Management and Informatics
Duration: One month
Rotation Director(s): Mandy O'Leary, MD, MPH
Paul Steele, MD
Description of Rotation
In this rotation, the resident experiences a broad spectrum of applied Laboratory Management and Informatics (M&I) issues relevant to the practice of pathology and laboratory medicine. The resident is expected to acquire administrative and leadership skills through individual instruction, formal lectures, interaction with staff and faculty, problem evaluation and resolution and/or assigned projects.
All rotations have some underlying M&I component embedded. The resident is encouraged to glean administrative experiences while on other rotations and use them to delve more in-depth during the M&I rotation.
The ultimate goal of this rotation is to prepare the resident to function as a director or partner in a pathology practice by augmenting the medical knowledge with current principles and practices of effective pathology laboratory administration.
Listed below are some relevant topics which help to achieve stated goals and objectives.
Management (Practice Administration)
- Motivation and Leadership (organization, communication and conflict resolution).
- Personnel Administration (staff selection, job description, scheduling, training, competency, proficiency, retention, appraisal constructive discipline and labor relations).
- Laboratory Operation (test menu, method/instrument evaluation and selection, procedure manual [formulation, review, approvals], inventory control, preventive maintenance and QC/QA/QI/PI).
- Specimen processing: from intake to completed report.
- Accrediting and Regulatory Compliance Administration (CAP, CLIA Licensing, JCAHO, CLSI [Clinical and Laboratory Standards Institute, formerly NCCLS], OSHA, CMS, FDA, HIPAA).
- Financial Management (budgeting, cost accounting, decision support, CPT [test coding], LMIP, reimbursement and fee schedule).
- Risk Management (liabilities, witnessing, records, HIPAA, ABN).
- Project Management, Process Control and Request for Proposal.
- Safety standards in laboratory practice and Mission Continuity.
- Laboratory Design and upgrades.
- Marketing Strategies; money matters and outsourcing
- Legal Services
- Use media resources available within the department and in the Medical Sciences Library, UC Health and Quest Diagnostic.
- Computer peripherals, networking and application services.
- Instrument interface, clinical data organization management, validation and analysis.
- Rules-based software for controlling repetitive and interpretive tasks and for determining errors in automated analyzers.
- Bar coding applications.
- Ethical and legal considerations concerning privacy and confidentiality of clinical data (HIPAA).
- Laboratory Information System (LIS) Horizon/Pathways and Impath/Powerpath) and its interface with the Hospital Information System (HIS).
- Data tracking, storage, mining and analysis.
- Critical Pathways Design (Algorithms).
- Benchmarking (Data analysis and control).
- Synoptic manual for the pathologists
Technology Assessment of emerging/evolving applications in Pathology and Laboratory Medicine – Opportunities for Projects.
- Lab Automation Systems and Workcells (Robotics and Information Technology)
- Point of Care Testing (POCT); Connectivity POCT equipment
- Clinical Trials
- Specimen Banking and Repository Technology
- Direct order entry (electronic test request design)
- Virtual Laboratory
- Technical and educational media evaluation
- Medical Heritage
- Preventive care
- Direct Access Testing
- PDA (personal digital assistant)
- Change Dynamics: Six Sigma and LEAN Metrics
The resident is expected to achieve a level of competence consistent with training and experience in the general business activities of a pathology practice and in the regulatory compliance governing standards of practice. Specific objectives listed below are linked to competency assessment found in Section VII.
- Describe the process to obtain a CLIA License.
- List CLIA test complexity categories.
- Define the College of American Pathologists Laboratory Accreditation Program.
- Differentiate the roles of CMS, CLIA, FDA, DOT, IATA, FDA, JCAHO, CAP, ASCP, OSHA and NCCLS in the practice of Pathology.
- Review the CAP General Checklist (standards and scoring guidelines) and at least the checklist of a laboratory or section for which the resident has completed a rotation.
- Conduct an interim (self-inspection) of a laboratory.
- Participate in a formal on-site CAP inspection, when possible.
- Review relevant Joint Commission standards and scoring guidelines for laboratory services. Attend a billing and coding session to enhance competency in CPT, ICD-9 and SNOMED coding. Understand what components make up the professional and technical of the charge. Distinguish between HIS, LIS, and other supporting Information Technology Systems utilized in Pathology.
- Attend Media Resource Sessions in the Department or the Medical Sciences Library and enhance ability to use appropriate presentation software, data management and Internet navigation.
- Review laboratory management exercises/study cases.
- Compare and contrast two separate laboratory experiences in terms of organization and operation, compliance, communication and data management, finance and safety.
- Conduct safety audit of a laboratory.
- Take the Environmental Health and Safety Blood borne Pathogens training online at http://www.researchtraining.uc.edu/catalog/type.cfm. Click on OSHA, take the CAP On-line training for lab inspections and retrieve certificate.
- Take online training course for Laboratory Safety Practice at http://www.medtraining.org
- Review compliance with Chemical Hygiene Plan. Print out certificate showing you have taken the online training for formaldehyde, DOT/IATA shipping/packaging.
- Recognize common warning labels and construct an NFPA label for a typical lab.
- Attend CAP Virtual Management College audio conferences.
The resident is assigned to various areas (some off-site) affiliated with the department and shadows key faculty, administrative, supervisory and/or technical specialists.
The resident will be evaluated through daily interaction with the faculty. At the end of rotation, the resident is expected to submit documents of completed assignments and may also prepare a written report on a special project or take a quiz consistent with level of training.