Critical Values最新文献

{"title":"Choosing Wisely Champions Spark Innovation in Health Care","authors":"S. Montgomery","doi":"10.1093/CRIVAL/VAW026","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW026","url":null,"abstract":"![Graphic][1] \u0000\u0000\u0000\u0000Unnecessary and wasteful practices in medicine continue to burden an already strained healthcare system. The current healthcare climate, however, provides pathologists and laboratory professionals a remarkable opportunity to lead the way in reducing unnecessary, often harmful testing while improving patient care.\u0000\u0000In collaboration with the American Board of Internal Medicine (ABIM) Foundation, ASCP would like to recognize several individual clinicians, as well as clinician teams, and their commitment to the ABIM Foundation's Choosing Wisely campaign. Since ASCP joined the Choosing Wisely campaign in 2013, many of its members have worked to advance the campaign's ideals, which intend to reduce waste in health care, in part by encouraging clinicians and patients to question which tests are really necessary, in order to decrease test overuse and improve the nation's healthcare system.\u0000\u0000“The Choosing Wisely Champions program recognizes clinicians for their contributions to the campaign, inspires clinicians seeking to implement Choosing Wisely in their own practices, and demonstrates how clinicians are driving change in health care,” says Lee H. Hilborne, MD, MPH, DLM(ASCP)CM, FASCP, chair of the ASCP Effective Test Utilization Subcommittee. “Clinicians can learn from one another by highlighting exemplars.”\u0000\u0000The Choosing Wisely Champions were chosen for advancing Choosing Wisely in their practice, playing a major role in the development of ASCP's recommendations, educating ASCP members about Choosing Wisely , conducting measurement of recommendations, validating research on the importance of recommendations, and demonstrating leadership of a local Choosing Wisely effort.\u0000\u0000Below are the honorees and a synopsis of their achievements.\u0000\u0000### Jason Baron, MD; Anand Dighe, MD; John Branda, MD\u0000\u0000The Division of Laboratory and Molecular Medicine in the Department of Pathology at Massachusetts General Hospital (MGH) hosts a highly active, …\u0000\u0000 [1]: /embed/inline-graphic-1.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127384748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow the Leader: Developing Great Leadership Skills","authors":"A. Kurec","doi":"10.1093/CRIVAL/VAW024","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW024","url":null,"abstract":"Leadership. Scanning the Internet, one finds thousands of articles, blogs, books, and webinars on how to be a leader or, more importantly, how to be a better leader. While each person may define leadership differently, he or she will likely hold a number of concepts in common. Much of what is written is based on practical and logical tactics, yet for many, these fall short of implementation, and thus become a source of failure. Great leaders, however, apply these tactics in conjunction with other innate skills to provide appropriate guidance for themselves and those around them.","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133986158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Technology and Collaboration Move Cancer Diagnostics to the Forefront in Sub‐Saharan Africa","authors":"S. Montgomery","doi":"10.1093/CRIVAL/VAW012","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW012","url":null,"abstract":"ASCP President David N.B. Lewin, MD, FASCP, left, and ASCP CEO E. Blair Holladay, PhD, SCT(ASCP)™, review the first biopsied breast cancer image uploaded from Rwanda.\u0000\u0000\u0000\u0000As African economic development improves, the prevalence of non‐communicable diseases (NCDs) will increase, with cancer at the forefront. NCDs such as cardiovascular disease, cancer, chronic respiratory diseases, and diabetes are often associated with the “globalization of unhealthy lifestyles\" such as unhealthy diets, physical inactivity, exposure to tobacco smoke, or the effects of alcohol.1\u0000\u0000Over the next five years, the annual number of new cancer cases is predicted to increase to 1 million.2 The economic costs associated with cancer—both immediate healthcare costs and loss of productivity—are threatening continued development and prosperity. Deaths from preventable cancers mean catastrophic health expenditures, lower household income, and potential impoverishment. Globally, the World Economic Forum projects that the NCD epidemic will inflict $21.3 trillion in losses in developing countries over the next two decades.3\u0000\u0000Pathology is important for diagnosing and treating cancer, but the countries in Sub‐Saharan Africa lack pathologists and trained laboratory personnel, infrastructure, and adequate opportunities for professional training.\u0000\u0000In October 2015, the American Society for Clinical Pathology (ASCP) and a coalition of partners committed to provide patients in underserved areas of Sub‐Saharan …","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114951175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Changing Workforce Brings New Challenges, Opportunities","authors":"H. C. Sullivan","doi":"10.1093/CRIVAL/VAW017","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW017","url":null,"abstract":"![Graphic][1] \u0000\u0000“For last year's words belong to last year's language And next year's words await another voice .\u0000\u0000And to make an end is to make a beginning!' \u0000\u0000“Little Gidding,” T. S. Eliot\u0000\u0000I am a creature of habit, uncomfortable with the idea of change. As I approach the end of my fellowship, my fellow cohorts, who started training with me five years ago, are all moving on to become practicing pathologists out there in the “real world.” While I am happy for them as they start this new chapter in their lives, I can't help feeling a bit sad to part ways after these years of camaraderie and friend-ship. Though saying goodbye is difficult, finding a job represents the crucial next step in every trainee's career. However, this can be an overwhelming task. I mean, I haven't had to apply for a job since high school, when I submitted an application to the local Ben and Jerry's. Like myself, other residents are just as nervous when it comes to looking for their first job out of training. In fact, when the American Society of Clinical Pathology (ASCP) Resident Council polled residents about issues that matter most, the top three were passing boards, applying for fellowships, …\u0000\u0000 [1]: /embed/inline-graphic-1.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121766171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Quest to be the Best-In-Value Clinical Laboratory","authors":"G. Sharma","doi":"10.1093/crival/vaw018","DOIUrl":"https://doi.org/10.1093/crival/vaw018","url":null,"abstract":"![Graphic][1] \u0000\u0000Our nation's healthcare system is undergoing a massive transformation and reorganization. Along with changing regulations and delivery models, the average patient is more connected to and involved in his or her care, more and more providers are utilizing electronic medical records to coordinate treatment, and insurance companies are leveraging analytical tools to study the pools of subscribers covered.\u0000\u0000Amidst this change, a slow but steady movement towards “smart” and “value‐added” care is underway. Pathologists and clinical laboratory administrators realize that the transactional fee‐for‐service (FFS) model is on the decline, while value‐based care and testing is on the rise. The Department of Pathology and Laboratory Medicine at Henry Ford Health System, Detroit (PALM HFHS) has taken innovative steps in placing and presenting the value proposition of its laboratory services.\u0000\u0000In the traditional healthcare delivery model, patient care is delivered through a physician‐led team. All services are transactional and often delivered in silos (clinic, laboratory, radiology, pharmacy, etc.), as requested by the clinical team. Critics of this model have often termed this “sickcare,” rather than healthcare, as the entire delivery mechanism seems to be focused on treating patients rather than keeping populations healthy.\u0000\u0000![Graphic][2] \u0000\u0000![Graphic][3] \u0000\u0000However, with looming shortfalls in the ability of our nation to fund its burgeoning healthcare costs, recent legislation and healthcare reforms have forced a reconfiguration of this model from an episodic and individualcentric approach to a long‐term and population‐centric approach. The latter is a preventive model of care, where the emphasis is in keeping the patient out of the hospital, and delivering care in the most seamless and cost‐ effective manner.\u0000\u0000This will also help in addressing the shortage in the trained and skilled personnel needed to sustain the existing care model. In the future, providers and hospitals will be reimbursed and incentivized (and penalized) based on multiple quality …\u0000\u0000 [1]: /embed/inline-graphic-1.gif\u0000 [2]: /embed/inline-graphic-2.gif\u0000 [3]: /embed/inline-graphic-3.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131073652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If a Patient's Cancer Is So Advanced, Who Decides Whether to Provide Palliative Care or Aggressively Treat It?","authors":"S. Montgomery","doi":"10.1093/CRIVAL/VAW013","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW013","url":null,"abstract":"![Graphic][1] \u0000\u0000![Graphic][2] \u0000\u0000Aron Rose, MD, is an ophthalmologist specializing in cataract and glaucoma surgery. He has treated patients and been invited to teach worldwide, including in China, Uzbekistan, India, Mongolia, Bhutan, Indonesia, Ghana, Myanmar, Gambia, and Liberia, and is an expert on blindness prevention and treatment in the developing world. The previous director of residency training and an associate clinical professor at the Yale University Schools of Medicine and Nursing, Dr. Rose also lectures regularly at the Yale Multidisciplinary Center for Bioethics.\u0000\u0000![Graphic][3] \u0000\u0000He also chairs the Bioethics Steering Committee of the American Society for Clinical Pathology (ASCP)‐led Partners for Cancer Diagnosis and Treatment in Africa, a Clinton Global Initiative: Commitment to Action that provides patients in underserved areas of Sub‐Saharan Africa access to rapid cancer diagnostics and appropriate care and treatment.\u0000\u0000Annually, approximately 650,000 people develop cancer and about 510,000 cancer deaths occur in Africa due to limited treatment and resources. More than one‐third of cancer deaths in Africa are from cancers that are easily preventable and/or treatable, if detected early. This initiative brings together organizations with the expertise necessary to diagnose cancer earlier and provide appropriate treatment, as well as establish a sustainable laboratory infrastructure to address these issues in the future.\u0000\u0000By leveraging leapfrog technology, and the skills and experience of ASCP members, clinicians in Sub‐Saharan Africa can have access to …\u0000\u0000 [1]: /embed/inline-graphic-1.gif\u0000 [2]: /embed/inline-graphic-2.gif\u0000 [3]: /embed/inline-graphic-3.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126120365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investing in Employees, Investing in the Future","authors":"Rex F. Famitangco","doi":"10.1093/CRIVAL/VAW019","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW019","url":null,"abstract":"![Graphic][1] \u0000\u0000![Graphic][2] \u0000\u0000The medical laboratory workforce plays a vital, yet often overlooked, role in the healthcare system. Medical laboratory professionals aid in detecting and diagnosing disease or pre‐disease states, as well as in monitoring the progress and results of treatment. Much of the healthcare industry thrives on testing and analyzing medical laboratory data; therefore, medical laboratory professionals are in high demand as the medical field continues to increase the use of laboratory testing for early diagnosis, treatment, and prevention of disease.1\u0000\u0000Technologies are ever advancing, and in tandem, laboratories are growing to accommodate new tests and testing methodologies. Breakthrough changes in science and medicine allow laboratories to be on the cutting edge of these medical advancements, and because of this, the industry itself is also growing constantly. Furthermore, the face of health care itself is changing. With the emergence of major legislation such as …\u0000\u0000 [1]: /embed/inline-graphic-1.gif\u0000 [2]: /embed/inline-graphic-2.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130419952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of the Pathology Workforce","authors":"D. Lewin","doi":"10.1093/CRIVAL/VAW015","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW015","url":null,"abstract":"![Graphic][1] \u0000\u0000![Graphic][2] \u0000\u0000As I sit writing this column during Lab Week, I reflect on the difficulties pathology encounters in its workforce, both in the United States and abroad. I have had the opportunity to attend a number of collaborative meetings where we looked at the workforce from a variety of different angles.\u0000\u0000In the US, the most pressing challenge is the impending shortage in the laboratory professional workforce. The 2014 ASCP Vacancy Survey1 reveals increased vacancy rates (compared to 2012 data) in all areas of the laboratory except cytology and cytogenetics. Additionally, it is anticipated that as Baby Boomers retire, the increased number of retirees will further exacerbate the shortage. Unfortunately the capacity to train new laboratory professionals has been in decline, with the closure of a significant number of laboratory technology training programs (leading to a decrease from 593 programs in 1996 …\u0000\u0000 [1]: /embed/inline-graphic-1.gif\u0000 [2]: /embed/inline-graphic-2.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"57 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133203714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Laboratory Professions Are My Next","authors":"Rezvaneh Parsa","doi":"10.1093/CRIVAL/VAW016","DOIUrl":"https://doi.org/10.1093/CRIVAL/VAW016","url":null,"abstract":"![Graphic][1] \u0000\u0000![Graphic][2] \u0000\u0000In 2015, the American Society for Clinical Pathology (ASCP) launched “What's My Next” an interactive campaign to address the workforce shortage in laboratory medicine. An important part of “What's My Next” is the Lab Hero program (formerly known as the Career Ambassador program). Since 2009, the Lab Hero program has put laboratory professionals and pathologists in classrooms across the country to teach students about career opportunities in laboratory medicine. Here, Rezvaneh Parsa talks about her experience in the program .\u0000\u0000My journey to the Lab Hero program began about five years ago, when I was having lunch in the break room of the laboratory where I worked, and I overheard a couple of my histotechnologist colleagues talking about an interesting volunteer opportunity through the Lab Hero program with ASCP. I researched the ASCP website and discovered more about this program, that seemed like a wonderful way to get involved. You can imagine my excitement when I was accepted into the ASCP Lab Hero program for the 20112012 school year.\u0000\u0000After the program's orientation, I thought about ways to spread the word about my career. I sent a round of emails and letters to the principals, counselors, science teachers, and biology department heads at my daughters' schools in Frisco Independent School District in Frisco, Texas. Those messages …\u0000\u0000 [1]: /embed/inline-graphic-1.gif\u0000 [2]: /embed/inline-graphic-2.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122511514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workforce and Technology","authors":"E. Holladay","doi":"10.1093/crival/vaw014","DOIUrl":"https://doi.org/10.1093/crival/vaw014","url":null,"abstract":"![Graphic][1] \u0000\u0000In the past decade, the laboratory has undergone changes so profound that it may appear almost unrecognizable to some today. We as pathologists and laboratory scientists are changing the face of healthcare. The work we do accounts for 70 percent of a patient's medical record, and influences diagnostic procedures and treatments. The many advances in laboratory technology in recent years have streamlined many pathology and laboratory services, and in turn have enabled us to provide better, more precise patient care.\u0000\u0000Some worry that this progress could replace the need for people in the laboratory. But even the most …\u0000\u0000 [1]: /embed/inline-graphic-1.gif","PeriodicalId":384814,"journal":{"name":"Critical Values","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128120769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}