State of the Department 2015 Striving for Excellence

State of the Department 2015 “Striving for Excellence” Department of Pathology and Laboratory Medicine University of Rochester School of Medicine and Dentistry Bruce Smoller, MD, Chair

Clinical Mission • Anatomic Pathology • Clinical Pathology • Affiliated Hospitals

Anatomic Pathology Personnel • New faculty: • Raul Gonzalez – GI Pathology • Abby Lott Limbach – Cytopathology, Head & Neck Pathology • Tamera Paczos – Gynecologic and Perinatal Pathology • Brooke Koltz –Cytopathology (part- time) • Rupal Mehta – Neuropathology, Autopsy

Anatomic Pathology • Personnel • Moved on: • Tony di Sant’Agnese – retired • Faqian Li – moved to Univ. Minnesota • Gabrielle Yeaney – moved to Cleveland Clinic • Wendy Cao - NYU

Surgical Pathology • Subspecialty sign-out • July 1 roll-out • Project realized by Drs. Whitney-Miller, Tang, Schiffhauer with the help of a working group • Also intimately involved were residents: • Diana Agostini-Vulaj • Mike Magguilli • Mary Barrett • Sapna Patel • Sohaib Abut-Farsakh • Laura Baxter (PA)

Surgical Pathology 120000 100000 80000 2012 2013 60000 2014 2015 extrapolated 40000 20000 0 Inpatient specimens Outpatient specimens Total specimens Consults

Cytopathology • Reading Pap smears from Haiti pro bono • Established Web. Cam system for immediate assessments in Cancer Center – hoping to grow this capability • Donna Russell (workshop) and Mike Facik (moderator, Diagnostic Seminar) are presenting at the ASC annual meeting

Clinical Pathology • Personnel • New faculty: • Amy Schmidt – Transfusion Medicine • Bing Zhang – Molecular Cytogenetics – starts 10/1

UR Medicine Labs Outpatient Orders 9

Patient Service Center Visits 10

Phlebotomy Home Draw Service 11

SED Rate Turn Around Time Goal = 90 min 12

Blood Management Program *For first 9 months of program

Blood Bank • Entered into testing agreement with Ortho Diagnostics for evaluating new analyzer to submit to FDA for clearance

Molecular diagnostics • Test volume tripled in past 10 years • 20 tests on 5 platforms • 5 new tests added in 2014 -15 • NEW THIS YEAR: Illumina Mi. Seq. Dx which brings the lab into the arena of Next Generation Sequencing

Cytogenetics Laboratory • Participated in LEAN poster session • Min Guo attended Association of Genetic Technologists annual meeting in Savannah, GA

HLA Laboratory • Worked with Molecular Pathology to implement sequence-based HLA typing • Worked with CLSS to get greatly expanded menu of test results into the Electronic Health Record so that clinicians can directly view them!

Affiliated Hospital Pathology • New faculty • Tamera Paczos

Strong West Billed Lab Tests Initial projection 19

Affiliated Hospital Pathology • Current: • Strong West (Brockport) • St. James (Hornell) • Wyoming • Pending discussions: • Noyes (Dansville) • Jones (Wellsville) • Auburn • Geneva

Affiliated Hospital Pathology • FF Thompson Hospital • Beginning to work with Kirk Heriot and their leadership • Laboratory consolidations • Additional pathology attending support

Research Mission • Extramural funding • Miscellaneous news items • Publications

New grants • Brendan Boyce – R 01 x 4 years • Arch Perkins – R 01 x 4 years • Richard Burack – R 21 x 2 years, Lymphoma Research Foundation grant • Zhenqiang Yao – Breast Cancer Coalition of Rochester grant x 1 year • Lianping Xing – Lymphatic Malformation Institute grant • Victoria Zhang – American Association of Clinical Chemists grant • Rupal Mehta – K 08 x 4 years

Other extramural funding • Andrew Evans – Wilmot fellowship

Research • Biobanking: • Closed down old tissue bank • Established contractual arrangement with Indivumed: • Expenses entirely theirs • Tissue split 50/50 after clearance from surgical pathologist on call • Specimen freezers on site • Tissue available via protocol for all URMC personnel for research

Research Mission • Personnel • Moved on: • John Krolewski – Roswell Park • Kent Nastuiuk – Roswell Park

Research Mission • Publications (very crude estimates): • Original articles: 115 • Chapters: 11 • Books: 1

Education Mission • Medical Technologists • Cytotechnologists • Medical Students • Residents • Fellows • Graduate Students • Faculty

William B. Hawkins Awards Departmental awards given to either Pathology year-out students or to graduating URMC students who emulate Dr. Hawkins’ Excellence in Medicine • Salvatore Priore, MD/Ph. D – Univ. Pennsylvania, Pathology • Daniel Marker, MD/Ph. D – Univ. Pittsburgh, Pathology

Residents Our new additions: • Caroline Bsrini, Univ. Aleppo • Shira Winters, Wake Forest

Residents and Fellows • Fond farewells: • Michael Lunt – private practice, central Illinois • Mary Barrett – URMC, GU fellowship • Moritz Stolla – Brigham & Women’s – transfusion medicine fellowship • Abraham Loo – private practice, hematopathology, Monmouth, NJ • Elizabeth Denby – year off • Asif Shahab – private practice, St. Louis, MO • Amanda Martin- Rochester General Hospital

Incoming Fellows • Amber El-Halaby (Ameripath) – breast pathology • Laura Bratton (Tulane) – GI pathology • Mary Barrett (URMC) – GU pathology

Education • Restructured organizational chart: • Scott Kirkley - Vice Chair for Departmental Education and Director, Residency Program • Linda Schiffhauer – Associate Director, Residency Program • Jennifer Findeis-Hosey – Director, Medical Student Curriculum • Bob Mooney and Lianping Xing – Co-directors, Graduate Student Program

Education • Faculty • Development of mentoring program with monthly monitoring and Chair oversight • (I, too, have a URMC mentor with whom I meet weekly!) • Formal annual faculty evaluations to provide feedback and planning for future

Education • Visiting Speakers: • Elaine Fuchs (Whipple) – Cutaneous stem cells • Thuy Phung – Global Pathology • Dina Mody – Future of Cytopathology • Kate Rittenhouse-Olsen – Immunohistochemical Validation of a Pan-carcinoma Immunotherapeutic • Andrew Feldman - Lymphomas • Mark Boguski – Molecular Diagnostics • Keri Donaldson – Blood banking • Darrell Triulzi – Red blood cell storage

Clinical Trials • Banner year in all ways!!!! • FY 2015 – first profitable year – made $2, 000 profit • FY 2016 – will make > $1, 500, 000 profit!!!!! • Debts to pay down but ultimately will result in an additional revenue stream for the department • Kudos to Dan Ryan for having the foresight and perseverance to make this come to fruition!

Faculty Kudos • Promotions: • Christa Whitney-Miller – Associate Professor • Elected positions: • Ping Tang – President-elect, Chinese American Pathologists Association

Faculty kudos • David Hicks: • Cited in CAP publications for playing a pivotal role in working with ASCO to develop and refine guidelines for standardized breast cancer predictive factors testing • Victoria Zhang: • President of North American Chinese American North American Chemists • Chair, Mass Spec Division of American Association of Clinical Chemists 38

Faculty kudos • Drs. Corsetti, C. Sparks, Ryan, Moss – patented an Outcome Event Mapping tool stratifying high- and low-risk individuals based upon lab data

Faculty kudos • Eric Shenck Award for Teaching Excellence” • Xi Wang, as voted by the residents • Chair’s Recognition Award • Christa Whitney-Miller for extraordinary efforts in developing a subspecialty signout model for surgical pathology 40

Staff kudos • Donna Russell appointed inaugural Director of Cytotech Training Program in conjunction with program at Daemen College and Roswell Park Cancer Institute

Staff kudos First responders to Ebola crisis: • April Ayrhart • Theresa Hart • Crystal Baggatta • Elizabeth Jackson • Allan Courtright • Marjorie Madej • Morgan Daniel • Patrick Paulot • Mike Enfonde • Suzette Zientarski • Geoffrey Harris

Staff kudos • For rapid response in getting together the Containment Laboratory: • Ila Marianetti • Mark Sage • Nancy Simpson • Dave Niggli • Bonnie Mc. Gorty • Donna Gaglio • Sue Daley • Nathan Loria • Diane Bullock • Chuong Ta • Bob Miller • Melissa Allen • Debra Jesien • Vicki Roberts • Vicki Vandewalle • Stasia Ortu

Staff kudos LEAN certificate winners: • Katrina Blaszyk - QA & Safety Coordinator • Deborah Congdon - AP QA Specialist • Holly Harrington-Smock - Supervisor • Illa Marianetti - Operations Coordinator • Scott Musial – Operations Coordinator • Maimoona Ramaswamy – Quality Systems Manager • Vicki Van. De. Walle – LEAN/Project Manager

Staff kudos • Quality Division • Maimoona Ramaswamy, Quality Systems Manager presented at a local ASQ (American Society for Quality) chapter meeting in February. • Her topic: the Quality Journey at URMC Labs 45

Staff kudos LEAN training completion: • Kelly French • Liz Jackson • Melissa Sullivan

Staff kudos Strong Stars: • April Ayrhart (2) • Noel Krzesinski (2) • John Patamisi (2) • Melissa Sullivan (2) • Coleen Harvey • Priscilla Mc. Daniel • Anita Parkhurst • Patrick Reilly • Ky Tran • Jan Vecchio • Jim Vilone

Staff kudos • Vicki Van. De. Walle received Six Sigma/Black Belt certification • 24 projects underway • Lab/Peds Team won silver medal at Greater Rochester Quality Consortium for reducing re-draws on pediatric patients from 1. 6% to 0. 20% • Lab Ops team saved $78, 000 in specimen handling time and reduced TAT for urine specimens • Phlebotomy team reduced collection errors (re-draws) from 13% to 2% • Cytology Team saved $69, 000 and improved TAT by 70% (less than 4 days now)

Staff kudos • Lynne Deng: MBA in Medical Management • Nathan Loria: MS in Healthcare Leadership and Management from UR School of Nursing

Staff kudos ICARE Bronze Medal Awards Brian Antoniak Donna Gaglio Julie Marini Cassandra Taylor Benjamin Johannes Janice Van. Dyne Steven Vandewalle Anne Meade Elizabeth Lawliss Stacy Mariano Mary Romano Robyn Searley Vicki Van. De. Walle Holly Smock Jennifer Barrante Todd Barnes Valerie Woodring Roger Van Horn Judy Jurewicz Omkar Potnis Ila Marianetti Kay King Scott Musial

National Medical Laboratory Professionals Week April 20 -24 • Daily Puzzle Contests • Lab Coat Decoration Contest (congrats to Blood Bank) • ICARE in Action Contest • Gift day – infusion bottles • Quality Day Presentation • Bagel Day • Breakfast Day

CAP Inspectors • Led by Elizabeth Peterdy and Ping Tang, URMC Pathology and Laboratory Medicine travelled to Pittsburg to perform a CAP inspection

URMC volunteer activities • Medical Career Day at SUNY Brockport: • Bradley Turner • Amanda Martin • Diana Agostini-Vulaj • Sachica Cheris “Having the opportunity to speak to those who have been through medical school and are now resident pathologists was very exciting for me. It was a once in a lifetime opportunity. . . They gave us a look behind the curtain. . . “

Global Outreach • Haiti – 40 pap smears reviewed pro bono • I cannot thank you enough for reading these paps for this patient population. It helps me "bring" more volunteers to Haiti to provide life saving expertise. Once I have the results of the paps, I will forward them on to the staff GYN doctor who has the ability to do colposcopy and biopsies. The biopsies should be able to be read by the brand new pathologist that has just joined the hospital staff. The staff has the ability to do cryotherapy if indicated. • Thanks again! • Catherine Cantwell • Jennifer Griggs – URMC Alum – spoke with URMC Pathology about contributing cytopathology services to Haiti – much interest and many plans for upcoming year – Jerome Jean-Gilles, perhaps others • Ethiopia – Dr. Hodes – pro bono AP services for bone and soft tissue tumors – Xi Wang, David Hicks and others involved

Global Outreach • Vietnam – multiple lectures, designing program for Viet Derm telepathology (Bruce Smoller) • Maimoona Ramaswamy signed on to help with laboratory improvement in conjunction with histotechnologists from Baylor College of Medicine • Kenya – Xi Wang returned from trip there with proposal to provide prolonged rotations for pathologists in Kenya to study pathology in our department 55

Physical Plant • Move 40 K square feet of laboratory activities to Bailey Road – hopefully by March 2016 (phase 1) • All of Clinical Trials and much outpatient testing that is currently based at Ridgeland Road • Consolidation of Molecular Genetics program including labs from SMH and from Ridgeland to move in phase one • Floor plans drawn and sign off on by all Medical Directors with the help of support staff

Physical Plant • Phase II (possibly to be combined into a single phase): • Involves moving many labs to expanded Bailey Road facility • Microbiology • Portions of cytopathology • Portions of surgical Pathology • Mass Spectrometry • Probably will begin construction spring 2016 and may take a year • Plans and drawings already in progress

Pathology and Laboratory Medicine Financials-May_2015 FY 2015 BUDGET Revenue SMH $ 324, 798, 716 PRACTICE PLAN $ 10, 417, 250 CLINICAL TRIALS $ 3, 025, 000 SMD $ 593, 400 TOTAL $ 338, 834, 366 Expenses YEAR-TO-DATE ACTUAL MAY_2015 $ 309, 518, 812 $ 467, 650 $ 9, 308, 255 $ 219, 200 $ 3, 749, 392 $ 593, 400 $ 244, 983, 466 $ 2, 805, 800 $ 9, 949, 600 Revenue $ 79, 815, 250 Margin $ - $ 543, 950 $ 93, 164, 050 $ 245, 670, 316 Expenses $ 76, 717, 344 323, 120, 409 $ 232, 801, 468 $ 7, 945, 379 $ 1, 362, 876 $ 2, 414, 688 $ 1, 334, 704 $ 704, 742 $ Margin $ (160, 792) $ 87, 782, 153 $ 235, 338, 256 62

Philanthropy • Developed quarterly newsletter to build sense of community • Plans for URMC Pathology reception at 2016 USCAP • Visiting with URMC Pathology alumni • Faculty members who contributed in 2014 -15: • Neil Blumberg • Dan and Charlotte Ryan • John Bennett

Philanthropic Goals • To develop an endowed Chair • To develop an Endowed Professorship (Education) • To develop a program for sustained funding for resident research and travel • To develop an endowed lecture series to support several outside speakers each year • To name the new Pathology Building (the holy grail!)

Thank you to all for a terrific year Let’s achieve even more this upcoming year!!!!!! “Striving for Excellence”

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