My first rotation in pathology was at a smaller community hospital; one of the pathologists there used to say, “If you aren’t at the table, you’re on the menu.” I’m not sure the source of this quote, but his point was good pathologists are involved with different committees in the hospital system, not only to contribute to the well-being of the institution, but to let them know how the laboratory could be of assistance, or if the items they were discussing were not feasible from the laboratory standpoint. This also ensured that any decisions made did not negatively affect the laboratory.
When I started working as a pathologist, it felt like before I could even put my bag down the microbiology coordinator was introducing me to the infection control nurse, whom requested I be a part of the infection control committee. My original plan had been to ease into my position and not over-commit myself, rather just observe the first year and then decide where I could best be utilized and dedicate my focus outside the lab. However, I figured infection control would be a great place to talk microbiology so I went to the meeting and was added to the members list that day. The involvement in this committee has led to some great relationships and changes in our labs. The infection control staff had a difficult time with our C. difficile assay since it was performed as a batch test, leaving their patients in isolation for up to 24 hours after submitting specimens. By attending these meetings I was able to see how the lab could implement a change and we brought in a different assay that had random access for C. difficile. This helped improve patient care, and strengthened the relationship between infection control staff and the laboratory. Since that time, I have gotten involved in a couple of other in-house committees on an ad-hoc basis. The involvement has allowed me to actively participate in other areas of the hospital and make connections with staff and physicians to see how the lab can best serve our patients.
In addition to the in-house committees, I was asked to participate in corporate laboratory service group that includes members of each corporate affiliate in our system. This committee discusses laboratory issues that affect the corporate system as a whole and has a sub-committee for test utilization. This committee was very active in laboratory utilization and gave me great information and a strong foundation to start from on how our own institute could implement some of these standards. For instance, there was a drive to remove sedimentation rates from most order sets and replace with CRP. This topic gave me a purpose to interact with other clinicians within our institution and talk about how these changes will affect lab results, ultimately the care of their patients, and get everyone on the same page.
While my year of ease and observation did not become a reality, the mentor I had in medical school’s advice did. Being involved with these committees has really shown me that by being at the table as a laboratory representative, we have a voice for how issues will affect patient care.
How about you – what has been the best committee you have gotten involved with? How are you sitting at the table? I look forward to hearing how others have been the voice for the laboratory.
-Lori Racsa, DO, is the director of microbiology, immunology, and chemistry at Unity Point Health Methodist, and a Clinical Assistant Professor at the University Of Illinois College Of Medicine at Peoria. While microbiology is her passion, has a keen interest in getting the laboratory involved as a key component of an interdisciplinary patient care team.
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