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From: Yanosy, Bonnie
To: Richard Cartun
Subject: RE: Histology Staffing
Date: Friday, February 19, 1999 8:31AM

Hi Richard,
We have been re-engingeered (spelling) twice in the last 4-5 years and
have gone from 7 staff to 4 and have taken over all the duties to assist
in the grossing area, logging in specimens in the computer, the morgue(
outside dieners actually do the autopsy), filling larger size containers
with formalin for the house to use, and all the cleaning and prep type
work for the Histo side that an aide might do. You know we do special
stains and immunos too. I am counted in that number. Since going to
Cerner and having West Hudson do our "continuous quality improvement "
plan last year, we do not count CAP units to figure out productiveity
and staffing but use their time values per unit of service. The
transcription area counts reports and Histo counts slides with FS and
accessions counted in. I add "project time" in depending on each day.
Everything other than the unit of service is a project with a time
value; i.e. cleaning the processor may take 30 mins.  Everything is
added in that would take a person away from doing a unit of service, ex.
phone calls, trips out of the department, extra control cutting etc. We
just about make it with the FTEs we have and they were sure that our
volume was going to really drop when the BPC opened the outside lab and
Bpt Hospital would not get any outside specimens. We are doing well by
the ORs and I think the acuity of the specimen and the extra work
envolved makes the time per block hard to justif as the old CAP unit. .
I count strickly by time, ex. a breast core may have many levels that we
put on one slide but I am sure to count them as extra cuts even if they
are not stained. Do some time studies but make sure you time all the
steps. Good luck if you invite a time study group in. The whole hospital
went through the process and I know Medicare reembursement is a constant
concern but quality of care has to be balanced in the act. Look at
working smarter by envolving your staff in the project. Just do not
promise them anything you can't give. Go UCONN. Bonnie Yanosy
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From: Richard Cartun
To: Histonet@pathology.swmed.edu
Subject: Histology Staffing
Date: Thursday, February 18, 1999 5:59PM

Dear Colleagues:

I believe Histonet had information on this subject before, but I didn't
take good notes.  I need to evaluate staffing in our Histology and
Immunopathology Laboratories.  It is my impression that we are severely
understaffed and I need to convince our administration that we need to
hire more people before "the ship sinks".   I have numbers regarding
FTEs, surgical and autopsy accessions, blocks processed, slides cut,
H&E-stained slides, histochemical stains, immunoperoxidase slides,
immunofluorescence cases, etc.  Where do I go from here?

Richard W. Cartun, Ph.D.
Director, Immunopathology
Co-Director, Histology
Hartford Hospital
Hartford, CT  06102
(860) 545-1596
e-mail: rcartun@harthosp.org