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Laboratory Medicine and the Kuwait Cancer Control Centre

February 27, 2015
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madlab_1

Did you know that regularly team members from the Laboratory Medicine Program travel to the Kuwait Cancer Control Centre (KCCC) and work in their laboratory, alongside our partners in Kuwait, and help out with projects such as quality improvement, policy and methodology changes and providing ideas and recommendations for change, improvements and growth.

We spoke with Scott MacDonald, Yasas Dissanayake and Dr. Ivan Blasutig who recently returned from a visit (Feb 6 – Feb 20, 2015) to tell us about their experience and what it was like working with the laboratory team at KCCC.

Why did you go?

Scott: As the Charge Technologist for Cytopathology at UHN LMP I was asked to help support the cytology lab at the Kuwait Cancer Control Center (KCCC).

Yasas: I went to the Histology lab and helped them to implement new methodologies, update their procedures and further helped them to prepare for the upcoming CAP inspection.

Ivan: I was there because the Kuwaiti reference imunology laboratory recently moved to the KCCC. This lab specializes in autoimmune and allergy testing and performs testing for the entire country. They joined the KCCC approximately six months ago and were not yet visited by anyone from UHN.

What was the experience like?

Scott: The travel part, the flights, hotel, meals were all very nice and Kuwait City has some interesting things to see such as the Grand Mosque and the old souk (market).  One of the best parts is interacting with other visit team members; it is really impressive to see level of expertise that these teams from UHN represented, it made me proud to be part of it.

Yasas: I had an incredible experience. I got to experience the dynamic of another Histology Lab from a different part of the world.

What is the team at KCCC like?

Scott: The lab staff at KCCC were friendly and accepting as they are generally keen to learn and improve their lab, like lab techs everywhere they want to do a good job to help take care of their patients.

Yasas: The Lab staff was welcoming, and they were willing to learn. They appreciated our help and were willing to do what was necessary to reach the standard that the UHN holds itself to.

What sort of work did you do?

Scott: The main objectives were to complete a mock accreditation visit and performance review of the cytology lab at KCCC and to follow up on recommendations from previous visits, all of which we accomplished.

Picture2In addition we went through the process to validate some new equipment and reagents, did some experiments for method development and moved along quite a few QA initiatives that they need to implement for lab accreditation.  Overall, I think it was a productive visit.  Jailan, the Senior Technologist for the KCCC Cytology lab, put in some long hours while I was there.

Yasas: I worked with the Histology Lab staff and helped them to improve their methodologies and procedures and further worked with them to implement new procedures and safety measures which subsequently will help them to prepare for the CAP inspection.

Ivan: I was there as an expert consultant to review their processes, procedures, assays and testing algorithms and provide recommendations for improvement. Additionally, I was there to perform a CAP assessment of both the Immunology and Biochemistry laboratories. In terms of value, I was able to provide them with a peer review of their testing practices as well as a perspective on total quality assurance from a CAP accredited immunology laboratory.

Picture1Why do you think this type of partnership is important?

Scott: I’ll leave the business part to someone more qualified.  I will say that with the cytotechnologists and pathologists we have, the support we receive, and with the leadership of Dr. Boerner I think we have a world class cytology lab at UHN.  Although the partnerships may involve more work for us (and of course we get more support in return), patients will benefit if we are either providing the cytopathology service or helping in that regard.

Yasas: I think this type of partnership is important to us because it exposes us to how patient care varies in different areas of the world and whether we are up to par. It also exposed how we can help our co-workers across the world to make sure that everyone is operating at the same level of excellence.

When do you go last time? How was this different?

Scott: I had been to Kuwait twice in 2012 and since that time the cytology lab at KCCC has improved a lot.  They have undergone hospital accreditation by Accreditation Canada, so there we requirements the lab had to meet for that.  Their Quality Management program has advanced a great deal from where it was.  A great majority or the recommendations from the earlier visits have been addressed and of course it takes time and really is a never-ending process.  We didn’t get to where we are at UHN overnight.

Anything else?

Scott: Yes, the partnership teams at UHN and in Kuwait do a tremendous job facilitating the visits.  Visitors needn’t concern themselves with very much besides doing the job they came to do.  The UHN team members in Kuwait are great hosts so I’d like to say “Thanks”!

Yasas: I want to mention about the UHN team in KCC, they were the most encouraging and supportive team and they took care of everything so we did not have to worry about anything. We only had to focus on our work.

 

LMP’s Dr. Lili-Naz Hazrati: One of the Toronto Star’s Torontonians to Watch in 2015

January 8, 2015
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lilinaz1Recently. LMP’s Dr. Lili-Naz Hazrati was named one of “10 Torontonians to Watch in 2015” by the Toronto Star.

Called a “sleuth in the world of neurological disease,” Dr. Hazrati’s recognition focuses on her work as a neuropathologist working to “untangle the mysteries of brain deterioration.” The article speaks to Dr. Hazrati’s work that focuses on Alzheimer’s disease and concussions suffered during athletics that lead to Chronic Traumatic Encephalopathy (CTE), through the Canadian Sports Concussion Project.    Read more…

2014 Lab Leadership Awards

October 31, 2014
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Every year, the Laboratory Medicine Program presents the Lab Leadership Award to three members of our LMP team in formal recognition of the leadership they have demonstrated over the past year.

“Leadership can mean many different things in laboratory medicine,” explained Michele Henry, Senior Director, LMP, who presented the three recipients with their awards. “We have roles for ‘official’ leaders, but what makes these three winners worthy is that they demonstrate leadership in their everyday work.”

Staff are nominated by their colleagues and coworkers explaining at length why the nominee  was worthy of being recognized as a leader in LMP.

Our three winners for the 2014 Lab Leadership Awards are Wes Morrison, Jennifer Hardaker and Anselmo Fabros. Read more…

Dr. Rasmus Kiehl and the Gerry & Nancy Pencer Brain Trust Art Show

October 24, 2014
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art showOn Friday, October 24th, the Gerry & Nancy Pencer Brain Trust on the 18th floor of the Princess Margaret Cancer Centre, held an Art Show to showcase some of the art of the patients, volunteers and clinicians of the clinic.

LMP’s Dr. Rasmus Kiehl, one of our neuropathologists, showcased several pieces of his art in the show. Many of his pieces hang in the halls of Toronto General Hospital., on the 11th floor, outside the Anatomic Pathology lab. Dr. KIehl uses microscopic images to create “compositional microscopy art.” He uses digital microscopy images to re-create an existing famous work of art, with many of the topics in his artwork centred around brain tumours.

art show2Also, included in the art show was a piece by  Dr. Catherine Maurice, who is a neurologist currently doing a neuro-oncology fellowship at PMH and will soon be on staff at the Pencer Cancer Centre. Here she is in front of her oil painting “A Field Of Cortex” that she painted for the Pathology Department and that will be on permanent display here, in LMP, in the near future.

Text from the booklet for that painting:
“The cerebral cortex is organized in 6 distinctive layers, each of them having a specific function. The painting represents a garden composed of different types of flowers representing each cell population. It is a concrete painting with special attention to Neurology.”

LMP and OSMT: An Interview with Karim Bhaloo

September 26, 2014
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KarimLast week, Karim Bhaloo, MLT in our cytogenetics laboratory, was named Vice-President of the Ontario Society of Medical Technologists (OSMT) and Chair of the MLA/T Examination Committee during the recent OSMT conference in Kingston, ON. The editorial team of The Pathology Report recently had a chance to sit down with Karim and talk to him about the OSMT, his new role and why he encourages other laboratory professionals to get involved.

Congratulations on being names Vice-President of OSMT. What are some things you are looking forward to in this new role?

Thank you. The biggest thing I’m looking forward to as Vice-President of OSMT is interacting with various stakeholders, internal and external to OSMT, in order to advance the interests of our profession and members. I am also looking forward to enhancing my leadership and communication skills as a leader in the industry.

Why is being involved with OSMT important to you?

Being involved with the OSMT is important, and should be important to all MLTs and MLA/Ts, because they are the advocate for the profession before the College, they provide leadership opportunities, are part of many stakeholder groups, and provide value added benefits such as educational courses, conferences, and professional liability insurance required by our regulatory body to name a few.

How did you first get involved with OSMT?

In the late 1980’s I wrote my OSMT certification exam as part of my MLA/T education process and worked as an MLA/T at a private laboratory. After further education, I became an MLT and contributed an article on the RHPA for the ADVOCATE magazine.

A little over four years ago, I decided to put my name forward to be the District Director (5) representing Toronto and over that time period, I have been the Chair of the conference committee that was held in Niagara Falls and chaired the Editorial Committee. Even now, as Vice-President, I will continue to be a member of the Editorial Committee and contribute an article whenever time permits.

What are some ways that OSMT helps other MLA/Ts?

The OSMT helps MLA/Ts by administering the certification exam required by many employers, provide leadership opportunities by participating in various committees, keeping its members current and informed about the profession, and providing value added benefits.

What can others do who want to get involved?

Those interested in getting involved can either contact myself or the OSMT office and express their wish to volunteer. Members can serve on various committees such as the conference committee that will be organized soon for next year’s conference.

Changing the Way We Measure Pathologist Workload

September 19, 2014
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abacusPersonalized Medicine has been changing the way pathologists work. The volume of work, along with the type of work, has been changing in ways that would have been unimaginable before the incredible growth of complex informational parameters obtained from morphologic, proteomic and genomic analyses . This means that the way pathologists have been measuring and tracking their time and workload has needed to change in order to accurately capture the new ways that they have been working.

Dr. Carol Cheung, pathologist in LMP, has developed a new model, published in Modern Pathology, to capture pathologist workload that leaves behind previous methods based on counting specimens and samples, and rather looks at the whole picture and measures all the different activities of today’s pathologists.

“In the past the workload of a pathologist was manually assigned different values based on the type of specimen” said Dr. Cheung. “However, in today’s world, the same specimen types may require differing amounts of work.  Our new method captures individual components of our work regardless of specimen or tissue type. ”

The new model, called Automatable Activity-Based Approach to Complexity Unity Scoring (AABACUS) captures pathologists’ clinical activities accessed from Laboratory Information Systems (LIS), including specimen acquisition, handling, analysis, and reporting.

“All data used by AABACUS are captured and stored in a departmental LIS as part of usual clinical workflow,” explained Dr. Cheung. “Once those data are exported into AABACUS, they can be translated into clinical workload activities. It’s a robust, novel system that provides a much better picture of workload for modern pathology practice. AABACUS is adaptable to all lab environments and allows for better planning and utilization of the pathology team.”

“There has always been a clear need to define pathologist workload and to effectively measure it,” adds Dr. Sylvia Asa, Medical Director, LMP. “The AABACUS model is useful for laboratory management because it’s objective, automated and applicable across every laboratory discipline. The information it provides is illuminating in terms of the different activities in a pathologist’s day, but also helps us make decision in terms of resource allocation, pressure points within the system and where to spend time and energy growing and adapting our department in order to better serve our patients.”

The paper, entitled “Modeling Complexity in Pathologist Workload Measurement: the Automatable Activities-Based Approach to Complexity Unit Scoring (AABACUS),” can be accessed as an Advanced Online Publication (September 12) on the Modern Pathology website.

LMP and Alzheimer’s Disease Research

September 12, 2014
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alzheimer_brainRecently the Government of Canada announced a new national effort to study age-related neurodegenerative diseases in a Canadian context, which includes LMP’s Dr. Lili-Naz Hazrati, along with several other UHN researchers.

Overall, the Canadian Consortium on Neurodegeneration in Aging (CCNA) involves more than 300 clinicians and researchers from across Canada. The teams will look at the current research on neurodegeneration and look at new and novel ways around the prevention, impact and progression of these diseases, such as Alzheimer’s disease, vascular dementia, fronto-temporal dementia, and Lewy-body dementia.

We spoke with Dr. Lili-Naz Hazrati, a neuropathologist in LMP and one of UHN’s researchers involved in the project about her thoughts on the project and what this might mean for Canadians struggling with neurological disease:

“Alzheimer’s is a complex disease affecting a large portion of the population and with no known effective treatment,” said Dr. Hazrati. “And this initiative will place us upon a network of national and international researchers.”

In speaking about why UHN and LMP is involved, she explained that “we are one of the nationally recognized centers involved in research on Alzheimer’s disease. Our involvement is two-fold: direct basic research on Alzheimer’s Disease and brain banking of these cases.”

Dr. Hazrati tells us that most funding agencies do not support tissue banking which has limited the collection of brains with and without disease – which can limit how much you are able to investigate Alzheimer’s Disease. The collaborative project is designed to allow more coordinated research effort to understand faster the pathophysiology of this devastating disease and hasten the way to prevention or treatment.

“This initiative is hopefully just a start and if the interest in neurodegenerative disease is maintained at the government level, it has the potential to have a huge impact on the Canadian public,” she added. “Most neurodegenerative diseases are chronic incurable diseases that not only affect the patients, but are very difficult on the care givers and the health system with huge economic impact at all levels. The potential benefits of this project are enormous and I couldn’t be more excited to be involved!”

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