Pathways to Excellence | Fall 2019

Pathways to Excellence URMC DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE | WWW.PATHOLOGY.URMC.EDU | FALL 2019

Under One Roof New Central Laboratory Encourages Collaboration as Teams Adjust to New Setting Three months into the Bailey Road relocation and consolidation effort, hundreds of Pathology & Laboratory Medicine employees are getting used to their new work home and the changes that have come with it.

One of the most telling examples of this is not just the bright laboratory and hallways filled with new offices and conference rooms. It’s the way people interact.

“I see people taking advantage of being near each other and being able to have more collaborative conversations,” said Director of Operation, Melissa Allen. “After years of having those interactions on the phone, it’s different face-to-face.”

You can see this happen with groups like the molecular core (Molecular Diagnostics, Microarray, and Cytogenetics) who share

specimens and are no longer separated geographically. They can now have hallway conversations and collaborate in person on a daily basis.

The main core laboratory is one of the largest open-concept labs that the design team has ever built – which has drawn attention from other regional institutions and made us a model that vendors and other clinical laboratories can aspire to.

Besides benefiting the lab from an operational perspective, there are practical perks to being under the same roof. Old friends can now meet for lunch. Coworkers make time to exercise together or take fitness classes with their colleagues onsite.

While the past year has brought many changes, the department and all those who worked hard to make the transition happen have much to celebrate in 2019.

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IN THIS ISSUE From the Chair.................................................................. 3

Research News.................................................................. 5

Regional Symposium......................................................... 4

Employee Appreciation..................................................... 5

Friends of Strong............................................................... 4

Focus on Faculty................................................................ 6

Under One Roof

Continued from page 2

Medical technologist, Johnny Santiago, right, in the new Microarray lab.

Medical technologist, Meghan Nowicki, works in the new Bacteriology area.

“Considering the size and scope of our operations, the golive went considerably well,” said Allen, noting that hundreds of people and pieces of equipment were moved four miles from Strong Memorial Hospital, as were staff and automation from the Ridgeland Road facility.

Testing officially went live at the new central laboratory on June 24. Since then, the department has successfully moved all outpatient testing to Bailey Road. It has been a team effort from day one, from couriers adjusting to new routes to workflow for receiving and testing specimens to meet critical turnaround times for clients.

“Everyone worked very well together despite the usual golive hurdles,” said Allen. These included some technical hiccups but, “Overall, there were no major issues for go-live, which was fantastic.”

The specimen work was moved in phases, starting with a percentage of outpatient and microbiology testing. The second phase was moving the remainder of work collected at patient service centers, followed by nursing home and home draw work.

Large new automation – most notably for chemistry and microbiology – brings greater capacity for growth as we continue to take on work from hospital affiliate sites who need centralized support.

Liz Peterdy, assistant director of operations for the Central Lab, said the approach to the transition was thoughtful throughout the process over the last several months.

“I am so proud of all the effort and hard work of the lab staff who made the move happen for all aspects of workload shifting, validation testing, and implementing new workflows,” she said. “I’m very excited to see lab stabilization and new opportunities to grow the Central Lab with our regional affiliates and collaborations.”

September marked the opening of Shell A, an addition to the original design for Phase I of the project. This frees up square footage to help enable the Emergency Department at Strong Memorial to proceed with its plans to expand. This space is home to the protein lab, toxicology, donor testing, computer support, and some automated chemistry equipment.

This coincided with the teardown of a plastic “wall” that divided the core lab from a wall of exterior windows. This allows natural light to stream into the core laboratory – a game changer for those who have grown accustomed to working in windowless labs for years.

“Shell A gives us windows in the lab,” said Peterdy. “It feels great because any large automated space is usually in the basement of a hospital somewhere.”

October marks the beginning of the final moves for Phase I at Bailey Road. At that time, groups including the phlebotomy administrative team, Client Services, and the rest of the Clinical Trials group will begin moving into their new offices.

Plans are now in motion for the onsite relocation of ground floor laboratories at Strong Memorial that will move into the G-2100 and 1-2100 areas, both of which are being gutted and redesigned to bring more onsite teams into new, well-lit space within the hospital in 2020. This next step is the next major hurdle for the next six months, Allen explained, but it’s another opportunity to improve workspace for staff.

“Many of our folks have been on the ground floor of the hsospital in extremely antiquated space that has needed updating for a very long time,” said Allen. “Having been through the Bailey Road project I can say with confidence that we will get there, and it’s going to be better no matter what.”

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FROM THE CHAIR Greetings from the Chair’s office. As the autumn rapidly closes in on us, I look at back at what was an incredibly eventful (and far too short) summer. In June, we relocated 700 pieces of equipment and nearly 400 of our team to the new Central Laboratory at Bailey Road. The enormous undertaking was a huge success and we encountered very few issues. Most importantly, there was no significant impact upon patient care and the move was largely seamless to our clinical colleagues and patients. It is hard to overstate the gratitude I feel towards everyone who was involved with this process. I was at the Medical School convocation ceremony yesterday and Dr. Taubman spoke glowingly about this to the audience. I am so proud to be associated with our department. Thank you to all.

Bruce Smoller, M.D.

Christa Whitney-Miller, M.D.

“ I am so proud to be associated with our department. Thank you to all.”

Meanwhile, the plans continue, in earnest, for the onsite relocation involving our researchers, the blood bank and the remaining parts of the automated hematology and chemistry laboratory.

The chief supervisors and medical directors continue to work closely with the space planners and the architects in hopes of replicating our recently completed smooth and successful move to Bailey Road. A bit farther down the line, but still in the planning phase, our anatomic pathology units are beginning to plan for the move of some aspects to the Bailey Road facility. This final phase is slated for about two years from now, but requires ample advanced planning in order to perfect it.

We have had several exciting developments within our faculty. Linda Schiffhauer, M.D. has assumed the role of director of the residency program, with Dr. Majed Refaai taking the role of associate director. This follows Dr. Scott Kirkley’s decision to step down after a hugely successful 18 year run in the position. Dr. Christa Whitney-Miller has been promoted to the role of vice chair for Anatomic Pathology, while maintaining her position as the director of Surgical Pathology. Dr. Jerome Jean-Gilles has been named the interim director of Cytopathology and has also recently been promoted to associate professor. Dr. Anwar Iqbal was recently notified of his promotion to the rank of professor. Congratulations to all!

As is always the case in July, we met our new first year residents (three this year) and a series of new fellows. We are busily completing the paperwork for additional new training positions in dermatopathology and pediatric pathology, adding to the many options now available for our trainees and for candidates throughout the country. We also met a group of new graduate students and medical technology students as our academic programs continue to expand. We are about to embark upon the next interview season for residents and we are hopeful to continue with our recent run of excellent classes!

Our faculty has also grown with the addition of Drs. Tanupriya Agrawal and Sachica Cheris to Cytopathology, Rossana Kazemimood to the GI Pathology group, and Ben Frisch to our research division.

Linda Schiffhauer, M.D

THANK YOU FOR GIVING BACK We are grateful for philanthropic support that allows us to maintain and accelerate clinical, educational, and research initiatives. To make a tax-deductible gift today or as part of your estate plans, please visit www.pathology.urmc.edu and click the “Make a Gift” button, or contact Melissa Head at (585) 273-2890 or melissa.head@rochester.edu.

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REGIONAL PATHOLOGY SYMPOSIUM HAS SUCCESSFUL FIRST YEAR Our department was pleased to host the inaugural Regional Updates in Pathology Symposium in Rochester on June 1.

The daylong event, which drew approximately 70 pathologists and trainees from across the Northeast, featured a slate of faculty-led presentations on subspecialty topics.

The symposium served to expose subspecialized pathologists to areas they might not be up-to-date on, but also to bring together those who lack other opportunities to network with their peers in the field as groups like RAAP (Rochester Area Association of Pathologists) have faded away.

Jennifer Findeis-Hosey, M.D., director of GI Pathology at URMC, was inspired to fill this void by starting an annual meeting for regional pathologists with the expectation that it would flourish and draw others from outside the region.

One of the goals was to give attendees a forum where they could learn from each other, helping them see examples of practice patterns at URMC and evaluate whether they can apply them in the workplace.

“It hopefully helps the pathologists who are still in a general practice model,” said Findeis-Hosey. “Part of the aim of this event is to highlight our faculty who are in subspecialty practice and give them a venue to teach their colleagues in general practice about recent developments in the ever-expanding field of pathology.”

The organizers look forward to growing the event in terms of guests and sponsors, starting in 2020. New next year will be special breakout sessions for PA’s and residents, with a possible virtual microscopy session.

If you are interested in attending or giving a guest presentation, email Jennifer_Findeis-Hosey@urmc.rochester.edu.

Drs. Jerome Jean-Gilles, Bradley Turner, and former fellow, Mary Barrett, M.D.

Symposium founder, Jennifer Findeis-Hosey, M.D., director of GI Pathology.

Keynote speaker, Mark Stoler, M.D., a department alumnus and cytopathologist.

Trainees, Drs. Bennett Wilson, Caroline Bsirini, Anna Israel, and Numbereye Numbere.

 S AVE THE DATE! The next Regional Updates in Pathology Symposium is scheduled for Saturday, May 30, 2020

$197,416

Charitable funds allocated to our department by the Friends of Strong Council this year. Thanks to the Friends for their support.

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RESEARCH NEWS Welcome to the first of a new column where you can read about new publications, funding, clinical and basic science projects by our faculty, trainees, and graduate students..

We look forward to showcasing this important aspect of our work at the Medical Center.

Got a research item to share? Email: Bethany_Bushen@urmc.rochester.edu.

Stabilization of TRAF3 Can Fight Age-Related Bone Loss A study led by Brendan Boyce, MB.Ch.B. and Zhenqiang Yao, M.D., Ph.D. together with a team including first author Jinbo Li, MS, a student in the Cell Biology of Disease graduate program, suggests that age-related osteoporosis could be prevented or treated through pharmacologic stabilization of the protein, TNF receptor-associated factor 3 (TRAF3).

The study published in Nature Communications notes the process by which young, healthy bones are naturally rebuilt, deteriorates with aging or menopause. Increased inflammation, or inflammaging, leads to an increase in bone-degrading osteoclast cells and a reduction in boneforming osteoblasts, which often leads to osteoporosis. The protein, TGF-beta, released in increasing amounts from bone during aging, causes breakdown of TRAF3 in osteoblast precursor mesenchymal progenitor cells leading to a reduction in the number of osteoblasts. The resulting increase in osteoclasts causes bone degradation.

By stabilizing TRAF3 levels in bone cells through new drugs, this research offers a novel mechanism for innovative treatments that provide long-term help for patients.

Research on Breast Cancer Metastasis Gets Boost Zhenqiang Yao, M.D., Ph.D. has received a new grant from the New York State Department of Health to investigate a compound that may eliminate breast cancer metastasis. The grant will allow him to continue work begun in a preliminary study supported by the Breast Cancer Coalition of Rochester in which Yao found a small molecular compound that effectively eliminates early stage metastatic breast cancer in bone and lung, in aggressive subtypes.

The new funding will help Yao investigate whether this compound eliminates metastatic breast cancer by blocking the interaction of the spreading cancer cells with the host organ microenvironment while directly killing the cancer cells. His long-term goal is to design a targeted approach to eliminate metastatic breast cancer while reducing possible side effects.

Welcome to a New Basic Science Faculty Member We’re happy to announce that Benjamin Frisch, Ph.D. has joined our faculty as an assistant professor. Frisch’s current research is focused on alterations of the bone marrow microenvironment induced by myeloid malignancies, with the ultimate goal of translation of novel therapeutic targets to clinical use.

Brendan Boyce, MB.Ch.B.

Zhenqiang Yao, M.D., Ph.D.

Benjamin Frisch, Ph.D.

Employee Appreciation Day at Sea Breeze The sun was shining on Sunday, August 18 as more than 1,100 staff and their families came to Sea Breeze Amusement Park in Irondequoit for the department’s annual summer appreciation event. All photos by Axel Kairies.

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Department of Pathology and Laboratory Medicine University of Rochester Medical Center 601 Elmwood Avenue, Box 626 Rochester, NY 14642

FOCUS ON FACULTY: MARK ETTEL, M.D. If you had to pick a common thread in Mark Ettel, M.D.’s professional interests, it would be problem solving. The junior faculty member celebrated his one-year anniversary on the GI pathology faculty at URMC this summer. He traces his interest in pathology back to his early days as a mathematics major at St. Olaf College in Minnesota, south of the Twin Cities region where he was born and raised.

His original plan was to get a math Ph.D. but discovered while taking biostatistics that he was more drawn to the biological aspects than to the actual statistics. The idea took root and he decided to go to medical school.

While at Creighton University in Omaha, Nebraska (“where there are 15,000 people and 15,000 cows,” he jokes) one of his first mentors introduced him to pathology. Ettel, who knew nothing about the field before medical school, found that it had everything he liked most about medicine and algorithmic thinking. “It’s a good combination of being intellectually stimulating while at the same time, very visually fascinating,” he said.

He completed residency at New York University followed by a GI fellowship at the University of Michigan, where he grew under the mentorship of Drs. Henry Appleman and Laura Lamps. The clinical aspects of GI are what he says drew him to the specialty – the variety of organs and diseases that oftentimes require the pathologist to look back at the patient’s medical history to find out more.

His research focuses on diseases of the esophagus, liver, and pancreas. He has already begun investigating inflammatory diseases, such as Barrette’s esophagus and its progression into neoplasia, and earlier this year presented findings at USCAP on sloughing esophagitis, or SE. This study examined the relationship

between the histologic pattern of injury in SE that and clinical picture for patients who suffer from it.

Ettel believes the role of pathologists like himself, who work behind the scenes, is a critical piece in the healthcare process. It’s one thing to understand what you see on glass slides, he says, and another to translate it into language that a clinician can use to help the patient. Clear communication is needed to provide the best patient care possible.

“You can understand everything histologically that’s going on but if you cannot write a report that a clinician can understand, then you’re useless,” said Ettel. “Describing findings is often part of our job, but the interpretation is our main job and any description included should be there to support the interpretation.”

Now that he’s worked a year on clinical service, Ettel says he’s learned from a number of AP faculty who have helped him gain knowledge and be clinically efficient with the daily workload.

This, in turn, has enabled him to participate in teaching others. At URMC he is the director of the residency program’s frozen section rotation, which he enjoys.

“You don’t go into academics unless you have some enjoyment of teaching as well as research,” he said. “Having so many good mentors, I want to be able to give back to the next generation in the same way.”

Outside of work, Ettel lives in Rochester’s Neighborhood of the Arts (NOTA) and is currently training for a half marathon.

He enjoys running near water, so you might see him out along the Genesee River or near the reservoir at Cobb’s Hill Park.

He still enjoys statistics, particularly as it relates to baseball.

The Rochester Red Wings are the minor league affiliate of the Minnesota Twins (his hometown team), so he tries to catch a few games during the season. He also make trips to visit family in Northern Minnesota – the “land of 10,000 lakes” where he spends time fishing and savoring the outdoors.

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