Educational Goals and Objectives
The goals an All PGY levels have the same goals and objectives. However the expectation for the resident’s performance increases as they gain experience and we will monitor this with our statistical program.
The objectives of the management rotation are to prepare and enable residents to:
- Demonstrate a commitment to developing management skills and reviewing and improving these to improve practice patterns.
- Explain management techniques and theories and the ability to utilize the literature.
- Communicate effectively in verbal and written form with their clinical colleagues, administrative, technical, and clerical personnel.
- Discuss the policies and regulations affecting health care (i.e., CAP accreditation, HIPAA, compliance to Medicare and billing regulations, etc.)
Although there is no formal rotation for Clinical Laboratory Management, the resident rotating on Clinical Chemistry is expected to assume the responsibilities of the Director and Associate Director with supervision. This is typically the second or third rotation for the resident in Chemistry. All laboratory calls and problems are directed to the pathology resident first. All decisions are discussed with the attending pathologist. By assuming this responsibility, the resident is exposed to cost containment, capital equipment purchasing, budget issues, personnel problems and clinical calls from patients with questions and/or complaints. When appropriate, the pathology resident is also included in legal issues involving the laboratory.
Each year, the laboratory is CAP inspected. Every other year it is formally by an outside inspection team and on the opposite years, it is performed by the laboratory personnel. The residents in pathology are expected to perform the inspection of the laboratory, reviewing each requirement with the Technical Specialist, Manager or Director. The residents are also offered the opportunity to inspect other laboratories when invited by the CAP.
A Clinical Laboratory Management series of 6 lectures is now formally presented by the Medical Director and Associate Medical Director of the Clinical Laboratory. A list of topics is included. These lectures are presented, sometimes with a project for the residents to work through, at one of the Thursday noon conferences each month. An example of one with a project is Capital Equipment Purchase: This module included an introductory lecture from the Medical Director and then the residents were given four RFPs to review and decide on a purchase. At the completion (one month later) the management conference was conducted with discussion of the decision and why it was made.
Pathology residents are also expected to review proficiency testing and results. Also, the residents participate in the introduction of new testing, the validation process and the final preparation with notices to the clinicians and any formal training necessary. Residents are expected to answer questions resulting from new and old testing, particularly from the reference laboratory clients.
Residents also participate in Quality Assurance activities, are expected to attend the monthly QA meeting and are encouraged to attend Performance Improvement sessions. In addition, the residents are encouraged to accompany the attending pathologist on visits to other facilities where Medical Directorship is provided. During this time, the resident is exposed to the operations of a community hospital and the pathology activities required.
On each rotation, the residents are instructed in the use of computer information systems that track specimens, provide results and assist in quality assurance. Residents are also instructed in and frequently perform on-line literature searches. In addition to textbook reading, residents are expected to locate recent articles and reviews on their assigned cases. Daily, residents use computer systems to assist them in tracking their assigned cases. The residents use the Laboratory Information System (Misys) and the Hospital Information System Medsite) to research historical data on patients and identify cases with a similar diagnosis for group study. These systems are also used for billing and CPT code functions. The LIS is utilized by the residents to track specimens and record test results in both a manual and an automated manner. Other information on patients, ie: Radiology reports, dictated H & Ps can be obtained through the HIS and is used to help the resident arrive at a working diagnosis when combined with clinical laboratory testing results.