Follow the Leader

November 2, 2017 // SAMC

There’s a lot of truth to the old adage, “seeing is believing.” When you follow in the footsteps of someone doing hands-on work, you find there is more to be learned from observing than telling, as evidenced by our new Follow the Leader program. Whether you’re a mentor or a student, job shadowing is an essential tool for learning and growing in the workplace and provides a critical link between evaluation and success.

The program gives senior leaders a chance to shadow frontline staff members and gain insight into the colleague’s daily work routine. The interaction and learning that happens during the 90-minute observation period creates synergy and builds relationships between administration and frontline staff, paving the way for open, honest communication.

The fourth Follow the Leader session involved President and CEO Nancy Hollingsworth, RN, and Pathology Laboratory Supervisor Andrea Conard, HT(ASCP). Below is a Q&A detailing their experiences:

Nancy Hollingsworth, RN
President and CEO

Tell us about your Follow the Leader experience, what tasks did you observe the colleague perform?
I am thrilled I had the opportunity to see the core activities that happen in our Pathology Lab as Andrea guided me throughout their daily operations. I appreciate her taking the time to walk me through it, as it is certainly a complex area with a lot of equipment, people and content expertise that’s required to make it all cohesively work well. I was impressed with the dedication that Andrea has to leadership and to developing the capabilities of her department. I had the opportunity to attend the Laboratory Services daily huddle where staff shared the daily safety story, gave updates on the situational awareness report (used to make sure everyone is aware of where the volumes are or where the pressure points might be), discussed technology enablement issues, followed by a report-out from each Lab service line to share information as a group regarding the day’s most pertinent tasks and how the activities of the Lab might impact the house and vice versa. Andrea also showed me the information systems that help to support the department’s  workflow like Ventana and NovoPath and what that looks like in terms of the colleague’s daily activities. She then showed me the Gross Room, which is the initial place where patient samples are prepared and serves as a hub for colleagues drop off samples from our proceduralists. While in this room, it was pleasing to hear the healthy interaction between our colleagues, surgeons and pathologists who all recognize it takes a high performing, cohesive team to make sure our patients receive the best care and services possible.

What department-specific topics/concerns did you discuss?
We had a conversation about opportunities to replace some of the antiquated equipment that has an impact on efficiency. Through this discussion, I discovered that we have processors that still use floppy disks! We definitely have an opportunity to update equipment so that we can remain fresh and well-equipped. We also talked about the recent College of American Pathologists Laboratory Accreditation Program (CAP) inspection and how well our Histology and Pathology departments performed. I appreciate the work effort Andrea has done to prepare us for that inspection, because the positive survey results are ultimately a reflection of the capabilities of the department and their applicability of the policies and procedures in place. Our quality assurance processes capture that and demonstrate it as well, but knowing that this happens every single day within the Lab operations is really golden.

What was something you hadn’t known about until this experience?
One thing that stuck out to me was seeing the inter-dependency of the Pathology department and how it impacts the house. I also enjoyed watching the department’s Histologist Rhonda Gamble work with a patient’s sample on a slide. I appreciate the precision that is required to look at it at the cellular level, it is really quite amazing! The tasks our Pathology colleagues perform are technically complex and require a fair amount of art. A notable comment from Rhonda was that they don’t even realize they’re holding their breath because of the precision required to produce a slide that is incredibly important to the patient! I also learned about the connectedness of the different segments between tissue processing and how every step in that sequence supports the next step. But what was most rewarding to witness was that our Pathology colleagues recognize there is a patient at the other end of every sample that is having a profound life experience – I certainly appreciate the care and deliberate attention they pay to producing the best product.

How have you benefited from this experience?
Through this experience, I appreciated getting to know Andrea. Although she is relatively new to our organization, she has really great vision for continuing to support this important area of our Medical Center. I learned a lot and have an even deeper appreciation for the complexity of the work that is done here for the benefit of our patients.

Andrea Conard, HT(ASCP)
Supervisor, Pathology Laboratory

Tell us about your Follow the Leader experience:
It was a very pleasant and profound experience for my colleagues and I. I think it is extremely important for Senior Leadership to see the front end of our operation and what we do on a daily basis. I feel very lucky and proud to be able to present a cohesive team who put all their efforts in achieving the best outcome for our patients. We work very collaboratively with pathologists, clinicians and vendors. Everyone in this environment is our customer. We pride ourselves in treating them all with respect as part of the core values of our institution. 

What department-specific topics and concerns did you discuss?
When we were notified Nancy was going to visit us, we came together to actively think about what to present. We wanted to make sure we had bullet points of interest and importance to discuss. I think we succeeded in doing that. In addition to showing Nancy the daily operations of our department as she has previously mentioned, I also brought to light that we do have very antiquated equipment that needs to be replaced. I am looking forward to getting new instrumentation because dependability and reproducibility of testing will assure optimal patient outcomes. We also discussed productivity and the workflow of our department and our recent successful CAP survey. It is evident that it takes a team effort. Everyone in our department contributes his or her expertise and gels well with other colleagues, which is of most importance.

What do you think people would be most surprised to learn about your department?
Many tasks my colleagues and I perform on a daily basis cannot be captured as a numerical value thus are not accounted for in the monthly productivity statistics. On a monthly basis, the Pathology department receives about 1,000 specimen containers. Those 1,000 specimens then translate to approximately 2,500 tissue blocks and thousands of slides to work up and stain. Not every specimen we receive requires the same investment of labor and time, yet they are all counted as one unit of work when it comes to productivity. On complicated dissections and tumors, we perform Immunohistochemistry (IHC) stains that are FDA approved and are predictive markers influencing the patient’s treatment. This also includes many send-outs for esoteric testing at reference labs. This in turn leads to many phone calls and other types of communication for results and requests from pathologists for additional information that need to be procured from other institutions. So out of those 1,000 patient samples that come through our door, a very large and diverse workload is generated on a monthly basis. New cancer cases have to be staged with the tumor registry and this is where we circle around again to the surgeon to fill out the staging form, and the treatments proceed from there, which references one more connection point that Nancy previously mentioned.

What did you appreciate most about this experience?
It was a rewarding experience validating my colleagues and my own passion for unrelenting pursuit of excellence. In the past 30 years, I’ve made it my ministry to travel the country and enhance the operations of Laboratories. I’ve only had an experience like this at one other institution. There was only one time where it was important enough for a CEO to visit departments and actively observe and see what and who participates. So I thank Nancy and I really appreciate the time she took to visit us!

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