A Transparent Oversight Policy for Human Anatomical Specimen Management

Although bovine auricular pavilion has been considered to have large surface vessels, descriptions of its vascularization are scarce. Notwithstanding this region has been used as an alternative route of administration of drugs. With help of an Anatomical specimen, arteriography and dissection have revealed a vast vascular network in the auricle. In this sense, once considered, this knowledge is capable of minimizing prospective complications from the unsuitable use of this region for therapeutic and anesthetic procedures. This study aimed to standardize and describe the arteriography of bovine auricular pavilion in order to acquire a greater knowledge about the local vasculature. Five steers, about one-year-old and weighing about 200 kg, were used, among which three Holstein x Gir crossbred and two Gir purebred. None had lesions in the ear. Of these, two animals were submitted to the standardization of procedures for arteriographies; two others underwent the examination itself. Another bovine, from necroscopy, was subjected to dissection of the ear. The arteriographic images and anatomic dissection pictures were compared to describe anatomical relationships. Arteriography enabled the visualization of lateral, lateral intermediate, intermediate, medial intermediate auricular branches, as well as the medial auricular branch. Conversely, the dissection of the superficial cervicoauricular muscle, between the auricular pavilion and the cornual process base, indicated a poor subcutaneous vascularization of this region, contrasting the rich vascularization near the auricular pavilion. The auricular pavilion arteriography identified a complex vascular network, which in terms of a practical application precludes the administration of slow-absorption drugs in this area. Nevertheless, the dissection images showed the poor subcutaneous vascularization of superficial cervicoauricular muscle surrounding area, making this site more favorable for the administration of long-acting substances.

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Improving diagnostic specimen management systems in an oral medicine department

BMJ Open Quality ◽

10.1136/bmjoq-2020-000926 ◽

2020 ◽

Vol 9 (3) ◽

pp. e000926

Author(s):

Olivia Barratt ◽

Melanie Simms ◽

Miriam John ◽

Michael Lewis ◽

Phil Atkin

Keyword(s):

Quality Improvement ◽

Positive Impact ◽

Cost Effective ◽

Clinical Findings ◽

Management Systems ◽

Oral Medicine ◽

Medicine Department ◽

Test Management ◽

Sustained Reduction ◽

Specimen Management

Histological, haematological and microbiological investigations are essential in the field of oral medicine and are a crucial adjunct to clinical findings, often being relied on to obtain a definitive diagnosis. Importantly, in some cases, these investigations can help exclude or confirm the presence of malignancy. This project highlighted some problems regarding labelling and recording of specimens in an oral medicine department and a lack of clear specimen management processes. It aimed to improve specimen management by reducing reported incidents surrounding diagnostic tests. Quality improvement methods such as process mapping were key to understanding the journey of specimens and the departments involved at each stage of the system. Initiatives included a recording log book, staff training, information signage around the clinic and delegation of responsibilities, all of which were implemented over multiple plan, do, study, act (PDSA) cycles. The project was extremely successful and since implementation there has been a clear and sustained reduction in reported incidents. The small number of incidents which did occur all involved transportation of specimens and none involved labelling or recording. One can conclude that the change in test management systems in terms of recording and labelling of specimens in the department has been sustained. Ongoing engagement with stakeholders and senior leaders is the priority to ensure further reduction in incidents in the future and that the improvements are maintained. This project demonstrates how simple, realistic, cost-effective, quality improvement initiatives can have a significant positive impact on patient care and hospital management systems.

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