Interfaces for pathology leaders 2016

Interfaces for Pathology Leaders AP Residents’ Management Mini-Series

Sandip SenGupta, MD January 27, 2016

Overview of this Session• Competencies of the “Involved Pathologist”• Interfacing with Clinicians• Interfacing with the Medical Staff• Interfacing with Hospital Administration• Interfacing with the Laboratory Staff• Interfacing with the Pathology Group• Interfaces beyond the Hospital• Strategies for Improving Interfaces

General Competencies for Pathologists

• Patient Care• Medical Knowledge• Practice‐Based Learning and Improvement• Interpersonal and Communication Skills• Professionalism• Systems‐Based Practice


• Patient Care– Compassionate– Appropriate– Effective for the promotion of health, prevention

of illness, treatment of health problems, and care at the end of life.


• Medical Knowledge– Of established and evolving biomedical, clinical,

epidemiologic, and social‐behavioural sciences– Application of this knowledge to patient care and

the education of others


• Practice‐Based Learning and Improvement– Review and evaluate one’s patient care and

laboratory practices– Appraise and assimilate scientific evidence– Continuously improve patient care and laboratory

practices by constant self‐evaluation and life‐long learning

– Demonstrate the skills and develop habits necessary to achieve goals for themselves and their laboratories.


• Interpersonal and Communication Skills– That enable them to establish and maintain

professional relationships with patients, patients’ families, and other members of the health care

teams


• Professionalism– behaviour that reflects a commitment to

continuous professional development and ethical practice

– An understanding and sensitivity to the diversity of the patient population

– A responsible attitude towards their patients, their profession, and society.


• Systems‐Based Practice– Demonstrate an awareness and responsiveness to

the larger context and system of health care– Able to call effectively on other resources in the

system to provide optimal health care

Interfacing with Clinicians• Pathologists need to understand and respect

clinicians’

perspectives, which are often different!

– eg. more concerned with patients’

reactions to their diseases than the scientific basis of the diseases

– Clinicians are more “psychological”, and less “molecular”

• Handle questions with empathy and humility– Staging the communication as one between

colleagues

“Triple A”

Concept• Accuracy• Availability

– Open‐door policy– Reply to all queries promptly

• Affability– Attend medical staff social and administrative functions

Richard J. Hausner, MDHouston

Interfacing with the Medical Staff• Interact daily with other health care professionals. • Provide clinical knowledge, eg. “curbside

consultations”• Volunteer for medical staff committees

– Eg. Infection Control, Transfusion– Utilization review, peer review, outcomes research – Medical staff social events

• Complaint management– “Thank you for bringing this to my attention”

• Conflict resolution

Interfacing with Hospital Administration • Reporting structure: CEO, CMO, COO, CNO, CIO (or President, Vice

Presidents)• Awareness of critical economic and regulatory issues facing hospitals• Understand what administration expects:

– Only the bottom line? Clinician complaints?– Do they value excellence and the science that pathology brings to the

hospital?

• Meetings with VP, at least monthly, to discuss:– Workload and productivity statistics– Budget and financial performance– Human resource issues– Professional accomplishments (eg. awards, results of inspections, complaints,

incidents)

– New or emerging plans for the institution• Chief Nursing Officer : identifying whether lab services are satisfactory• Chief Information Officer: LIS, automation, interfaces, etc.

Interfacing with the Laboratory Staff• Most important interface due to dependencies.• Understand the categories of technical and

managerial personnel: MLA, MLT, senior & charge MLT’s, manager.

• Ph.D. Laboratory Scientists: clinical biochemists, microbiologists, cytogeneticist …

• Hierarchical organizational charts (functional structure)

Interfacing with the Pathology Group• The professional practice group provides the framework for

one’s professional, financial, and emotional satisfaction, or discontent.

• Group members: pathology peers, doctoral scientists• Prime prerequisites for group success:

– Excellent Pathologists– Respect for one another – Leaders and followers who are comfortable in their

respective roles. – All members are good communicators.

Other Prerequisites for Pathology Group Success

• A formal organizational plan describing domains, authority, reporting relationships

• A designated director with a written job description for all members

• A formal decision‐making process that defines directorship, hierarchies, domain leadership, development of P&P

• A formal, written mechanism for preparing budgets, establishing salary schedule, monitoring contracts

• A shared sense of participation in group decision making• Consistency and fairness in group operations. • Consensus on mission statements and strategic plan

Interfaces Beyond the Hospital • University appointment for intellectual

pursuits: teaching, research• Involvement in medical professional

organizations: OAP, OMA, CAP, etc.• Extramural: Royal College, CCO, grant review

panels, • Fundraising activities –

community

involvement

Strategies for Improving Interfaces • Come out from behind the “black box”

(VISIBILITY!)

• Become more involved in clinical care: eg. interpretation of test results for clinicians

• Participate in multidisciplinary teams (eg. tumour boards, collaborative care plans)

• Provide continuing medical education (eg. rounds, seminars, workshops)

• Don’t be afraid to directly identify with the patient.

Health & Medicine

Interfaces for pathology leaders 2016