Pathology Puts Focus on Clinical Mission

UC’s pathology department has long been known for its research strengths, with robust programs in infectious diseases, lipid biology and cardiovascular disease. Now leaders within the unit are now focused on rebuilding its clinical component, the majority of which has been contracted out for more than 15 years.

Fred Lucas, MD, associate professor and vice chair of clinical services, has been working with a team of pathology faculty and staff, as well as hospital administrators, to restore pathology’s clinical services within UC Health University Hospital.

Since the mid-1990s, much of these services within the hospital have been outsourced to area laboratories. But in July, all of anatomic pathology was brought back in-house, and efforts are under way to bring all pathology services in the clinical lab back within the hospital.

On-site pathology services make sense for physicians, researchers, and most importantly, patients, says Lucas, as having these capabilities in-house makes for quicker turnaround.
 
"Just last Thursday afternoon I received two breast biopsies and was able to process them by 10 a.m. the next day,” he says. "Our old system of sending biopsies out to be processed would have meant the physician and patient would have had to wait the weekend to get test results.”

The speedier turnaround holds true for histology, immuno-histology and cytology samples, because these tests once sent out to other labs can now be kept in the hospital and evaluated on current platforms.

Imperative for Training

Lucas says a more patient-focused pathology unit also benefits trainees. In fact, he says, "Having clinical pathology services on site is imperative for training residents.

"It’s fantastic for residents. They learn how slides are made—from specimen to block to slide—and are able to then learn how to interpret results.”

And perhaps just as important, Lucas adds, "They learn what it means to manage these resources. They have direct exposure to issues with managing a laboratory.”

"The interaction with the laboratory personnel is very important because it gives the pathology resident a real-life experience that books cannot teach,” says Nella Cristina Fernandez-Reggentin, MD, chief resident in pathology.

"When we spend time at the bench we observe the flow of the specimens from the moment they are received; we get to see the troubleshooting of different instruments and we learn about the turnaround time for different tests.”

Fernandez-Reggentin says another important aspect of training has to do with the awareness residents gain of the regulations that standardize the practice of laboratory medicine, and of their responsibility to comply with those standards to guarantee a quality service to patients.

"Having all of these opportunities in house, gives us a better perspective of the dimension of our role as medical director of the clinical laboratory.”

What’s Next

Lucas stresses that pathology isn’t simply trying to recover the services it is currently capable of supporting. The department is also working to add services and equipment to provide an even broader range of capabilities for patient care and research.

The third floor of University Hospital’s Laboratory Medicine Building is currently under construction and pathology will take possession of this area later in the fall. A microbiology lab will fill this space and the department is working to add in-house molecular testing for hospital-wide infections like Clostridium difficile (C. diff), flu and methicillin-resistant staphylococcus aureus (MRSA).

Pathology also plans to add volatile chemical testing, a benefit to the emergency department, which is under intense time pressure to quickly evaluate patient conditions and make the correct decisions with regard to treatment.

A newly redesigned pathology website launched Aug. 3 at http://pathology.uc.edu/.