Saturday, November 07, 2009
PA Section News
This week, all PA Section members of the CAP will be receiving the minutes of the annual general meeting of the Section from July. It was agreed at the previous AGM that any vote on important items required a minimum number of attendees at the meeting; that number was not attained at this year's meeting. Please read the minutes carefully and pay particular attention to the two appendices as they contain important information upon which you will be asked to vote within the very near future. We hope that using this method will enable a greater number of members to cast a vote.
Tuesday, October 20, 2009
CBC advertisements
Tell me that this isn't ironic! I'm in my car on the way home from work last Friday, listening to CBC Radio 2 Drive as usual, and on comes an ad. 'An ad?' you might say. 'Isn't that unusual? CBC doesn't have advertising.' Well, true. Our national broadcaster IS advertisement-free except when it comes to tooting their own horn (and taking up yet more time in their otherwise vacuous schedule -- I mean, really, have you listened lately? Have you ever heard -- and this goes for CBC TV too -- an organization that takes SO much bloody time telling you what they're about to do? What the heck is the point?!). But I digress; sorry about that. Back to the point that I was trying to make. I'm listening to this ad and what is that ad about? It's about the fact that CBC Radio 2 doesn't have ads (and is thus worth listening to)! It makes this statement at least 4 times during the ad! Do they ever even proof-listen this stuff?!
But that isn't the best part: the best part is that this ad is ONLY on CBC (for CBC). Has anyone out there heard this ad on any other staion? Nope! Shouldn't it be on OTHER radio stations (which btw everybody else is listening to -- EVEN WITH ads?!!). I know, I know, CBC (aka Canada) is TOO DAMN POOR to contemplate paying to have their ad run on other stations so instead they run it on their own. PULLLLEASE!
But that isn't the best part: the best part is that this ad is ONLY on CBC (for CBC). Has anyone out there heard this ad on any other staion? Nope! Shouldn't it be on OTHER radio stations (which btw everybody else is listening to -- EVEN WITH ads?!!). I know, I know, CBC (aka Canada) is TOO DAMN POOR to contemplate paying to have their ad run on other stations so instead they run it on their own. PULLLLEASE!
Wednesday, July 15, 2009
Who's regulating who?
One hears a lot these days about alleged atrocities being perpetrated by members of our national police force. There's much ado and discussion surrounding the use of tazers; indeed, whether they should be used at all or whether good, old-fashioned physical methods ought to be used instead. There are routine and regular complaints by the public and even by lawyers directed against other lawyers; by public and especially by members of the opposition against politicians for abusing their elected posts; against all manner of professionals -- all supposedly well-intentioned individuals just trying to do their jobs; or so they would have us believe. Don't kid yourself. People just can't get along; believe me. Some of the people who write about warm, squishy topics related to their professions don't get it either. Most people, in my experience, have a personal agenda which motivates their off-handed responses to questions and their comments -- especially comments concerning subjects that they really know very little about.
To make this issue all that much more difficult to take (by the poor powerless public forced to watch), many of the professions on this continent are, in essence, self-regulated. The military, the police forces, lawyers, the government, teachers, physicians...the list goes on...all have powerful 'associations' (aka 'unions') with powerful lobbies in high places. All are involved to a varying degree in actually creating their so-called 'practice' and then regulating it; policing themselves; snitching on themselves; investigating themselves and meeting out 'just' verdicts against themselves. Everything is nicely documented and everybody goes through the motions in order to appease the scrutiny of the media. What is really missing here? What is wrong with this picture? Where in all of this does the non-member get a real say in the proceedings? How can the organizations have anything but a heavily biased perspective? This situation is, and has been for many years, inherently unjust.
Then we get well-meaning governments, lobbied by well-meaning members of the populace, attempting to make 'real' change in the structure of these so-called professional organizations. In their attempts, they withhold funds and take the 'hard line,' again, to appease the public; to be seen to be doing something in the public's interest. The debate goes on and on and nothing ever changes except the position of the organizations becomes increasingly entrenched in the fabric of the civilization as they survive yet another onslaught from the poor down-trodden (that's us).
Those who belong to these organizations become more and more sure of their place; more and more confident of their opinions. They scrutinize their points of view less and less before they open their mouths. Why should they? Everyone around them supports them, defends them, pats them on the back and reveres them as some sort of authority; while those 'outside' who may not share that opinion, can't touch them. That which matters most is support and acceptance within the ranks of the organization.
It's one thing to put your young family in the back of a Jeep YJ; get drunk; speed through a neighbourhood; drive over and kill an innocent pedestrian and then abandon the kids AND leave the scene of the crime -- one would think that this crime should be investigated just like any other and should result in a just punishment (let's watch as this unfolds. Are you as skeptical as I?). It's another thing to have a member of an organization utter slanderous remarks about members of another organization. This crime may seem to be somewhat more defensible than the first crime. Although not as clear-cut as DUI vehicular homicide, a crime it remains. To add to the crime, consider the fact that the slanderous remarks were based on dated here say; the source? Fellow members of the organization. Are you getting it now?
It's marginally satisfying that the remarks were made in such an ill-informed, arrogant manner that they induced considerable heated discussion amongst some fellow members of the organization. What really bugs me is that they were not only aimed at members of my organization; they were aimed at particular members of my organization, all of whom I know; most of whom I hold in high regard.
That which unfolds within the next month or so should be interesting to witness. Stay tuned.
To make this issue all that much more difficult to take (by the poor powerless public forced to watch), many of the professions on this continent are, in essence, self-regulated. The military, the police forces, lawyers, the government, teachers, physicians...the list goes on...all have powerful 'associations' (aka 'unions') with powerful lobbies in high places. All are involved to a varying degree in actually creating their so-called 'practice' and then regulating it; policing themselves; snitching on themselves; investigating themselves and meeting out 'just' verdicts against themselves. Everything is nicely documented and everybody goes through the motions in order to appease the scrutiny of the media. What is really missing here? What is wrong with this picture? Where in all of this does the non-member get a real say in the proceedings? How can the organizations have anything but a heavily biased perspective? This situation is, and has been for many years, inherently unjust.
Then we get well-meaning governments, lobbied by well-meaning members of the populace, attempting to make 'real' change in the structure of these so-called professional organizations. In their attempts, they withhold funds and take the 'hard line,' again, to appease the public; to be seen to be doing something in the public's interest. The debate goes on and on and nothing ever changes except the position of the organizations becomes increasingly entrenched in the fabric of the civilization as they survive yet another onslaught from the poor down-trodden (that's us).
Those who belong to these organizations become more and more sure of their place; more and more confident of their opinions. They scrutinize their points of view less and less before they open their mouths. Why should they? Everyone around them supports them, defends them, pats them on the back and reveres them as some sort of authority; while those 'outside' who may not share that opinion, can't touch them. That which matters most is support and acceptance within the ranks of the organization.
It's one thing to put your young family in the back of a Jeep YJ; get drunk; speed through a neighbourhood; drive over and kill an innocent pedestrian and then abandon the kids AND leave the scene of the crime -- one would think that this crime should be investigated just like any other and should result in a just punishment (let's watch as this unfolds. Are you as skeptical as I?). It's another thing to have a member of an organization utter slanderous remarks about members of another organization. This crime may seem to be somewhat more defensible than the first crime. Although not as clear-cut as DUI vehicular homicide, a crime it remains. To add to the crime, consider the fact that the slanderous remarks were based on dated here say; the source? Fellow members of the organization. Are you getting it now?
It's marginally satisfying that the remarks were made in such an ill-informed, arrogant manner that they induced considerable heated discussion amongst some fellow members of the organization. What really bugs me is that they were not only aimed at members of my organization; they were aimed at particular members of my organization, all of whom I know; most of whom I hold in high regard.
That which unfolds within the next month or so should be interesting to witness. Stay tuned.
Sunday, February 15, 2009
MIS Standards 2009
Those of you who follow this blog from time to time and who are not PA Section (of the CAP) members should be made aware of an important development regarding the newly-revised MIS Standards (previously known as the MIS Guidelines). The Canadian Institute for Health Information (CIHI) has taken over two years to put into place a sweeping change in the Standards which affect all laboratories (ie. labs that use the Workload Measurement System, WMS, to monitor workload). Among the many changes is the incorporation of a number of changes that directly affect PAs. The previous version of the Standards had NO units which directly recognized the existence of PAs. The new version recognizes the tasks that PAs perform in both autopsy and surgical pathology. In keeping with the provincial Fee Guides (for pathologists), they allow PAs to claim units for the different complexities of surgical specimens. PAs may now claim units for consulting with a pathologist prior to grossing a specimen, for photography, for sampling for ancillary studies (EM, tumour banking, etc.) and for various other duties in the gross room. In the morgue, PAs may now claim units which truly reflect their efforts when performing routine, as well as specific dissections, for preparing a clinical history, for reporting on the case, etc. What used to be, quite frankly, both frustrating and embarrassing, has changed over night.
This ought to be pretty momentous news for PAs, whether their institution uses the units or not. PAs should realize that this is (finally!) a recognition and a validation of not only their profession but of the many tasks that they perform. Many hospitals use the WMS to justify resources from the Ministry from year to year. PAs have heretofore, compared to the Technologists beside whom they have been working for over 30 years, not appeared to be contributing. In fact, Lab Technicians, Lab Assistants, Morgue Attendants and others appeared to contribute more to the annual workload than did PAs. Now, there will be quite a large jump in the units and as a result, PAs can hold their heads high in the knowledge that they are pulling their weight.
The productivity of PAs may now be compared between sites, between hospitals, between provinces and -- important to supervisors and managers -- between individuals. To this end, it is important to lobby the necessary individuals in your organization to update the WMS in your particular IT system with the new Standards. Be aware that there are still some outstanding tasks which are on the list but which have yet to be determined (eg. the number of units to be assigned to a particular task).
It is somewhat fortunate that the complexity of surgical pathology specimens closely (but not exactly) mirrors that which is used by the pathologists. As a result, just one complexity needs to be entered into the IT system for each specimen and this can be used to monitor the workload of both the PA and the pathologist. There may be some debate as to the method for entering the complexity (ie. who enters the code that defines the complexity? The person performing the accessioning of the case? The PA? The pathologist?) but any system is better than none at all. A perceived shortcoming may be that the system does not abide by the widely accepted L4E (level 4 equivalent) system for monitoring the workload of pathologists. The WMS for PAs was, in keeping with the prescribed method of the CIHI, created based on the amount of time that is required to complete a given task, not on the basis of the relative 'importance' of a task. Thus, there will be some minor (justified) differences which some may notice when comparing the two systems. For example, it takes quite a bit of time for a PA to process a leg amputation but the relative importance of that specimen is very low.
This ought to be pretty momentous news for PAs, whether their institution uses the units or not. PAs should realize that this is (finally!) a recognition and a validation of not only their profession but of the many tasks that they perform. Many hospitals use the WMS to justify resources from the Ministry from year to year. PAs have heretofore, compared to the Technologists beside whom they have been working for over 30 years, not appeared to be contributing. In fact, Lab Technicians, Lab Assistants, Morgue Attendants and others appeared to contribute more to the annual workload than did PAs. Now, there will be quite a large jump in the units and as a result, PAs can hold their heads high in the knowledge that they are pulling their weight.
The productivity of PAs may now be compared between sites, between hospitals, between provinces and -- important to supervisors and managers -- between individuals. To this end, it is important to lobby the necessary individuals in your organization to update the WMS in your particular IT system with the new Standards. Be aware that there are still some outstanding tasks which are on the list but which have yet to be determined (eg. the number of units to be assigned to a particular task).
It is somewhat fortunate that the complexity of surgical pathology specimens closely (but not exactly) mirrors that which is used by the pathologists. As a result, just one complexity needs to be entered into the IT system for each specimen and this can be used to monitor the workload of both the PA and the pathologist. There may be some debate as to the method for entering the complexity (ie. who enters the code that defines the complexity? The person performing the accessioning of the case? The PA? The pathologist?) but any system is better than none at all. A perceived shortcoming may be that the system does not abide by the widely accepted L4E (level 4 equivalent) system for monitoring the workload of pathologists. The WMS for PAs was, in keeping with the prescribed method of the CIHI, created based on the amount of time that is required to complete a given task, not on the basis of the relative 'importance' of a task. Thus, there will be some minor (justified) differences which some may notice when comparing the two systems. For example, it takes quite a bit of time for a PA to process a leg amputation but the relative importance of that specimen is very low.
Sunday, January 04, 2009
PA training and recent news
After a protracted waiting period, I am, with the able assistance of one of the experienced PAs and a few of the pathologists, finally training 2 PAs. They are enjoying the opportunity and are gaining much-needed experience at the grossing bench. The formal training will last 4 months and will be complete in the spring. Then the real learning begins (as you all know). I also hope to involve them to a degree in a few autopsies within the next couple of months.
There are finally enough PAs in Kelowna these days to allow me to step away from the grossing bench for a while and to finally brush up some of the grossing procedures. The written procedures will provide standardization of procedures across the Okanagan and will be a valuable resource for all, especially the newly-trained PAs.
The newly-renovated and expanded Kelowna gross room is a welcome change. A downdraft grossing station was fabricated and installed a few months ago and a biological safety cabinet was purchased and installed recently.
Most of the changes made as a result of the Lean process being applied to the Histology lab and gross room have been for the better; some have proved to be in need of further refining. The process will be applied to the clinical labs in the near future. Despite all of the upheaval, the experience has taught a number of us to not be quite so threatened by change; wary maybe, but not threatened. It will be nice if beneficial changes can be applied to some of the other sites. Good news will naturally travel as lessons learned are communicated amongst the group.
There are finally enough PAs in Kelowna these days to allow me to step away from the grossing bench for a while and to finally brush up some of the grossing procedures. The written procedures will provide standardization of procedures across the Okanagan and will be a valuable resource for all, especially the newly-trained PAs.
The newly-renovated and expanded Kelowna gross room is a welcome change. A downdraft grossing station was fabricated and installed a few months ago and a biological safety cabinet was purchased and installed recently.
Most of the changes made as a result of the Lean process being applied to the Histology lab and gross room have been for the better; some have proved to be in need of further refining. The process will be applied to the clinical labs in the near future. Despite all of the upheaval, the experience has taught a number of us to not be quite so threatened by change; wary maybe, but not threatened. It will be nice if beneficial changes can be applied to some of the other sites. Good news will naturally travel as lessons learned are communicated amongst the group.
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