The one-month rotation consists of a structured curriculum in laboratory and health care management, presented as a one-month required rotation during the last half of the fourth year. All PGY-4 residents attend as a group, and fellows in other pathology department programs, such as Cytopathology, are allowed to attend sessions of interest to them. The small group size provides a flexible format and offers a more interactive experience between the faculty and the residents than would be possible with a larger group.
An important feature of the program is that the sessions are presented by senior leaders, instructors, and experts from throughout the medical center, including pathology faculty, hospital laboratory administration, and leaders from the hospital and medical school. The format is intentionally diverse and includes lectures, discussion groups, site visits, and assigned tasks with follow-up review.
The subject matter is presented in sessions that include an overview and selective analysis of relevant federal and state regulations, performance standards, accrediting agencies and organizations, risk management, human relations, interpersonal relations and leadership, health and safety standards, information management, QA/QI systems and methods, billing and coding, budget processes, capital equipment, laboratory design, bench-marking, point-of care testing, reference and referral lab testing, outreach and network systems, and strategic planning.
Goals and Objectives
Using small group sessions and senior institutional leaders, the rotation will provide the residents with basic knowledge of laboratory management within the context of health care delivery in a variety of systems. Topics include:
- regulatory standards
- accreditation oversight and organizations
- inspection and certification
- QA/QI benchmarking tools such as Six Sigma, LEAN, and FMEA
- safety requirements
- risk management
- liability and malpractice
- professional credentialing
- pathologist contracts in academia, private practice and industry
- billing and coding
- HR and benefits
- supervision and leadership skills
- selection and validation of laboratory information systems
- outreach, networks and centralized lab service models
- budgeting and capital equipment
- staffing models
- managed care
- automation in chemistry, hematology, microbiology, blood bank
- basic IS networks and telecommunications
- point of care testing
- reflex, reference and referral testing
At the beginning of each session, instructors are expected to provide a list of the objectives specific to their presentation or activity.
- Complete online CAP inspector training
- Attend all sessions.
- Participate in interactive lectures and site visits.
- Complete and pass any examinations.
- R. A. McPherson, M. R. Pincus (eds). Henry’s Clinical Diagnosis and Management by Laboratory Methods. (2007), chapters 1-12. [recommended]
- Handouts provided by individual instructors.
Supplementary materials are provided by individual instructors as handouts, web links and slide presentations.
Residents are evaluated based on attendance at scheduled activities, level of participation during interactive sessions and performance on examinations. Exams include those administered individually by the presenting faculty and the nationally administered RISE exam.
The program is evaluated by the following methods:
- At the end of the rotation, the residents complete an online comprehensive critique of the program and of the individual faculty presentations.
- The residents are interviewed as a group by the director at the final session of the rotation to provide feedback and recommendations.
- The rotation faculty are asked to provide feedback and specific recommendations.
- The pathology department Residency Committee reviews the program for changes.
- The RISE exam is reviewed for content elements and for the performance of the residents in each of the four years.
Milestones: Laboratory Management
- SBP2: Lab Management: Regulatory and compliance: Explains, recognizes, summarizes, and is able to apply regulatory and compliance issues (AP/CP)
- SBP3: Lab Management: Resource Utilization (personnel and finance): Explains, recognizes, summarizes, and is able to apply resource utilization (AP/CP)
- SBP4: Lab Management: Quality, risk management, and laboratory safety: Explains, recognizes, summarizes, and is able to apply quality improvement, risk management and safety issues (AP/CP)
- SBP5: Lab Management: Test utilization: Explains, recognizes, summarizes, and is able to apply test utilization (AP/CP)
- SBP6: Lab Management: Technology assessment: Explains, recognizes, summarizes, and is able to apply technology assessment (AP/CP)