Re: Cytology Department Organizational Structure
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 ).
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, http://www.asq.org/learn-about-quality/process-analysis-tools/overview/fmea.html.
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.