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Cytology Department Organizational Structure

posts: 3 1 stars user offline United States

I am looking for information regarding departmental organizational structure. My lab uses a central processing accessioning area with rotating path techs to do the actual processing. Adequate training and personnel availability is always an issue. The cytology supervisor (termed Technical Specialist) has "oversight" responsibility for the techs doing the gyn and non-gyn processing but not supervisory responsibility. These people are often responsible for tasks and responsibilities other than cytology related. This occurs during the same shift on a daily basis. Scheduling is done by the path tech supervisor (a PA who also oversees the path department IT function and must cover grossing duties).

I have never encountered this particular situation before. We move from one crisis to the next. Does anyone out there have information about recommended org structures where the processing people report to the cytology supervisor. Cytology, at my facility, is considered just one "section" of Anatomic Pathology and not a department in and of itself.

Non-gyn TAT's are suffering as are numerous quality issues. It's almost impossible to enact lasting changes let alone make improvements. Any help out there. I need to get this model changed.

admin posts: 330 5 stars user offline United States

I would say that in my experience, cytology processing usually falls under Cytology, which is considered its own department, or division of AP. Whether there is any "formal" or published reference to this, I am not certain, or at least I am not aware (or don't remember rolleyes).

There are CLIA specific regulatory requirements for training and personnel competency and these should be SOP defined. If there is a rotational component to these areas, then adequate training needs to be performed by the appropriate individual who is assigned that responsibility. In this case, it sounds like that is your cytology supervisor. I would carefully review the CLIA requirements for the general cytology supervisor to assure that all requirments are being met in your situation. If there are "shared" responsibilities or tasks, again, this would require adequate cross-training. Beause of your stated issues with clarification of responsibilities and duties with respect to training of personnel, I would suggest going to the regs and verifying that the appropriate supervisoring personnel are in place as specified in CLIA. That may assist you with any "organizational" changes (if any) that would need to be made. In addition, if there are significant quality issues that are not being adequately addressed, the Technical Supervisor should ultimately be made aware of this situation.

I am presuming that base on your statement that you aren't able to enact lasting changes and/or improvements, that there has been an attempt to address these issues at an AP dept level, such as through the QA program and/or committee. If not, it may be a worthwhile excercise to define the issues, and examine the processes involved with these issues. This link may point you to some useful information, link)

Hopefully, others can provide some assistance as well, as I certainly not an expert. There are others out there with lots of experience. Perhaps someone who is well-versed in the CLIA regs could answer you privately, if they do not wish to do so in a public forum.

Thank you for your inquiry. It definitely stimulates some thought.

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