Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment –...

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ANATOMIC PATHOLOGY ANATOMIC PATHOLOGY Faculty Meeting, August 10, 2009 Faculty Meeting, August 10, 2009 FY2009: Successes, Opportunities & Challenges

Transcript of Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment –...

Page 1: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

FY2009:Successes, Opportunities &

Challenges

Page 2: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

FY2009:Successes, Opportunities &

ChallengesDISCLAIMER

high level overviewdata accuracy dictated by available systems

inherent risk of operator error

Page 3: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

Our PlayersOur Patients

ResearchEducation

Safety, Quality & InnovationFY2010 Goals

Page 4: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our PlayersOur Players

LostLostRobert Ruiz

Mohammad Yousef

Page 5: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our PlayersOur Players

LostLost GainedGainedRobert Ruiz Mohammad Yousef

Mohammad Yousef Xin JingStewart Knoepp

[Raja Rabah][Michael Roh][Angela Wu]

Jeff HodginRaj Patel

Mike Caplan

Page 6: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Work Our Work -- RVUsRVUs

5.0%

0

45,000

90,000

135,000

180,000

FY05 FY06 FY07 FY08 FY09

Tota

l RVU

s

0%

3%

6%

9%

12%

% A

nnua

l Inc

reas

e

Annual Growth Rate 5.0%Annual Growth Rate 5.0%(37.6% in 5 years)(37.6% in 5 years)

Page 7: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Work Our Work -- RVUsRVUs

Total RVUs Expressed as 12 month Rolling Average, FY2002 - FY2009

7,500

8,500

9,500

10,500

11,500

12,500

13,500

Jun-01Dec-0

1Jun-02

Dec-02

Jun-03Dec-0

3Jun-04

Dec-04

Jun-05Dec-0

5Jun-06

Dec-06

Jun-07Dec-0

7Jun-08

Dec-08

Jun-09

Tota

l RVU

s/m

onth

12,829 RVUs/month

7,780 RVUs/month, Jun-01

13,465 RVUs/month

Total RVUs Expressed as 12 month Rolling Average, FY2002 - FY2009

7,500

8,500

9,500

10,500

11,500

12,500

13,500

Jun-01Dec-0

1Jun-02

Dec-02

Jun-03Dec-0

3Jun-04

Dec-04

Jun-05Dec-0

5Jun-06

Dec-06

Jun-07Dec-0

7Jun-08

Dec-08

Jun-09

Tota

l RVU

s/m

onth

12,829 RVUs/month

7,780 RVUs/month, Jun-01

13,465 RVUs/month

Annual Growth Rate 5.0%Annual Growth Rate 5.0%(37.7% in 5 years)(37.7% in 5 years)

Page 8: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Players & Our Work Our Players & Our Work –– “Productivity”“Productivity”

RVUs per Clinical FTE (12 month rolling average)

400

450

500

550

600

Jul-01Jan-02

Jul-02Jan-03

Jul-03Jan-04

Jul-04Jan-05

Jul-05Jan-06

Jul-06Jan-07

Jul-07Jan-08

Jul-08Jan-09

RVU

s/FT

E/m

onth

437 JUN08

497 JUN09

Annual Increase 13.7%Annual Increase 13.7%(0.4% in 5 years)(0.4% in 5 years)

495 JUN04

Page 9: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Recruitment Recruitment –– JAN06 thru AUG09JAN06 thru AUG09

IncrementalIncremental ReplacementReplacementDan Visscher Jeffrey MyersJon McHugh Xin JingJeff Jentzen Stewart Knoepp

Angela Wu

Jeff Hodgin Steve OlsenRaj Patel Michael Roh

Mike Caplan Raja Rabah

Page 10: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Recruitment Recruitment –– JAN06 thru AUG09JAN06 thru AUG09

Breast pathology 1Cytopathology 3Dermatopathology 2Forensic pathology 1GU pathology 1Head & neck pathology 1Pediatric pathology 2Pulmonary pathology 1Renal pathology 1Surgical pathology 4

Page 11: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Recruitment Recruitment –– JAN06 thru AUG09JAN06 thru AUG09

Breast pathology 1Cytopathology 3Dermatopathology 2Forensic pathology 1GU pathology 1Head & neck pathology 1Pediatric pathology 2Pulmonary pathology 1Renal pathology 1Surgical pathology 4

4 subspecialties accounted for greatest number of new hiresnew hires (+ neuropath) and unfilled unfilled positionspositions (+ cardiac path) in 2005 APC survey

Page 12: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

0

4

8

12

16

surgpath

cyto-path

heme-path

derm peds GI &liver

GYN renal breast neuro-path

pulm GU0%

20%

40%

60%

80%

100%*

*

* **

67%

Recruited to• 4 of the 5 subspecialties for which there was the

greatest demand based on survey of journal† ads (OCT-DEC07) for 66 academic positions

†AJSP, AJCP, APLM, HP, MP

Page 13: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

0

4

8

12

16

surgpath

cyto-path

heme-path

derm peds GI &liver

GYN renal breast neuro-path

pulm GU0%

20%

40%

60%

80%

100%*

*

* *** * * *

Recruited to• 4 of the 5 subspecialties for which there was the

greatest demand based on survey of journal† ads (OCT-DEC07) for 66 academic positions

• 8 of 12 specified subspecialties

†AJSP, AJCP, APLM, HP, MP

Page 14: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

We continue to recruit the best and the

brightest to keep pace with clinical demand.

Page 15: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

Our PlayersOur Patients

Page 16: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

66,883 68,295 69,991 72,280

80,120

0

20,000

40,000

60,000

80,000

2005 2006 2007 2008 2009

Tota

l Cas

es

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

Ann

ual G

row

th R

ate

Annual Growth Rate 10.8%Annual Growth Rate 10.8%(24.2% in 5 years)(24.2% in 5 years)

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients -- CasesCases

Page 17: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY08FY08 FY09FY09 % change% changeinsideinside 51,763

6,3615,8818,275

72,280

56,391 8.9%

MLabsMLabs 7,829 23.1%transfertransfer 7,633 29.8%

consultsconsults 8,267 (0.1%)TOTALTOTAL 80,120 10.8%

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients -- CasesCases

8,267

7,829

7,633

56,391 insideMLabstransferconsults

inside + transfers=

80% of cases

Page 18: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– Surgical Surgical

PathologyPathology

FY08FY08 FY09FY09increase increase

(decrease)(decrease) % change% changebreastbreast 2,147 2,492 345 16.1%

GIGI 15,672 16,199 527 3.4%GUGU 2,261 2,233 (28) (1.2%)

GYNGYN 5,680 5,690 10 0.2%PedsPeds 1,562 1,562

36,98336,983(66%)(66%)

Room 1Room 1 9,372 8,807 (565) (6.0%)

Page 19: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY ANATOMIC PATHOLOGY 20092009

Our Patients Our Patients –– Pediatric Pediatric PathologyPathology

112

138 142

108122

136 131

106

147132

155

133

0

40

80

120

160

Jul-08Aug-08

Sep-08Oct-08

Nov-08Dec-08

Jan-09Feb-09

Mar-09Apr-09

May-09Jun-09

# of

Cas

es p

er M

onth

0

1

2

3

4

Mea

n TA

T (d

ays)

# of cases TAT (days)

Raja Rabah, DirectorMike Caplan Dave LucasJon McHugh Jeff Myers

Raj Shah Dan Visscher

Page 20: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY08FY08 FY09FY09increase increase

(decrease)(decrease) % change% changebreastbreast 2,147 2,492 345 16.1%

GIGI 15,672 16,199 527 3.4%GUGU 2,261 2,233 (28) (1.2%)

GYNGYN 5,680 5,690 10 0.2%PedsPeds 1,562 1,562

Room 1Room 1 9,372 8,807 (565) (6.0%)PedsPeds + + RmRm 11 9,372 10,369 997 10.6%

ANATOMIC ANATOMIC PATHOLOGY 2009PATHOLOGY 2009

Our Patients Our Patients –– Surgical Surgical PathologyPathology

Page 21: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY08FY08 FY09FY09increaseincrease

(decrease)(decrease) % change% changeIDID 11,744 13,551 1,807 15.4%

MDMD 4,936 6,519 1,583 32.1%TDTD 1,952 2,019 67 3.4%DPDP 2,856 2,274 (582) (20.4%)

TOTALTOTAL 21,488 24,363 2,875 13.4%13.4%

ANATOMIC ANATOMIC PATHOLOGY 2009PATHOLOGY 2009

Our Patients Our Patients --DermatopathologyDermatopathology

Page 22: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients -- NeuropathologyNeuropathology

FY08 FY09increase

(decrease)%

changeNFNF 679 719 40 5.9%IBIB 206 205 (1) (0.5%)

MMMM 171 174 3 1.8%ConsultsConsults 149 137 (12) (8.1%)

TOTAL NPTOTAL NP 1354 1372 18 1.3%

Growth in surgical neuropathologyGrowth in surgical neuropathology

Page 23: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY08FY08 FY09FY09increaseincrease

(decrease)(decrease) % change% change

renalrenal 666 656 (10) (1.5%)

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– Renal PathologyRenal Pathology

Renal Biopsy Service, FY06-FY09 (12 mo rolling avge)

0

20

40

60

80

100

Jul-05Jan-06

Jul-06Jan-07

Jul-07Jan-08

Jul-08Jan-09

Cas

es p

er m

onth

Page 24: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Placenta (Pl) Cases, FY05 - FY09

Avg=110.5

UCL=194.4

LCL=26.7

-50

0

50

100

150

200

250

Jul-04 Jan-05 Jul-05 Jan-06 Jul-06 Jan-07 Jul-07 Jan-08 Jul-08 Jan-09

Cas

es p

er m

onth

FY2008FY2008 FY2009FY2009increaseincrease

(decrease)(decrease) % change% change

PlacentasPlacentas 1,255 1,212 (43) (3.4%)

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– PlacentasPlacentas

placenta practice relatively stable!placenta practice relatively stable!

Page 25: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Seeking volunteers!Seeking volunteers!Seeking volunteers!

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– PlacentasPlacentas

Page 26: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY08FY08 FY09FY09 % change% changeinsideinside 51,763

6,3615,8818,275

72,280

56,391 8.9%

MLabsMLabs 7,829 23.1%transfertransfer 7,633 29.8%

consultsconsults 8,267 (0.1%)TOTALTOTAL 80,120 10.8%

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our PatientsOur Patients

MLabs + consults=

20% of cases

8,267

7,829

7,633

56,391 insideMLabstransferconsults

Page 27: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– Consultation CasesConsultation Cases

5,6576,083

7,361

8,275 8267

-0.1%

0

3,000

6,000

9,000

2005 2006 2007 2008 2009-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

46.1% increase(FY2005 - FY2009)

Page 28: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– Consultation CasesConsultation Cases

Avg=513.4

UCL=649.4

LCL=377.4

89

189

289

389

489

589

689

Jan-06 Jul-06 Jan-07 Jul-07 Jan-08 Jul-08 Jan-09

Cas

es p

er m

onth

FY07FY07 FY08FY08 FY09FY09

% change, FY07% change, FY07--FY09FY09

4,188 4,865 5,821annual % changeannual % change 16.2% 19.7%

39.0%

Consultation cases transcribed in UH office suite continue to be area of active growth!

Consultation cases transcribed in UH office suite continue to be area of active growth!

Page 29: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– CytologyCytology

FY08FY08 FY09FY09increaseincrease

(decrease)(decrease) %change%changeTOTALTOTAL 54,659 52,565 (2,094)

(2,214)4179

(44)122

1

(3.8%)GynGyn TotalTotal 43,119 40,905 (5.1%)NonNon--GynGyn 9,204 9,245 0.5%ASPASP 2,336 2,415 3.3%

ASP 1†ASP 2‡ASP 3

1,029945362

9851,067363

(4.3%)12.9%0.3%

†assisted FNAs‡pathologist performed FNAs (Cancer Center)

Page 30: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– Autopsy & ForensicsAutopsy & Forensics

293269 249

297 292

-1.7%

0

100

200

300

FY05 FY06 FY07 FY08 FY09

Auto

psie

s pe

r ye

ar

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%

Ann

ual %

Cha

nge

Washtenaw Washtenaw CtyCty ME cases = 94 (32%)ME cases = 94 (32%)

Page 31: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY2010 FY2010 –– full integration of full integration of WCMEWCME

Page 32: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Our Patients Our Patients –– Autopsy & ForensicsAutopsy & Forensics

23.0%

19.0%

23.0%

21.0%

19.0%

0

50

100

150

200

250

300

FY05 FY06 FY07 FY08 FY09

Aut

opsi

es p

er y

ear

15%

20%

25%

UH A

utop

sy R

ateUH autopsy rates declining

FY2010 goal to increase

Page 33: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Our practice is growing and changing (i.e. it’s

about more than just the numbers!).

Page 34: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

Our PlayersOur Patients

Research

Page 35: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009ResearchResearch

15

13

15

13

0

2

4

6

8

10

12

14

16

Peer-reviewed publicationsAbstractsChapters

Doug Fullen

Tom Giordano Celina Kleer

Rajal Shah

Page 36: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009ResearchResearch

Fiscal YearFiscal Year % change% change20072007 20082008 20092009 FY08FY08--0909

(7.5%)

10.8%

(5.4%)

(18.9%)

FY07FY07--0909peerpeer--

reviewed reviewed publicationspublications

159 186 172 8.2%

abstractsabstracts 77 83 92 19.5%

lectureslectures 93 129 122 31.2%

edit edit bdsbds 26 37 30 15.4%

Page 37: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

> $1.3 million increase≈ 3.9 FTEs in recovered effort

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– FundingFunding

$4,457,606 $4,374,470

$3,018,472$3,258,603

$4,579,223

$0

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

FY2005 FY2006 FY2007 FY2008 FY2009

Direct IndirectTotal

Page 38: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– FundingFunding

FYFY # projects# projects # faculty# faculty awardsawards20072007 13 8 $ 92,12820082008 6 5 $ 28,36020092009 4 4 $ 11,800

TOTALTOTAL $132,288

FY2010: increase utilization of project funds

Page 39: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Promotion (September 2008)Thomas Giordano – ProfessorAndrew Lieberman – Associate Professor

Assoc American Physicians – Kathy ChoAm Soc Clin Invest – Andy Lieberman

Senior Editor, Cancer Research – Kathy ChoAssociate Editor, Lab Invest – Kathy Cho &

Kent Johnson

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– Academic RecognitionAcademic Recognition

Page 40: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Promotion (September 2008)Thomas Giordano – ProfessorAndrew Lieberman – Associate Professor

Assoc American Physicians – Kathy ChoAm Soc Clin Invest – Andy Lieberman

Senior Editor, Cancer Research – Kathy ChoAssociate Editor, Lab Invest – Kathy Cho &

Kent Johnson

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– Academic RecognitionAcademic Recognition

Page 41: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Promotion (September 2008)Thomas Giordano – ProfessorAndrew Lieberman – Associate Professor

Assoc American Physicians – Kathy ChoAm Soc Clin Invest – Andy Lieberman

Senior Editor, Cancer Research – Kathy ChoAssociate Editor, Lab Invest – Kathy Cho &

Kent Johnson

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– Academic RecognitionAcademic Recognition

Page 42: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC ANATOMIC PATHOLOGY 2009PATHOLOGY 2009

Research Research –– VisibilityVisibility

President, ASCPBarbara McKennaPresident, ASCPBarbara McKenna

Page 43: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– VisibilityVisibility

NAMEPresident (2008) & Chair of Bd (2009)

Jeff Jentzen

NAMEPresident (2008) & Chair of Bd (2009)

Jeff Jentzen

Page 44: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

29 abstractsproffered papers (4 moderators)

3 short courses (faculty)3 companion societies (speakers,

moderator)2 evening specialty conference

(speaker, panelist)

17 faculty9 residents6 fellows

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– VisibilityVisibility

Page 45: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

America’s Best Doctors/Top Physicians

Joel Greenson

Lori Lowe

Rajal Shah

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Research Research –– VisibilityVisibility

Page 46: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

We remain academically productive and are nationally and internationally visible.

Page 47: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

Our PlayersOur Patients

ResearchEducation

Page 48: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

14 AP faculty M1/M2 lectures

≈ 50 hours4 faculty M4 clerkship mentors

ANATOMIC PATHOLOGY ANATOMIC PATHOLOGY 20092009

Education Education –– UMMSUMMS24 AP faculty in M1 and/or M2 laboratories

≈ 386 contact hours

Page 49: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Department Graduate SchoolKathy Cho, Dave Gordon, Tom Giordano, Celina Kleer, Andrew Lieberman, Peter Lucas

postdoctoral fellowshipsresidencyAP fellowships

breast, cytopath, derm, GI, GU, pulmonary, surg path

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Education Education –– Graduate & PostgraduateGraduate & Postgraduate

Page 50: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Elizabeth C. Crosby AwardAndy Flint

Token of Appreciation from Medical Students (TAMS)

Andy FlintDave GordonSteve Ramsburgh

House Officer Teaching AwardSteve Olsen

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Education Education –– RecognitionRecognition

Galens Medical Society to,“a faculty member for

outstanding teaching of medical students in a basic

science area.”

GalensGalens Medical SocietyMedical Society to,“a faculty member for

outstanding teaching of medical students in a basic

science area.”

Page 51: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Elizabeth C. Crosby AwardAndy Flint

Token of Appreciation from Medical Students (TAMS)

Andy FlintDave GordonSteve Ramsburgh

House Officer Teaching AwardSteve Olsen

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Education Education –– RecognitionRecognition

Student Council for,“their significant

contributions to the success of students during their medical

school years.”

Student CouncilStudent Council for,“their significant

contributions to the success of students during their medical

school years.”

Page 52: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Elizabeth C. Crosby AwardAndy Flint

Token of Appreciation from Medical Students (TAMS)

Andy FlintDave GordonSteve Ramsburgh

House Officer Teaching AwardSteve Olsen

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Education Education –– RecognitionRecognition

Page 53: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY ANATOMIC PATHOLOGY 20092009

Education Education –– CMECME25 AP and departmental faculty

2 guest speakers21 case presentations8 breakout sessions3 plenary lectures

web based registrationvirtual microscopy

slide/audio capture of presentationspublication of proceedings

Page 54: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

“Great venue. Case presentation works well. I liked the length of the

meeting- 2.5 days in about right. I will definitely consider attending again!”

“UM Chief Resident is very friendly, generous, and hospitable (a quality guy).”

“The lectures were rapid fire- great-

hope the handouts have the salient

points.”

“It is well organized, practical topics discussed, and the

hand out printed material is superb. Keep it going.”

“Excellent content and quality of the info and staff.”

“Excellent timing of breaks between talks, organization and format; did not

feel the conference ‘dragged on’.”

“The breakout sessions allowed for a comfortable

environment for interaction between staff and

attendees.”

Page 55: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic
Page 56: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic
Page 57: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

We are successful educators measured

across a broad range of students and target

audiences.

Page 58: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFaculty Meeting, August 10, 2009Faculty Meeting, August 10, 2009

Our PlayersOur Patients

ResearchEducation

Safety, Quality & Innovation

Page 59: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

Just-in-Time Built-in-Quality

QU

AN

TITY

QU

ALITY

MPQS

• Error Proof• Surface Problems• Stop and Respond

to Abnormalities• Solve Problems

at Root Cause

• Pacing by Demand• Continuous Flow• Pull Systems

Make Value Flow By Eliminating Errors and WasteSTA

BIL

ITY

MQS Methods (All Mission) Sources: J Shook J Billi J Liker S Hoeft Park-Nicollet /jmk 04 09 07

LeveledWorkload

Continuous Improvement(P-D-C-A) and Learning

StandardizedWork

Michigan Pathology Quality SystemQuality – Safety – Efficiency – Service – Satisfaction

CustomerDefines Value

Work Force- Skilled, Capable, Flexible- Engaged, Motivated- Design Work, Solve Problems

Technology and Equipment- Reliable, Tested- Serve People and Processes- Preventive Maintenance -TPM

Materials- Materials Readiness- Supplier involvement

Methods- Robust Processes- Organized Workplace (5S)- Visual Control

Page 60: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009Safety & QualitySafety & Quality

Page 61: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

AP OPS DASHBOARD7/17/09

Equipment Requests

Request # Item(s) Notes

1 Cassette labelers Problem log being maintained. Working on concrete implementation date.

2 Cytyc Imager Cytology Director and Supervisor to establish new ROI for consideration.

3 Processor Equipment ordered 6/24/09. Arrival date will be communicated.

Innovation Projects

Project # Name Notes

Michigan Slide Trays

Delivery of 7,000 trays to arrived July 15th. Market Lab photo shoot of product occurred 6/3/09 for cover of July catalog. Operational plan to remove current slide trays to go live July 20th.

Suncoast Software Some initial view graphs completed and under review. Bi-

weekly meetings began 4/30/09.

1WinscribeDigital Dictation

Stored procedure protocol sent to WinScribe 4/13/09. Development began 4/28/2009. Validation of script complete. GYN service selected for extended pilot from gross to sign-out.

2 Slide Tracking Tool

Presented at AP Ops 1/9/09. Modifications presented 1/23/09. Pilot to begin after presentation.

3 Online P&Ps

1

2

P&Ps implementation team being formed to assist AP Division laboratories enter and link to CAP checklists.

Project Management

Project # Name Notes

4 Automated slide sorter

Prototype has been created. Adjustments being made. Progress will be updated at future AP Ops meetings.

Sent to Campus construction services to determine project timeline. RFP and contractor selection to occur in about three weeks.

Processor & recycling room2

Updated AP Ops 9/12/08 re: progress. Specific issues being addressed to move recommendations forward.LARP4

Construction began 5/4/09. Punch-list walk through July 16th. Minor alterations to be performed. Equipment delivery scheduled for July 20th and 21st. Activation planned for July 27th. PA search continues. Meet with SON surgeons July 15th. Incremental histotech position posted and offer made. Operational task force began 6/12 to develop activation plan.

EAA frozen section4

Walk-in refrigerator/freezer installed. Possible complications to delay its use. Open-house scheduled for July 22nd. Activation date of July 23rd.

Morgue3

Sent to Campus construction services to determine project timeline. RFP and contractor selection to occur in about three weeks.

Grossing Room1

NotesNameProject #

Facilities Projects

Additional hardware installed. Pilot ongoing.5S Gyn Sign-out 5

Final flowchart solution presented at January Thoracic Faculty meeting. Solution supported.

CVC frozen sections3

Final Phase 2 clean-up has been completed. Phase 3 to begin soon.5S AP asset areas2

Sent to Campus construction services to determine project timeline. RFP and contractor selection to occur in about three weeks.

Blockbusters1

NotesNameProject #

Lean Projects

Page 62: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

TOTAL OT HOURS FY '06-'09AP DIVISION

Avg=528.3

UCL=918.7

LCL=137.9

-69.6

130.4

330.4

530.4

730.4

930.4

Jul-0

5Se

p-05

Nov-0

5Ja

n-06

Mar

-06

May

-06

Jul-0

6Se

p-06

Nov-0

6Ja

n-07

Mar

-07

May

-07

Jul-0

7Se

p-07

Nov-0

7Ja

n-08

Mar

-08

May

-08

Jul-0

8Se

p-08

Nov-0

8Ja

n-09

Mar

-09

May

-09

OT

HOUR

S

Anatomic Path Hospital Expense By Month

$0$100,000$200,000$300,000$400,000$500,000$600,000

Jul-05Sep -05Nov-05Jan-0 6Mar-0

6May-06

Jul-06Sep -06Nov-06Jan-0 7Mar-0

7May-07

Jul-07Sep -07Nov-07Jan-0 8Mar-0

8May-08

Jul-08Sep -08Nov-08Jan-0 9Mar-0

9May-09

Salaries and Wages Supplies Total Expense Linear (Total Expense)

Anatomic Path Hospital Expense per RVU By Month

$15

$20

$25

$30

$35

$40

$45

Jul-0

5Sep

-05Nov

-05Ja

n-06

Mar-06

May-06

Jul-0

6Sep

-06Nov

-06Ja

n-07

Mar-07

May-07

Jul-0

7Sep

-07Nov

-07Ja

n-08

Mar-08

May-08

Jul-0

8Sep

-08Nov

-08Ja

n-09

Mar-09

May-09

Controllable Cost per RVU

Anatomic Path Hospital Expense per CDM By Month

$10

$15

$20

$25

$30

$35

Jul-0

5Sep

-05Nov

-05Ja

n-06

Mar-06

May-06

Jul-0

6Sep

-06Nov

-06Ja

n-07

Mar-07

May-07

Jul-0

7Sep

-07Nov

-07Ja

n-08

Mar-08

May-08

Jul-0

8Sep

-08Nov

-08Ja

n-09

Mar-09

May-09

Controllable Cost per CDM

AP OPS DASHBOARD7/17/09

Page 63: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic
Page 64: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGY 2009ANATOMIC PATHOLOGY 2009InnovationInnovation

“old” innovation

“new” innovation

Page 65: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

We are passionately committed to safety and

continuous improvement with an eye toward innovative

solutions.

Page 66: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

. . . a place that everyone, everywhere

imagines when considering excellence in academic anatomic

pathology.

Page 67: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFY2010 GoalsFY2010 Goals

implement EAA frozen section practice

EAA Planning GroupJulie Jorns Celina Kleer

Craig Newman Christine RigneyTiffany Vail Dan Visscher*

Misty Wideman Angela Wu

Page 68: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

ANATOMIC PATHOLOGYANATOMIC PATHOLOGYFY2010 GoalsFY2010 Goals

implement EAA frozen section practiceidentify and contract for new LIS

integrate UH autopsy and WCME servicesprogram plan for new location (TBD)

reformat quarterly QA/Lean meetings with broader staff/faculty participation

A. James French visiting professorshipannual AP research day

Page 69: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

FY2010 GoalsFY2010 GoalsAP Research Day AP Research Day –– A ProposalA Proposal

WHY: spawn new ideas and foster collaboration for research projectsWHEN: 3rd Saturday in JanuaryWHERE: ??? (Alumni Center, BSRB, Palmer Commons, Campus Inn, . . . ?)TENTATIVE PROGRAM08:30 – 10:00 am poster session

two categories: posters recycled from national/international meetingsAP funded projects

10:00 – 10:30 am BREAK10:30 – 12:30 pm platform presentations

12:30 – 1:30 pm LUNCH1:30 – 2:30 pm Keynote speaker

Internationally/nationally recognized figure in anatomic and/or molecular pathology to present cutting edge observations of practical diagnostic value

2:00 pm ADJOURN

Page 70: Anatomic Pathology Faculty Meeting · Surgical pathology 4. ANATOMIC PATHOLOGY 2009 Recruitment – JAN06 thru AUG09 Breast pathology 1 Cytopathology 3 Dermatopathology 2 Forensic

CONGRATULATIONSCONGRATULATIONSandand

THANK YOU!THANK YOU!