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Beth Israel Lahey Health Department Chair, Pathology in Burlington, Massachusetts

Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Job Description:

The Department of Pathology and Laboratory Medicine at LHMC is well positioned to advance excellence in Pathology services. We are one of only six full departments at LHMC, with the chair reporting directly to the hospital president. The Department offers a collaborative environment for anatomic and clinical pathologists to enhance patient care by improving diagnostics using an integrative approach in multiple clinical areas.

Our approach is patient centered and evidence-based, while supporting innovation and evolving technology that offers faster and/or more accurate results, either in our own laboratories, or with our referral laboratory partners. We collaborate with clinical providers both within our facility and throughout the BILH system. We strive for the highest quality of testing and results to facilitate care for our patients, and satisfaction for our colleagues, partners and clients. We are constantly reviewing performance using productivity and quality metrics to identify areas for improvement.

Our collaborative and supportive model is demonstrated by our current involvement in both professional and technical aspects of pathology and laboratory medicine at Mount Auburn Hospital, Beverly Hospital and Addison Gilbert Hospital. At these institutions, we have established a collaborative relationship to provide mentorship and structure for work flow, processing, quality management and diagnostics. Pathology physicians at all four of these institutions report to the LHMC Pathology and Laboratory Medicine chair.

We have also established pathways to improve connectivity between the Lahey and Mount Auburn EPIC/Beaker instances. The system relationship provides a structure for consultation for complex cases requiring advanced care.

Compliance with regulations and standards promulgated by the Department of Health and Human Services, the College of American Pathologists, third-party payers, the Massachusetts Department of Public Health, the Joint Commission on Accreditation of Health Care Organizations, FDA, Foundation for the Accreditation of Cellular Therapy, and Association for the Advancement of Blood and Biotherapies is maintained.

Lahey Hospital and Medical Center values research and education as evidenced by renowned internal programs and an exciting new affiliation with UMass Chan Medical School.

ANATOMIC PATHOLOGY

Overview

Anatomic Pathology (AP) was established in 1983 with the mission to provide on-site services to providers and patients of Lahey Clinic. Operations began with only two pathologists, but have since expanded to twenty highly trained surgical pathologists covering multiple subspecialty services in Burlington, Peabody, Mount Auburn and Beverly. Technical and administrative staff have expanded as well. Diagnoses are provided for over 35,000 surgical pathology specimens and almost 17,000 cytopathology specimens for Burlington and Peabody. Mount Auburn and Beverly add approximately 16,000 to 17,000 surgical specimens at each site. Autopsies are performed in Burlington as well.

Cytopathology

The laboratory provides gynecological and non-gynecological services, including interventional radiology and endoscopic biopsy services with rapid on-site evaluation.

The volume of gyn cytology specimens has averaged nearly 11,000 per year, and we have recently begun assisting affiliated hospitals with their screening volume.

The non-gyn cytology specimens account for approximately 6,200 annually and include various specimen types such as exfoliative and non-exfoliative cytology specimens.

The interventional and endoscopic on-site evaluation of specimens averages 280 cases per year.

Surgical Pathology

Surgical Pathology includes histologic evaluation and sign-out of routine biopsies and complex surgical cases, frozen section evaluation, and on-call duties. The staff members participate in various multidisciplinary management conferences and are involved in collaborative efforts in clinical research projects and teaching programs of the hospital and medical school.

The Surgical Pathology subspecialties represented within the department include the following. In addition to routine histologic evaluation, a variety of specialized immunohistochemical and molecular techniques are available. HER2 FISH, immunofluorescence microscopy and flow cytometry are performed on-site.

Breast Pathology

Dermatopathology

Endocrine Pathology

Gastrointestinal Pathology

Genitourinary Pathology

Gynecologic Pathology

Head & Neck Pathology

Hematopathology

Neuropathology

Pulmonary Pathology

Renal Pathology

Autopsy Service

Autopsies are performed at the request of providers and with the written consent of the legal next of kin. Specific clinical questions to be answered must be provided at the time of request.

Immunohistochemistry & Fluorescence in-situ Hybridization (FISH) Laboratory

Over 130 antibodies and biomarkers have been validated for in-house testing and interpretation. These tests are available for all Lahey affiliated sites. This provides the ability to perform a wide range of studies on renal, skin and liver biopsies, and allografts; tumor markers, hormone receptors, and prognostic markers; various other biomarkers for targeted therapies such as PD-L1, ALK-1, BRAF V600E; and markers of microsatellite instability.

LABORATORY MEDICINE

Professional and Technical Staff

  • Laboratory Medicine is staffed by five full-time clinical pathologists, each with subspecialty training in the disciplines that they oversee. A clinical pathologist is on call 24/7.

  • Clinical pathologists participate in a wide range of organizational and BILH system committees, and provide critical expertise for clinical pathways, as well as consultations in test selection and interpretation across all subspecialties.

  • Technical and non-technical staff between the Burlington and Peabody campuses numbers over 200.

  • Approximately 3,000,000 tests were performed in the last year.

  • Sections of the laboratory include:

  • Chemistry, Toxicology and Immunology

  • Hematology and Coagulation

  • Point-of-Care Testing

  • Flow Cytometry

  • Blood Banking and Apheresis Services

  • Molecular Diagnostics

  • Microbiology, Virology, and Parasitology

  • Phlebotomy

  • Specimen Processing

  • Lab Support Services

Highlights of Current Activities

Molecular Diagnostics

The laboratory developed a robust molecular diagnostics/molecular pathology program that incorporates state-of-art IHC as well as nucleic acid tests.

  • The molecular tests include a next generation sequencing (NGS) solid tumor DNA test (the first and currently only NGS program in the BILH health system).

  • A laboratory for PCR-based Covid testing to provide turnaround time of less than 24 hours for the majority of hospitals in the BILH system, as well as system-sponsored offsite collection centers.

Microbiology

  • The Microbiology lab has advanced technologies for rapid identification and preliminary antimicrobial susceptibilities including MALDI-ToF MS, Sepsityper, and GenMark ePlex blood culture panel, all of which have provided improved patient care.

  • The lab has taken on extra volume from the BILH system, including specimens from sister hospitals that would otherwise have gone to an outside reference laboratory. The project includes management of IT issues and medical director support due to differences in orders/reporting to create a smooth experience.

  • Daily rounds are conducted in the laboratory with ID clinicians and trainees to provide a forum to review all relevant new results for the hospital.

  • Confirmatory Lyme Western blot testing is also performed.

  • Multiple platforms for rapid Covid testing are also supported.

Clinical Informatics

  • LHMC has a pathologist who is board-certified in Clinical Informatics, Epic-trained in orders, analytics, and Beaker Clinical Pathology with several years of experience as a physician builder and certification in Beaker Clinical Pathology.

  • LHMC pathology can provide expert input to Epic IT teams. With table access to Clarity, we can provide SQL-query-based business intelligence and data-driven insights for clinical decision support. LHMC pathology can work directly with clinicians to utilize best practice laboratory information that simultaneously improves clinical practice and eliminates waste.

  • We employ intra-laboratory algorithms to reduce labor requirements, provide workflow embedded technical expertise to all patients at all hours without real-time human consultation, standardized best practices, and laboratory budget cost savings. We can reduce reference laboratory send out costs by rationalizing sharing of specimens among BILH sites using the Epic External EMR portal, andeliminating manual processing by working with clinicians to move send out tests to an interfaced reference laboratory.

  • LHMC pathology will be able to capitalize on the intellectual property embedded in an enterprise collection of send out procedure codes using proficiency in tools and workflows that can achieve full implementation, including defense against aggressive marketing of reference lab services directly to clinicians without pathology oversight.

Blood Bank

The LHMC Blood Bank provides comprehensive technical services and serves as a depot for several BILH hospitals. The depot model has allowed community hospitals to maintain a more robust inventory while reducing wastage of products. Emergency orders from affiliates are also supported, often with time savings compared to delivery from the suppliers.

  • Universal leukoreduction and irradiation of cellular products for patient safety is our standard of care.

  • Regular conferences with all blood bank leaders in the BILH system allows member hospitals to benefit from and contribute to system improvements and better care, while advancing the goals of BILH.

  • The Blood Bank stocks an array of coagulation factor concentrates, which allows the pathologists to assist in the care of factor deficient patients.

  • In partnership with the Red Cross, a full range of apheresis services are offered for both inpatients and outpatients on a 24/7, 365 basis.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

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