Pathologists’ Assistants are allied health professionals that are supervised by Pathologists. Despite their importance, they are a relatively newer field with limited research provided to guide their professional standards. To direct Pathologists’ Assistants on professional standards, connections should be made to other healthcare professionals standards. This review will highlight and reflect on professional standards such as privacy for the patient, laws to follow in healthcare, personal protective equipment, continuing education, personal biases, reflection in regards to errors, and interprofessionalism. In doing so, a deeper understanding of the professional standard for a Pathologists’ Assistant will be developed and appreciated.
Title: Pathology and Professionalism in the Age of Social Media
Summary: Reflects on what respect for patients means in the digital age. Social media is a prominent part of our society today, the article addresses how to navigate protecting the patients right to privacy in a world that overshares online. Greysen and others, “found that 92% of state medical boards have reviewed at least one report of unprofessional online behavior by physicians” (as cited in Peedin and Karp, 2018, p.1). This statistic is shockingly high and indicates the need to be hyperaware and critical of the things we post or share before doing so. Crane and Gardner remind that when sharing an image, the publisher should always de-identify the patient and receive the proper consent(as cited in Peedin and Karp, 2018, p.1).
Analysis: Pathologists’ Assistants take pictures for medical legal purposes, publications, abnormal pathology and more. It is important to understand the responsibility that comes from taking such photos. One should be mindful and carefully think through what they will be sharing before doing so because of HIPPA privacy laws. In pathology, nothing should be shared online out of respect for the patient and their right to privacy. If shared publicly for a conference or publication, then the appropriate channels of de-identifying and consent need to be taken. Equally important is the impact of a professionals actions online. If inappropriate content is published, then it could break the trust of the profession and professional.
Title: How to stay on top of OSHA compliance
Summary: Shares the importance of organizations adhering to Occupational Safety and Health Administration laws and regulations. Failure to be efficient could result in fines that range from $7,000 to $12,471 (“How to stay on top of OSHA Compliance,” 2016, p.1). Rose Comstock, a risk manager, suggests a lack of training could be to blame when deemed uncompliant (“How to stay on top of OSHA Compliance,” 2016, pp.1-2). While Chris Mancillas, a senior VP of EPIC Insurance Brokers and consultants, suggests it could be due to a lack of resources (“How to stay on top of OSHA Compliance,” 2016, p. 2). In reality, both probably contribute to insufficient compliance. Understanding what contributes to non-compliance and the repercussions of not complying are important to maintain lab safety of employees and prevent high expenditures.
Analysis: A pathology lab has many organizations that overlook the lab. Some include OSHA, the Environmental Protection Agency, Joint Commission, and the College of American Pathologists. It is important to recognize the importance of each agency that overlooks the lab and how they are important to the communities safety, the labs safety and the quality of procedures. For example, Pathologists’ Assistant will often help uphold compliance by checking reagents for expiration dates to ensure the quality of the reagents. If this is missed, it can result in repercussions against the lab. As previously discussed, other non-compliant areas could result in large fines. In addition, Pathologists’ Assistants should also follow specific rules of their organization to avoid mistakes when handling specimens.
Title: Factors limiting the usage of personal protective equipment in a tertiary-care hospital
Summary: Using personal protective equipment in healthcare is one of the most important things a healthcare professional can do to protect themselves, co-workers and patients. This article tries to understand why PPE still goes unused even when the awareness of its importance is well understood. The authors distributed an anonymous survey to members of the hospital. The survey gave hypothetical situations and asked what PPE should be used? Then followed up by asking what PPE they would actually use in the correlating scenarios. This was to test the knowledge of the individual vs. the actions of the individual. Proper PPE was often neglected when not readily available, the procedure was considered low risk, or if the provider deemed it uncomfortable (Jain et al., 2013, p.107).
Analysis: Pathologists’ Assistants will be in contact with pathogens every day. Following standard procedures and using the proper PPE should be an everyday habit. Forgetting or not following through with PPE could be detrimental to your health, co-workers health, and the safety of the patient. For example, not changing gloves in between cases could lead to a misdiagnosis of the patient. Not using gloves to cut a frozen could lead to Hepatitis B. Not decontaminating a work surface could lead to a co-workers illness. Maintaining a clean/safe environment will ensure everyone’s safety.
Title: The Benefit of Continuing Professional Development for Continuing Pharmacy Education
Summary: Pharmacists have been required to take continuing education courses for over 40 years in the United States (Wheeler & Chisholm-Burns, 2018, p.198). According to the Accreditation Council for Pharmacy Education, 90% of the credits offered to Pharmacists are knowledge-based activities (as cited in Wheeler & Chisholm-Burns, 2018, p. 199). Knowledge-based activities do not always translate to patient care. It is suggested to use a Continuing Professional Development approach where, “the learner reflects, plans, learns, evaluates, and applies,” in doing so, learning will become more meaningful (Wheeler & Chisholm-Burns, 2018, pp. 199-200). There are many different ways to continuously learn, but finding the best way to learn can be subjective. All options for learning should be explored to determine the type for optimal patient care.
Analysis: This article relates to Pathologists’ Assistants because the certifying organization, American Society for Clinical Pathology, currently has a required amount of continuing education credits required to ensure that competency in the field is kept. It is important for a PA to continue their education to confirm their previous knowledge is still relevant and to correct misconceptions about previous learnings. In addition, the continuing education credits are important because maintaining their certification develops a sense of credibility in the PA. It tells the Pathologist that they are competent to perform the tasks asked of them.
Title: Are Cognitive Biases Influencing Your Clinical Decisions?
Summary: Everyone has some form of bias. The problem with our individual biases is when it begins to affect the patient care. This article focuses on physicians with cognitive biases that affect patient care. Croskerry discusses how reviewing a patient’s medical history and stopping an investigation after the initial finding can all lead to a false sense of certainty that can lead to misses in the patient’s health (as cited in Klocko, 2016, p. 33). In health care, it is important not to jump to conclusions and be patient until all the facts have presented themselves.
Analysis: Although pathology biases do not occur directly with a patient, they can still occur. When sectioning a specimen, it’s possible additional pathology will be discovered. If the grosser is not looking for everything, then this can be missed. A Pathologists Assistant should be observant of the entire specimen and when in doubt take the extra time to receive a second opinion from the pathologist. Conflicts of interest may also arise. An example of this would be a personal specimen or family members specimen arriving in the lab. It is important to treat the specimen fairly when in the lab and not give preferential treatment over another specimen.
Title: The detection and prevention of errors in laboratory medicine
Summary: Labs strives to prevent errors from occurring. Despite their efforts, “The risk of adverse events and inappropriate care due to laboratory errors ranges from 2.7% to 12%” (Plebani, 2010, p.105). Many factors affect lab error, working to identify those errors will ultimately correct future mistakes. According to Reason, there are three ways to view medical errors which include, the person model, the legal model and the system model (as cited in Plebani, 2010, p.106). The person model, means blaming the persons mistake for the error, the legal model means blaming the person for causing the error due to negligence, and the system model is blaming the process that led up to the mistake (Plebani, 2010, p.106). By understanding the three types of this model, it is surmised that the system model is the most beneficial to employees because it allows for trusting culture and open discussion about how to correct problems that arise (Plebani, 2010, p.108).
Analysis: Pathologists Assistants are human. Anyone that is human will make mistakes. There are several areas where errors can occur such as the orientation of a specimen, mislabeled specimens and missing specimens. It is important to recognize that this happens, but also to admit when it happens. If a PA does not admit to a mistake, then the mistake can never be corrected and can ultimately affect the patient outcome. Understanding that a mistake is normal and does not define your competency aids a trusting culture where lab professionals can be open and honest about what is working and what isn’t.
Title: The Ethics and Value of True Interprofessionalism
Summary: Focuses on the personal story of one medical students experience as an intern. The intern had the opportunity to work with nurses, receptionists, medical assistants and more. This student reflected later on the experience and was quoted, “By asking each team member to share her expertise with me, I transitioned from being simply a medical student working with one physician to an integrated member of the team” ( Colleen Farrell, 2016, p. 887). This is not just a personal experience, inadequate interprofessional care has been shown to have numerous negative effects including not communicating when necessary (Colleen Farrell, 2016, p. 888). This article viewed the importance of interprofessionalism from a person perspective as well as a logical one.
Analysis: Pathologists’ Assistants are expected on a daily basis to interact with other healthcare professionals (Pathologists, Cytotechnologists, Histotechnologists, surgeons, nurses, transcriptionists, etc.). It is important to understand the role that everyone plays in relation to the specimen the PA is grossing. By understanding the limitations and processes that each profession has to go through, it can eliminate frustrations and gain an appreciation for how each profession contributes to patient care. It can also show the PA how their job will subsequently affect the latter jobs. In addition, it can also give other professionals a good representation of the PA profession, and a new found respect. Overall, by having an active interest in the process as a whole, it can provide better patient care and improved professional relationships.
In summary, Pathologists’ Assistants may not have defined professional standards, but learning from other professions in the healthcare field will help to build their own standards. By recognizing the importance of privacy for the patient, laws to follow in healthcare, personal protective equipment, continuing education, personal biases, reflection in regards to errors, and interprofessionalism, Pathologists’ Assistants can become better providers that are more self-aware of their actions.
References
Farrell, C. (2016). The Ethics and Value of True Interprofessionalism. AMA Journal Of Ethics, 18(9), 887.
How to stay on top of OSHA compliance. (2016). Medical Environment Update, 26(10), 1-3.
Jain, M., Dogra, V., Mishra, B., Thakur, A., & Loomba, P. S. (2013). Factors limiting the usage of personal protective equipment in a tertiary-care hospital. Canadian Journal Of Infection Control, 28(2), 105-110.
Klocko, D. J. (2016). Are Cognitive Biases Influencing Your Clinical Decisions?. Clinician Reviews, 26(3), 32-39.
Peedin, A. R., & Karp, J. K. (2018). Pathology and Professionalism in the Age of Social Media. Archives Of Pathology & Laboratory Medicine, 142(4), 441-442. doi:10.5858/arpa.2017-0467-ED
Plebani, M. (2010). The detection and prevention of errors in laboratory medicine. Annals Of Clinical Biochemistry, 47(2), 101-110. doi:10.1258/acb.2009.009222
Wheeler, J. S., & Chisholm-Burns, M. (2018). The Benefit of Continuing Professional Development for Continuing Pharmacy Education. American Journal Of Pharmaceutical Education, 82(3), 198-203.