Learning From The Past
While Working On Our
Future
Grand Rounds January 12, 2005
Objectives
• By the end of this interactive presentation, the
attendees will:
– Have gained an understanding of the past and current
challenges of an academic department of pathology
– Be able to contribute to the direction and future
planning of the department
– Become aware of the future challenges and potential
opportunities for London Pathology Laboratories in the
context of Lab Reform
Who Are We?
• A UWO Basic Science
Department with a
graduate program and
heavy teaching
responsibilities within
FMD, Faculty of Health
Sciences and Faculty of
Science
Who Are We?
• A Clinical Department in
the London Hospitals (and
UWO) with a residency
program in Pathology and
other Laboratory Disciplines
and located within the new
Pathology and Laboratory
Medicine Program
The Way We Were
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A strong teaching department
A multi-sited clinical department
A department with a modest research effort
An under-funded and understaffed department, by 1998 we
had
– Budgetary losses of :
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Total FTE lost
3 FTE at UC
1 FTE oral pathology
1 FTE SJHC
3 FTE at Vic
8 FTE
The Way We Were II
• Additional challenges between 1998-2000
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8 departures (FO,IT,MT,IC,DS,SR,DM,RA)
Workload
Compensation
Equipment (microscopes, computers, teaching
equipment)
– 3 very different sites
– Low morale
“The Action Plan”
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Pathology Leadership Team
Working groups : HR, Compensation
Departmental Retreats (3 since 2001)
Advocacy
Search for new opportunities / paradigm
Things Began To Happen
• HR: recruitment of 8 pathologists
(CA,JS,ER,LCA,KFK,MMW,BW,MBM) and
replacement of 1 retirement (MD for GW)
• Opening of new morgue at UC, New Forensic
Pathology Unit contract
• Communications strategies GNB
• Consolidation of clinical sites (with satellites) in
Sept 2002
UC
SSC
SJHC
And Continues…..
• Development of “best practices”
• Development of “team approach”
• Path Net and new pathology module and new
computers
• Workload distribution monitoring
• Audits / QA committee, TAT
• Launching of Tissue Committee
• Modest increase in ergonomic equipment
• Launching of the LPA
• Launching of the LLSG: joint venture (2000)
The Way We Are: Clinical
• After filling an additional FTE with FV, we had 3
departures over the summer/fall of 04
• Aggressive recruitment underway
• Increased efficiencies (ie: gross room)
• 10 new ergonomic scopes (8+2)
• Comprehensive and evolving scheduling
• Similar volumes but increased complexity
The Way We Are: Clinical
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Expanding Forensic effort
Modest increase in lab equipment
Improved clinical teaching facilities
1.6 locums
Consolidated Pathology and Lab Medicine Programs
OCRN
New Manager
The Way We Are: UWO
• Royal College Review of residency programs
• New Medical Curriculum (2001) and expansion of
medical class by 40%
• Expansion of the dental class
• New sections (x3) Path 240A
• Biotech-Pathology for Ivey
• Bachelor of Medical Science program with
• New enviro-pathology course
• New forensic medicine course
• New toxicology-pathology specialization program
The Way We Are: UWO
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The strength in teaching continues (awards)
Biggest and strongest graduate program ever
Master Research Plan
Finance Management Committee/ AFP
Support for resident travel and research
Promotions
1 Fellow, 12 residents,19 Graduate Students
Outstanding
Pressing
Issues:
People
• Human Resources
• Workload
• AFP
Outstanding
Pressing
Issues:
Space
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Land-locked
Residents room
Offices
Satellites
UWO research space
Outstanding Pressing Issues:
Equipment
• Electron Microscope
• Ergonomic scopes
• Capital equipment
Outstanding
Pressing
Issues:
Academic
• UWO base faculty and
staff
• Research space
• Protected time
• Web education
• Image archives
Outstanding
Pressing
Issues:
Regional
• Laboratory Reform
• LHINs
• OMA-MOH
negotiations
Southwest
Regional Map
MOHLTC and LHINs
LHINs
Next Steps
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Departmental Review and review of the Chair
Workload initiative and preparation for AFP
Compensation equalization
Continue to recruit
Satellites, shell-space, other space
Engagement in Regional Process
Lessons I Have Learned
Normal time is different than construction time
A reflection of our mood?
Communication is everything
Knowledge is valuable
Dispersed leadership works
Balance always
Wisdom from the troops
Advocacy
Building alliances
Walk the halls………
Quotes
• History never looks like history when you
are living through it.
– John W. Gardner, quoted by Bill Moyers
US administrator (1912 - )
• Success is the ability to go from one failure
to another with no loss of enthusiasm.
– Sir Winston Churchill
British politician (1874 - 1965)
A special tribute to the
memory of “my dear friend”
David Ohene-Fianko
Thank You