mission of the NIH and the NCI by providing anatomic pathology clinical services to the Clinical Center and to all of the categorical institutes. It is CLIA-certified and inspected by the College of American Pathologists. It provides services in surgical pathology, autopsy pathology, hematopathology, cytopathology, ultrastructural and pediatric pathology, cytogenetics, flow cytometry and molecular/special diagnostics. Clinical Operations is the administrative core of the clinical component of the Laboratory of Pathology. It oversees the Quality Management program, the core laboratory services, the Laboratory Information System (LIS) and manages the clinical diagnostic tissue archive of the laboratory. As a service to investigators throughout the NIH, scientists may request tissues for research from the archive following appropriate ethical approval (from their IRB or from the OHSR). In this fiscal year through the end of July, we processed about 280 new and ongoing requests for tissue. This resulted in approximately 14000 individual biospecimens for research from our tissue archive. The LIS is part of the SoftLab system used by the Clinical Center and it interfaces with the hospital information system so that anatomic pathology results are available online. As part of the tissue request process, we do searches of the pathology database and provide lists of cases match criteria supplied by investigators. The LIS is also used by Clinical Operations to generate benchmarks and quality assurance statistics for managing the clinical diagnostic services. In 2009, Clinical Operations initiated a program to scan pathology reports on cases reviewed from hospitals other than the Clinical Center. This program will eliminate our need to bind reports into paper volumes and will give pathologists ready access to the reports. We currently have reports scanned from 2008 to the present and are maintaining the report archive in real-time. We also acquired a slide image scanning system. This system will allow the Laboratory of Pathology to retain images of slides that need to be returned to originating hospitals and to have images of whole slides readily available for clinical conferences within the NIH Clinical Center. Over 5000 slides have been scanned thus far. Clinical operations also oversees pathologist-supervised tissue division for research. Patients who undergo surgery at the NIH Clinical Center frequently have tissue divided between research and diagnostic purposes, as dictated by IRB-approved protocols. The Laboratory of Pathology participates in the Tissue Processing and Procurement Facility (TPPF). The TPPF is staffed by a Research Nurse and a part time Technical Laboratory Manager and is housed in our frozen section room. Their equipment includes a sterile hood and supplies of liquid nitrogen and dry ice. The TPPF coordinates tissue procurements in the operating room (OR), facilitation of the complex procurement that often involves multiple investigators and multiple protocols. A pathologists' assistent (PA) works with investigators, identifying what tissues need to be procured, how they are to be stabilized and what protocols allow the tissue procurement to occur. The PA also works with the senior resident, and between the perform most of the procurements. Procurements may take place in the TPPF lab, in the OR or in an investigators lab. This system allows as many investigators as possible to benefit while meeting the standard-of-care for anatomic pathology. The Technical Laboratory Manager maintains the lab, assists in procurements and assists the Clinical Laboratory Manager in property and maintenance activities for the Laboratory of Pathology.
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