third annual pathology educational...

Third Annual Pathology

Educational Symposium

November 2 - 4, 2015

Turner Auditorium 720 Rutland Avenue

Baltimore, MD 21205

Sponsored by the Department of Pathology

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Description: This Continuing Education event is intended for all employees of the Johns Hopkins Medicine Department of Pathology and Johns Hopkins Medical Laboratories.

Cost: Free for all Pathology and Johns Hopkins Medical Laboratory employees

Preregistration is encouraged (and required to receive lunch):

Preregistration is open September 14 - October 15, 2015.

Preregistration can be done through the ActivTracker website for all JHMI staff:

http://pathology.jhu.edu/department/training/symposium.

cfm See your Supervisor for approval to attend during your normal working hours.

JHM I.D. badge is required for electronic attendance tracking. Registration: Turner Lower Concourse. Register only once on the first day of attendance to pick up materials. Breaks: Light refreshments will be available between sessions in the Lower Turner Concourse.

Lunch: Will be provided for attendees who have preregistered for lunch and attend at least one session that day. (Lunch may not be available for those not preregistered for lunch.) Lunch pick-up is in the Turner Lower Concourse: Monday, November 2 12:15-12:45p Tuesday, November 3 12:00-12:45p Wednesday, November 4 12:00-12:45p

http://pathology.jhu.edu/department/training/symposium.cfm


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New Poster Session: Poster presentations will be available for the duration of the Symposium and will allow attendees to receive additional P.A.C.E.® Continuing Education credit. Questions must be answered for a minimum of five posters and a minimum passing score of 80% must be achieved. No partial credits can be awarded, and answers must be turned in by November 13, 2015. Examples:

Questions answered for 5 posters with 80% receive 1.0 CEU. Questions answered for 10 posters with 80% receive 2.0 CEU.

Preregistration is not required for Poster Session. Attendance Documentation & Certificate:

1. Swipe I.D. badge / sign in for all sessions attending. (NO CE credit will be available for those arriving more than 10 minutes after

the start time.) 2. Record Session Code on Attendance Documentation

form (provided at the end of the session). 3. Turn in completed Attendance Documentation form at

registration desk or email to Symposium Committee. Both sign-in / swipe-in & Attendance Documentation form are required to receive your PACE® certificate.

4. Certificate and evaluations will be emailed to attendees within three weeks of the Symposium.

Volunteer Opportunities: If you would like to help with the

Symposium, please register at http://vols.pt/eb8ujK to sign up. Volunteers are needed in several areas:

Registration Desk: Hand out materials & give directions to rooms. Moderator: Introduce session and speaker. Room Lead: Assist attendees in swiping/signing in for their session.

Lunch: Assist attendees with obtaining lunch.

Johns Hopkins Medicine is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.® Program.

http://vols.pt/eb8ujK

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Monday, November 2, 2015

8:00a-3:30p: Registration (Turner Concourse)

Opening Session & Pathology Grand Rounds 8:30a-9:30a Room: Turner Auditorium

Taking Quality to the Next Level Course # 612-202-15 / 1.0 credit hours

Peter J. Pronovost, MD, PhD, FCCM

The C. Michael and S. Anne Armstrong Professor for Patient Safety and Quality Johns Hopkins Medicine Senior Vice President for Patient Safety and Quality, Director of the Armstrong Institute for Patient Safety and Quality Professor, Anesthesiology, Critical Care Medicine, Surgery, Nursing, Bloomberg School of Public Health, Carey Business School

Level of Instruction: Basic Category: General Target Audience: All are welcome Description: Dr. Peter Pronovost is an anesthesiologist and critical care physician who is dedicated to finding ways to improve patient safety. He developed a method to reduce central line catheter infections that could be fatal. Time Magazine named Dr. Pronovost as one of the world’s 100 most influential people for his work in patient safety. Please join us for a kick-off to our Third Annual Pathology Symposium with a presentation on how Johns Hopkins is leading efforts to improve healthcare quality and safety. Objectives: At the completion of the presentation, the audience will be able to:

Identify at least one way to improve patient safety Explain how to improve the quality of our work

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10:00a–11:00a Room: TBA

Update on Hepatitis C: The End of the Beginning Course # 612-203-15 / 1.0 credit hours

Alexandra Valsamakis, MD, PhD Associate Professor of Pathology Johns Hopkins University School of Medicine Director, Clinical Virology and Molecular Microbiology Laboratories Johns Hopkins Hospital

Level of Instruction: Intermediate Category: Microbiology Target Audience: All are welcome Description: This session will describe the current status of screening to identify individuals infected with hepatitis C virus (HCV), the drugs currently used to treat chronic hepatitis C, and useful diagnostic tests in detection and management of HCV infection.

Objectives: At the completion of the presentation, the audience will be able to:

Summarize new screening recommendations for the identification of individuals with chronic hepatitis C

Identify and describe the new drugs used for treatment of chronic hepatitis C

List which diagnostic tests are useful in therapeutic management with new drug regimens for chronic hepatitis C

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10:00a–11:00a Room: TBA

Snakes, Snake Hunting, and the Pathophysiology of a

Snakebite

Course # 612-215-15 / 1.0 credit hours

J. Judd Fite, MD, MBA Resident Physician, PGY3 Department of Pathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: General, Hematology Target Audience: All are welcome

Description: This is a unique and fun presentation that uses photos and field experiences to portray the beauty and wonder of snakes. Dr. Fite will discuss the pathophysiology of snake bites and how isolated compounds from snake venom have played a significant role in medicine and the specialty of pathology. Objectives: At the completion of the presentation, the audience will be able to:

Explain how snake venom is a complex mixture of compounds unique to a species with specific functions

Appreciate how the isolation of compounds has had a significant impact on the practice of medicine from hematology to the fight against cancer

Explain the pathophysiology of snake envenomation

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11:15a-12:15p Room: TBA

Urine for a Good Talk: Why Urinary Tract

Cytopathology Is Popular Once Again


Christopher J. VandenBussche, MD, PhD Assistant Professor of Pathology Division of Cytopathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: Cytopathology Target Audience: All are welcome

Description: The microscopic examination of urinary tract (UT) specimens has been used for decades to help evaluate kidney diseases and detect UT cancers (such as bladder cancer). Because UT cancer has become one of the most expensive cancers to the United States health care system, interest has grown in how the microscopic examination of urine, a relatively inexpensive test, can be improved to better manage patients at risk for UT cancer. This session will examine the history and concepts behind UT cytopathology, recent new findings which are altering the practice of UT cytopathology, and future challenges facing this field. Objectives: At the completion of the presentation, the audience will be able to:

List the major cytomorphological findings in the microscopic examination of UT specimens and describe their clinical significance

Identify the major controversies in the field of UT cytopathology and how recent studies have helped address these controversies

Describe the limitations of UT cytopathology and how new clinical tests may help overcome these limitations

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11:15a-12:15p Room: TBA

What Does the Culture of Safety Mean to

Laboratorians?


Meredith Hurston, MHA, MLS(ASCP) Quality Assurance Specialist, CQI Office Department of Pathology The Johns Hopkins Hospital

Linda Gluck, MT(ASCP), MS Quality Assurance Specialist, Clinical Microbiology Division Department of Pathology The Johns Hopkins Hospital

Lisa Shifflett, BB(ASCP)CM

Quality Assurance Specialist, Transfusion Medicine Division Department of Pathology The Johns Hopkins Hospital

Level of Instruction: Basic Category: Quality Assurance/Safety Target Audience: All are welcome

Description: This presentation will provide an overview of the culture of safety in Pathology as determined by the Spring 2015 Safety Culture survey administration. What is our perception of safety in our work setting? Who monitors the safety and quality for the Department of Pathology? When we enter a PSN (Patient Safety Net) event, does it go into a “black hole”? What is the process for investigation and review of PSNs? How are our Department's quality and safety indicators reported throughout the Johns Hopkins Medicine?


Describe the current perception of the culture of safety in Pathology

Explain how PSNs are investigated and reviewed

Recognize their role in the culture of safety and the value in reporting potential adverse events

Discuss the current fiscal year indicators being monitored by the Hospital Quality Program

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Monday, November 2, 2015 1:00p-2:00p Room: TBA

Weird Micro III: The Animal Planet


Paula C. Mister, MS, MT, SM(ASCP)CM Educational Coordinator, Clinical Microbiology Division Department of Pathology The Johns Hopkins Hospital

Level of Instruction: Intermediate Category: Microbiology Target Audience: All are welcome (especially technologists, leads, and physicians)

Description: The third installment of a fun and interactive session in which unusual and interesting cases from the Johns Hopkins Clinical Microbiology Laboratory will be presented. The audience will assist in making the diagnosis from the clinical information and clues provided. This session will focus on pathogens, in particular from animal sources. Each case will be followed by a brief discussion on both new and old methods for identification of these pathogens. Objectives: At the completion of the presentation, the audience will be able to:

Integrate information from patient history, symptoms, lab results, and additional clues provided to postulate microbiologic pathogens from the cases presented

Develop an increased awareness of unusual animal pathogens, or pathogens from unusual sources in the clinical laboratory

Describe laboratory methods that can detect these pathogens in an accurate and timely way

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1:00p-2:00p Room: TBA

Sickle Cell Disease


Sophie Lanzkron, MD, MHS Director, Sickle Cell Center for Adults at Johns Hopkins Associate Professor of Medicine and Oncology Johns Hopkins Medicine

Level of Instruction: Intermediate Category: Hematology / Blood Bank Target Audience: All are welcome

Description: This session will discuss the basic pathophysiology of sickle cell disease, diagnostic testing, and those tests used to follow disease. In addition, complications and therapies will also be described. Objectives: At the completion of the presentation, the audience will be able to:

Describe the pathophysiology of sickle cell disease

Explain the role of hematology testing to diagnose and follow sickle cell disease

Identify the role of the Blood Bank in the treatment of sickle cell disease

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The Magic of Auto-SMILE


Michael Reach, PhD IT Contractor Pathology Informatics Johns Hopkins Hospital

Aidel Weisberg, BA IT Specialist Pathology Informatics Johns Hopkins Hospital

Rod Julius, BA Programmer Analyst Pathology Informatics Johns Hopkins Medicine

Level of Instruction: Basic Category: Computer/IT, Quality Assurance Target Audience: All are welcome

Description: Demonstration of a new web-based system which uses automation to simplify and standardize workflow and output. The systems development team includes staff members from Pathology Data Systems, the Patient Safety Monitoring in International Laboratories (SMILE) group, and consultants. The system is currently in use by the SMILE contract group to monitor over 150 international laboratories and is in early development for use by JHH Continuous Quality Improvement Programs office. Objectives: At the completion of the presentation, the audience will be able to:

Explain "What is Auto-SMILE?"

List some of the challenges and benefits involved in automation of quality assurance workflow

Execute a basic-level query on SMILE data

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When Good Devices Go Bad! Managing Technology

Malfunctions Course # 612-228-15 / 1.0 credit hours

Jeffrey Natterman, RRT, MA, JD Risk Manager, Johns Hopkins Hospital Associate Senior Counsel, Johns Hopkins Health System Johns Hopkins Medicine

Level of Instruction: Basic Category: Quality Assurance/Regulatory Target Audience: All are welcome Description: Healthcare organization staff are expected to apply highly sophisticated technology to treat patients directly or indirectly. Maintenance and training, including regular competency checking and proper data gathering, are critically important to ensure that patients are appropriately treated. Equally important is managing technology that is either poorly designed, malfunctions, or is recalled. This lecture material will give the audience an overview of issues facing technology managers including the regulatory framework for reporting and responding to device failures. Specifically, information will include the FDA regulatory requirements for reporting technologies that fail, the burden on hospitals and manufacturers, recall management, in addition to human factor related issues the healthcare team faces daily. Objectives: At the completion of the presentation, the audience will be able to:

Explain the legal reporting and management requirements for technology failure

Apply concepts related to proper training, human factors, and other interface issues for healthcare workers who use devices in the workplace

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Difficult or Depressed? Recognizing Depression


Karen L. Swartz, MD Associate Professor of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Director, Mood Disorders Clinical Programs Director, Adolescent Depression Awareness Johns Hopkins Hospital

Level of Instruction: Basic Category: General Target Audience: All are welcome

Description: Being sad or upset is a normal part of life, but when are these feelings something more? This session will discuss the differences between typical feelings and the medical illness, major depression. Symptoms and treatment options of depression will also be reviewed. Objectives: At the completion of the presentation, the audience will be able to:

Discuss the symptoms of depression Identify current treatments of depression

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3:30p-4:30p Room: Tilghman Auditorium

Microbes that Make You Mad


Zina Meriden, MD Resident Physician, PGY4, Department of Psychiatry 2012 Graduate of AP/CP Residency, Department of Pathology Johns Hopkins University School of Medicine

Level of Instruction: Intermediate Category: Microbiology Target Audience: All are welcome

Description: Infection with various microbial pathogens may mimic a primary mental illness. Being able to draw this distinction has major implications for patient treatment. The purpose of this talk will be to present some of the more common pathogens which can underlie psychiatric disturbances, as well as the diagnosis and treatment of these organisms. Objectives: At the completion of the presentation, the audience will be able to:

Appreciate that infection with microbial pathogens can simulate an organic psychiatric illness

Describe the epidemiology, diagnosis, and treatment of several microorganisms that can cause psychiatric disturbances

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Tuesday, November 3, 2015

8a-3:30p: Registration (Turner Concourse)

8:30a-9:30a Room: TBA

Phlebotomy “Hot” Topics: Ergonomics; Pediatrics; Blood

Cultures


Mark Sobota, BS, CSP Industrial Hygienist, Johns Hopkins Health Safety and Environment Johns Hopkins Hospital

Charles Anderson Jr., PBT(ASCP) Adjunct Instructor, CCBC Venipuncture Program PACE Business Analyst, Johns Hopkins HealthCare

Reginald Taylor, BS, M(ASCP)CM

Clinical Lab Scientist III, Clinical Microbiology Division Department of Pathology, The Johns Hopkins Hospital

Level of Instruction: Basic Category: Phlebotomy/Quality Assurance Target Audience: All are welcome

Description: This session will include three important topics for phlebotomists and their co-workers in the laboratory. Focusing first on the precious phlebotomists themselves, a safety specialist will encourage the team to engage in ergonomic practices every day to stay healthy. Next, we will turn our focus to our precious pediatric patients by reviewing anatomy and physiology and proper blood collection techniques. Lastly, we will focus on precious blood culture collections by reviewing their impact in patient care, the importance of following procedure, and the insights gained from quality monitoring. Objectives: At the completion of the presentation, the audience will be able to:

Describe ways to protect against self-injury while performing phlebotomy

Distinguish performing phlebotomy on pediatric patients from other age groups

Recognize the importance of blood cultures in patient care and the need for proper collection

Explain at least three unique and specialized duties phlebotomists perform as part of the patient care team

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Tuesday, November 3, 2015 8:30a-9:30a Room: TBA

A Lung Mass: What Could It Be?


Zahra Maleki, MD Assistant Professor of Pathology Division of Cytopathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: Cytopathology Target Audience: All are welcome

Description: Lung masses have a very wide differential diagnosis. They can be a single mass or multiple masses, benign or malignant, primary or metastatic tumors. This presentation reviews the diagnostic procedures, differential diagnosis for lung mass or masses, ancillary tests, and molecular studies. Objectives: At the completion of the presentation, the audience will be able to:

Describe the diagnostic procedures utilized for lung masses

List most important clinical history and symptoms

Describe benign conditions that cause lung nodules

Describe the major primary lung cancers

Identify risk factors for lung cancer

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From the Morgue to the Molecular Lab:

An Abbreviated History of Anatomic Pathology


Lisa Rooper, MD Resident Physician, PGY4 Department of Pathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: General Anatomic Pathology (Histology & Cytopathology) Target Audience: All are welcome

Description: This presentation aims to provide an entertaining overview of the history of anatomic pathology. What did the public think of the earliest autopsies? Who was the first person to look at tissue under a microscope, and what did he see? What went wrong during the first frozen section performed at Johns Hopkins? Why did surgeons provide the original surgical pathological services? When did cytopathology become an accepted technique for diagnosis and screening? How did public scandals shape pathology practice? And how do new diagnostic technologies fit into these traditions? Learn the answer to these questions and more regarding the background of our field and our jobs. Objectives: At the completion of the presentation, the audience will be able to:

Explain how pathology became a unique medical specialty

Discuss the importance of Johns Hopkins in pathology history

Describe how public events shaped pathology practice today

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Adventures of a Floating Laboratory: A Mercy Ship

Experience


Amie Merriken, MLS (ASCP)CM Clinical Laboratory Scientist III, Clinical Microbiology Division The Johns Hopkins Hospital


Description: Ever wonder what it would be like to work in a laboratory on the largest civilian hospital ship? Come join us for one medical laboratory scientist's eight-week experience on the Africa Mercy in Madagascar and discover the rewards and challenges of this adventure. Learn how the ship is run and how she worked alongside other healthcare professionals to help the Malagasy people. Objectives: At the completion of the presentation, the audience will be able to:

Describe the setting of the clinical lab, tests performed, and testing methods used on the ship

Explain the challenges encountered and solutions implemented in this unconventional setting

Describe some of the patients served and the rewards of serving on this mission

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Quality Laboratory Practice: Pre-Analytical Phase of

Laboratory Testing


Kathy Nucifora, MPH, MT(ASCP) Director of Accreditation COLA

Level of Instruction: Basic Category: Phlebotomy/Quality Assurance Target Audience: All are welcome

Description: This presentation will focus on those errors which can occur in the pre-analytic phase of the life cycle of a laboratory test and will include test ordering, patient identification, and specimen acquisition. Ideas and tools on avoiding these pitfalls will be discussed. Objectives: At the completion of the presentation, the audience will be able to:

Evaluate areas in pre-analytic phase of where errors are prone to occur

Discuss best practices to avoid these errors

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11:00a-12:00p Room: TBA

New Syphilis Serology: A Paradigm Shift in

Syphilis Testing for the 21st Century


Barbara Detrick, PhD Professor of Pathology Johns Hopkins University School of Medicine Immunology Director, Department of Pathology Johns Hopkins Hospital

Level of Instruction: Intermediate Category: Immunology Target Audience: All are welcome

Description: Infectious syphilis has re-emerged in the United States and worldwide. The presentations of syphilis, often described as “the great imitator,” can be varied and atypical. Thus, serology remains a critical component in the diagnosis of syphilis. This session will feature the fascinating history of syphilis, a review of the early testing system, and presentation of the modern, up-to date algorithm for syphilis. Even today, there is no single serological test to identify active disease. In 2011, the Immunology Laboratory at Johns Hopkins Hospital implemented the new reverse sequence algorithm for syphilis. This presentation will highlight the utility of this paradigm shift to the newer serological tests, and through interesting cases, share our experience over the past four years. Objectives: At the completion of the presentation, the audience will be able to:

Discuss the utility of the new reverse syphilis algorithm

Compare the advantages of the new reverse syphilis algorithm to the traditional syphilis algorithm

List and describe the methods used in the reverse syphilis algorithm

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11:00a-11:30a Room: TBA (30 minute)

Patent Medicine: Selling The Cure


Norm Barker, MS, MA, RBP Professor of Pathology & Art as Applied to Medicine Johns Hopkins University School of Medicine

Michael Torbenson, MD Professor of Pathology Mayo Clinic Rochester, Minnesota


Description: This presentation of trade card images explores several major themes used in the advertising of patent medicines. These advertising themes are of historical importance because they document and illuminate one of the most critical time periods in the history of Western medicine: the transition from ancient Galenic notions of internal humors as a cause of disease, to modern understandings that both internal and external factors, such as microorganisms, can cause disease. Objectives: At the completion of the presentation, the audience will be able to:

Appreciate a historical perspective on the patent medicine industry at the turn of the 19th century before the government started to regulate ingredients

Describe how the newly invented art form of chromolithography which brought color to millions affected printed ephemera and the patent medicine trade

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The Value of Postmortem Microbiology Cultures


Stefan Riedel, MD, PhD, D(ABMM), FCAP Associate Professor of Pathology Johns Hopkins University School of Medicine Director, Clinical Pathology Laboratories Johns Hopkins Bayview Medical Center

Level of Instruction: Intermediate Category: Microbiology, Quality Assurance, Autopsy Target Audience: All are welcome

Description: The utility of postmortem microbiologic examinations has been

a topic of controversy ever since the inception of evidence-based scientific concepts in medicine in the 19th century. Numerous published studies describe a lack of correlation between antemortem clinical and laboratory

findings and postmortem culture results. However, there is equal evidence from other studies that indicates at least one limited utility of postmortem

microbiologic examinations in select cases. In the past, autopsies and postmortem microbiologic examinations have contributed to the discovery of novel infectious microorganisms. However, the problems of implementing routine procedures in daily autopsy practice related to the lack of consensus on the broader utility, as well as a lack of regulatory guidelines, have also been well appreciated. This presentation provides an overview of the utility of postmortem microbiologic examinations, together with some practical aspects and guidelines for those confronted with making the decision to allow or discourage the use of bacteriologic cultures obtained during autopsies. Objectives: At the completion of the presentation, the audience will be able to:

Describe the potential concerns regarding the postmortem spread of microorganisms

Describe the methods for specimen procurement for postmortem microbiology cultures

Identify the limitations of postmortem microbiology cultures and examinations

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Get Computer Security Savvy - Answers to Questions

You Didn’t Know You Had


Alan O’Neill, B.S. and Pathology Data Systems Staff Pathology Data Systems The Johns Hopkins Hospital

Level of Instruction: Basic Category: Computer/IT Target Audience: All are welcome

Description: With each passing day, cybersecurity becomes more critical. Threats to your computer can sneak in and cause serious damage if you are not aware of what to look for. In this program, you will learn to become mindful of potential security threats to your work and home computers that use the Windows operating system, and you will increase your awareness of possible dangers that can be avoided. The program will also give tips to help you make more informed decisions and implement better security practices. Objectives: At the completion of the presentation, the audience will be able to:

Utilize better security practices while operating work and home Windows computers

Recognize potential security threats and understand reasonable courses of action

Identify possible risks when connecting to public Wi-Fi

Describe the importance of maintaining Windows updates and application updates

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Parasite Look-Alikes: Do You Know One When You

See One?


Patricia (Trish) J. Simner, PhD, D(ABMM) Assistant Professor of Pathology and Medicine Johns Hopkins University School of Medicine Director of Medical Parasitology Johns Hopkins Hospital

Level of Instruction: Intermediate Category: Microbiology Target Audience: All are welcome

Description: This will be a fun interactive case-based session describing parasite look-alikes submitted to the Johns Hopkins Parasitology Laboratory. A few "true" parasite cases will be thrown in to keep the audience on their feet. Objectives: At the completion of the presentation, the audience will be able to:

Differentiate true parasites from parasite look-alikes encountered in the parasitology laboratory

Describe the basic epidemiology and laboratory testing required for identification of parasites in the clinical laboratory

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Interventions to Alter Testing Behavior: How

to Manage Questionable Orders and

Mishandled Specimens without Making

Everybody Hate You Course # 612-212-15 / 1.0 credit hours

Jennifer Bynum, MD Resident Physician, PGY3 Department of Pathology Johns Hopkins Medicine

Level of Instruction: Basic Category: Quality Assurance/Safety Target Audience: All are welcome

Description: We all have occasional unpleasant conversations with our colleagues about inappropriately ordered tests and/or inappropriately handled specimens. Many of these problems can be systematically addressed, and we will discuss different approaches to behavioral change, specific strategies for implementing change, and specific strategies for dealing with disagreement both before and after changes are made. Objectives: At the completion of the presentation, the audience will be able to:

Identify the advantages and disadvantages of passive, active, and multifaceted approaches to changing behavior

Review strategies for implementing change and understand the data that supports what works best

Describe strategies for approaching and dealing with disagreement among those impacted by implemented changes

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Blood Transfusion: The History of a Life-Saving

Technology


Peter Miller, MD Transfusion Medicine Fellow Department of Pathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: Blood Bank Target Audience: All are welcome

Description: Sometimes to understand where we are, we need to see how far we have come. Blood transfusions have been possible for almost 200 years. About 15 million units of blood are donated each year in the United States. Although the first successful human blood transfusion was performed in 1818, it was not until 1901 when the first human blood groups were discovered that blood transfusion became a reality. From discoveries of other blood antigens to better knowledge of antibody production, this technology has progressed to what millions of patients depend on as life-saving. The inspiring and sometimes tragic history of blood transfusion helps us appreciate this technology and theorize about what is possible in the future. Objectives: At the completion of the presentation, the audience will be able to:

Describe the major milestones in the history of blood transfusion technology development

Identify the key factors and scientists which influenced the development of blood transfusion technology

Define the basic concepts of incompatibility and antibody production as they apply to blood transfusion

Discuss several of the future research goals in transfusion medicine

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Wednesday, November 4, 2015

8a-3:30p: Registration (Turner Concourse)


William Henry Welch and the Transformation of

Medicine in America Course # 612-214-15 / 1.0 credit hours

Ralph H. Hruban, MD Baxley Professor and Director of Pathology Professor of Oncology Johns Hopkins University School of Medicine Pathologist-in-Chief Johns Hopkins Hospital Director, Sol Goldman Pancreatic Research Center Johns Hopkins Medicine


Description: Dr. William Henry Welch was the first director of the Department of Pathology here in the Johns Hopkins University School of Medicine. Dr. Welch fundamentally transformed American Medicine from a primitive practice learned through the apprentice system, to a science-based field thought through rigorous scientific training. In this talk we will trace the remarkable life story of our first director. Objectives: At the completion of the presentation, the audience will be able to:

Describe one of the major changes that the Johns Hopkins University School of Medicine brought to American Medicine

Explain how William Henry Welch played a central role in setting the direction for the Johns Hopkins University School of Medicine

Name the four doctors in the famous John Singer Sargent painting of “The Four Doctors”

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Tumor Immunology and the Development of

Companion Diagnostic Tests for Anatomic Pathology


Stella Redpath, PhD Leader for Medical and Scientific Affairs Roche Tissue Diagnostics

Level of Instruction: Intermediate Category: Immunology/ Surgical Pathology/ Molecular Target Audience: Technologists, Leads, Physicians

Description: Cancer involves cellular changes. Some of these changes help tumors escape immune detection. Finding these proteins, such as PD-L1 and PD-1, and developing drugs that target them can undo this process, allowing the patient's immune system to fight again. Development of companion diagnostic tests using immunohistochemistry to detect the expression of PD-L1 markers in cancer marks a new and exciting future for the role of anatomic pathology in personalized healthcare. Objectives: At the completion of the presentation, the audience will be able to:

Identify the theory of cancer development

Describe the relationship between immunological response and cancer cellular changes

Appreciate the role of targeted drugs in personalized cancer treatment

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Pharmacogenetics: Are Your Drug-Metabolizing

Enzymes Fast or Slow?


Allison Chambliss, PhD Clinical Chemistry Fellow Department of Pathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: Clinical Chemistry/Molecular Target Audience: All are welcome

Description: Appropriate dosing of pharmaceuticals is critical to prevent sub-therapeutic efficacy or the occurrence of adverse events. However, genetic variability may significantly influence an individual’s response to a therapeutic agent. Wide genetic variability has been observed in a number of drug-metabolizing enzymes which are responsible for the activation or inactivation of numerous drug classes. Targeted identification of specific genetic variants may assist in providing the optimal drug at the optimal dose to the correct patient. With the aid of case studies, this presentation will describe representative genetic variants that are known to influence the metabolism of commonly-prescribed medications. The presentation will also explore the current analytical platforms and challenges associated with implementing pharmacogenetic testing in a clinical laboratory environment. Objectives: At the completion of the presentation, the audience will be able to:

Describe the role of genetics in the metabolism of commonly-prescribed medications

Relate genotypes of frequent drug-metabolizing variants to drug activity

Discuss the advantages and disadvantages of current approaches to pharmacogenetic testing

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Positively Pathology - Are You Passing It On?


Doris Pendergrass, SPHR, SHRM-SCP Human Resources Director Department of Pathology Johns Hopkins Medicine


Description: No matter what your title or location, Positively Pathology starts with you! We all want to work in a positive work environment. We all want the Department to have a well-respected and positive reputation across all of Johns Hopkins Medicine and in the communities we serve. How do we each play a role in that and what can you as an individual do to contribute? Objectives: At the completion of the presentation, the audience will be able to:

Generate realistic ideas for how to personally be a part of improving civility, kindness, and creating a positive work environment

Practice a few techniques for keeping yourself positive and upbeat, even on hectic or stressful days

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11:00a-12:00p Room: TBA

Blood Collection and Component Manufacturing Course # 612-224-15 / 1.0 credit hours

P. Dayand Borge, Jr., MD, PhD Medical Director, Eastern Division American Red Cross

Level of Instruction: Basic Category: Blood Bank Target Audience: All are welcome

Description: Ever wonder where the blood components in the blood bank come from? How donors are selected, blood collected, and manufactured into the products that are issued to patients? Please join us for a presentation from one of our blood suppliers. Objectives: At the completion of the presentation, the audience will be able to:

Discuss the current state of blood donor recruitment and the issues faced when targeting specific types of donors

Describe the manufacturing process for preparing red blood cells, platelets, plasma, and cryoprecipitate for transfusion

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11:00a-12:00p Room: TBA

Lab "Errors": A Practical Guide to Investigation in

the Clinical Lab Course # 612-226-15 / 1.0 credit hours

Deborah S. Williams, BA, MT(ASCP) Quality Assurance Specialist Department of Pathology CQI Office Community Division, Suburban Hospital

Level of Instruction: Intermediate Category: Quality Assurance Target Audience: Technologists, Leads, Supervisors, Managers

Description: “What happened and how do I figure out why?” This presentation will be an overview of the different types of errors/ variances that may occur in the Laboratory from patient testing to laboratory practice and quality assurance. The investigation process will be broken down into basic, general components that can be applied to any failure, error or deviation from a process, to determine what happened and how. Through the use of examples the investigation components will be demonstrated. This presentation will be particularly useful for the bench tech who troubleshoots QC failures to the QA specialist who investigates CAP proficiency failures or patient care issues. Objectives: At the completion of the presentation, the audience will be able to:

Define categories of "Errors/Variances" that occur in the Clinical Lab

Define basic components of any investigation process

Demonstrate basic investigation techniques

Apply basics of investigation to each error category

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Advances in Antithrombotic Therapy Monitoring


Thomas S. Kickler, MD Professor of Pathology, Medicine, and Oncology Johns Hopkins University School of Medicine Director, Hematology and Coagulation Laboratories Johns Hopkins Hospital

Level of Instruction: Intermediate Category: Hematology Target Audience: All are welcome (especially technologists, leads, nurses, and physicians)

Description: Review the general pharmacology of anticoagulants and discuss the therapeutic monitoring of both antiplatelet drugs and anticoagulants. Objectives: At the completion of the presentation, the audience will be able to:

Explain the pharmacology of warfarin and heparin so that one may better understand the monitoring of these agents, as well as the new target-specific agents

Describe the principles of coagulation testing using clot-based and chromogenic assays

Identify the tests used in monitoring antiplatelet agents

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Laboratory Management and Laboratory

Leadership: Why We Need Both


Allen Valentine, MBA, C(ASCP) Administrator, Department of Pathology Administrative Director, Johns Hopkins Medical Laboratories Johns Hopkins Medicine

Level of Instruction: Intermediate Category: Hematology Target Audience: Leads/Supervisors/Managers

Description: As laboratorians, we are natural managers due to the regulatory standards and our scientific responsibilities. However, we often need to be reminded that we need to utilize leadership skills to motivate our teams. It is the perfect balance of management and leadership that results in great outcomes. Objectives: At the completion of the presentation, the audience will be able to:

Identify the difference between managerial and leadership skills

Determine when to utilize management traits versus leadership skills

Identify Pathology outcomes where there was an emphasis of

management skills or leadership skills or both

35



Autoimmune Hemolytic Anemia: Diagnosis, Drugs,

and Transfusion


Paul M. Ness, MD Professor of Pathology and Oncology Johns Hopkins University School of Medicine Director, Division of Transfusion Medicine Johns Hopkins Hospital

Level of Instruction: Advanced Category: Blood Bank Target Audience: All are welcome (especially technologists, leads, nurses, and physicians)

Description: The Transfusion Service prides itself on providing crossmatch-compatible blood for patients in need of a red blood cell (RBC) transfusion, but what do you do in the case of autoimmune hemolytic anemia? This talk will review clinical and laboratory diagnosis of the two most common types of autoimmune hemolytic anemia and how to manage them even when crossmatch-compatible blood is not available. Objectives: At the completion of the presentation, the audience will be able to:

Identify two types of autoimmune hemolytic anemia based on clinical and laboratory findings

Recommend treatment and transfusion options for patients with autoimmune hemolytic anemia

Explain the laboratory’s role in selecting donor units for patients with warm autoimmune hemolytic anemia

36



Separating the Wheat from the Chaff: What is Celiac

Disease and Gluten Sensitivity?


Whitney M. Green, MD Fellow, Gastrointestinal and Liver Pathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: Immunology & Surgical Pathology Target Audience: All are welcome

Description: Celiac disease (aka gluten intolerance) is an autoimmune disorder that occurs in genetically predisposed individuals and is characterized by an intestinal inflammatory response to gluten, a protein found in wheat and other related grains. In recent decades, the incidence of celiac disease has risen dramatically to suggest interplay of changes in various environmental factors in those who are susceptible. Moreover, while celiac disease is well-recognized manifestation of gluten sensitivity, there is a spectrum of disease that includes non-celiac gluten sensitivity which has a myriad of intestinal and extraintestinal manifestations. We will discuss the gluten, the pathophysiology of celiac disease, and its diagnosis and treatment, as well as the difference between celiac and non-celiac gluten sensitivity. Objectives: At the completion of the presentation, the audience will be able to:

Explain "What is gluten?"

Describe the pathophysiology, diagnosis, and treatment of celiac disease

Explain the difference between celiac disease and non-celiac gluten sensitivity

Describe the extraintestinal manifestations of gluten sensitivity

37


3:30a-4:30p Room: TBA

Cervical Cancer: From Henrietta Lacks to the HPV

Vaccine Course # 612-232-15 / 1.0 credit hours

Marissa White, MD Resident Physician, PGY3 Department of Pathology Johns Hopkins University School of Medicine

Level of Instruction: Basic Category: Cytopathology/ Surgical Pathology / Microbiology Target Audience: All are welcome

Description: Cervical cancer previously was a leading cause of female cancer-related deaths, particularly in women of childbearing age. With the introduction of cervical cancer screening, the death rate from cervical cancer has significantly decreased. Recent advances such as changes to cervical cancer screening practices and recommendations, and the introduction of routine human papillomavirus (HPV) vaccination aim to reduce the incidence of cervical cancer and further improve patient survival. This presentation will review the pathogenesis, basic cytology, and histology of cervical precancerous and cancerous lesions. Additionally, we will discuss the changes to cervical cancer screening practices and current recommendations for HPV vaccination. Objectives: At the completion of the presentation, the audience will be able to:

Identify the methods of HPV transmission

Discuss the basic cytology and histology of cervical precancerous and cancerous lesions

List the current recommendations for cervical cancer screening

Identify patient populations recommended by the CDC to get the HPV vaccine

38



Tissue Donation for Transplantation: The People,

the Process, and the Success of Dermal Grafts

for Post-Mastectomy Breast Reconstruction


Rick Kolovich, RN, CPTC, CCTC, CTBS Clinical Manager Donor Services Living Legacy Foundation

Heather Brennan, PhD Director, Marketing Musculoskeletal Transplant Foundation

Lauralee Brown, RN, MHSA, CPHQ Regional Director Musculoskeletal Transplant Foundation

Level of Instruction: Basic Category: General/Blood Bank Target Audience: All are welcome

Description: The gift of musculoskeletal tissue (bone/skin) donation after death has a profound effect on thousands of recipients annually. The gift of dermal (skin) tissue provides surgical patients with grafts to rebuild the breast wall post-mastectomy from breast cancer following breast reconstruction. The gift additionally assists the donor family as they seek to find solace and a positive outcome from the loss of their loved one. Musculoskeletal donation is a win-win for so many. This presentation will discuss the referral/recovery process and dermal utilization at Johns Hopkins Medicine.


Describe the Living Legacy Foundation (LLF) tissue donation process, from donor referral to recovery

Describe the significance of dermal tissue for post-mastectomy breast reconstruction

39

Third Annual Pathology

Educational Symposium Schedule at a Glance

Color Key:

General Chemistry Computer

Surgical Pathology Hematology Molecular

Blood Bank Microbiology Quality Assurance

Cytology Immunology Phlebotomy

Pathology Symposium Committee

Chairs: Barbara Parsons & Lorraine Blagg

Barbara Detrick Marian Turpin Christine Hostetter Mayer Rubin

Debbie Williams Monica Gray Doris Pendergrass Nancy Nath

Eunhee Rim Paula Mister Jo Shim Renata Karlos Karen Bordenet Rosemary Hines Kelly Baloga Suzy Nicol Kurt Michael Tammy Heacock Linda Gluck Vanessa Rodas-Eral Maria Barata

40

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ch

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nd

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gistra

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8a

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8:0

0

AM

Taking

Qu

ality to

the N

ext Level

8:3

0

AM

Snakes, Sn

ake

Hu

ntin

g an

d th

e

Path

op

hysio

l. o

f a Snakeb

ite

Up

date o

n

Hep

atitis C:

The En

d o

f th

e Begin

nin

g

10

:00

AM

Cu

lture o

f Safety in

the

Lab

Urin

e For a

Go

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Talk: Wh

y U

rinary Tract

Cyto

path

olo

gy Is P

op

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nce

Again

11

:15

AM

Lun

ch

12

:15

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The M

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Sickle Cell

Disease

Weird

Micro

III: Th

e An

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1:0

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Micro

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sfusio

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M

Tissue

Do

na

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for

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st- M

aste

cto

my

Ce

rvic

al

Ca

nc

er:

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m

He

nrie

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ks to

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cc

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43

REGISTRATION

Name: ______________________________ Badge #:___________________ Email: _________________________________________________________ JHM Entity: __________________ Division: ___________________________ Supervisor/Manager: _____________________________________________

Selection for the Sessions: Employee: This is a preliminary schedule and is subject to change. To aid us in planning and assigning rooms for each talk, please register at

http://pathology.jhu.edu/department/training/symposium.cfm You must also register for lunch if you wish to have a lunch available to you only on days you are attending. Registration deadline is October 15, 2015. You may be required to get Supervisor approval before registering.

Are you interested in Volunteering for this event? http://vols.pt/eb8ujK Examples: Session Moderator, Registration, Room Lead, Lunch, etc.

MONDAY, NOVEMBER 2, 2015

Time Course

8:30-9:30a Taking Quality to the Next Level 612-202-15 10:00-11:00a Update on Hepatitis C 612-203-15 10:00-11:00a Snakes, Snake Hunting, and a Snakebite 612-215-15 11:15-12:15p Urine for a Good Talk 612-216-15 11:15-12:15p Culture of Safety in the Lab 612-225-15 12:15-12:45p Lunch 1:00-2:00p Weird Micro III: The Animal Planet 612-209-15 1:00-2:00p Sickle Cell Disease 612-229-15 1:00-2:00p The Magic of Auto-SMILE 612-206-15 2:15-3:15p When Good Devices Go Bad 612-228-15 2:15-3:15p Difficult or Depressed? 612-231-15 3:30-4:30p Microbes that Make You Mad 612-218-15 TUESDAY, NOVEMBER 3, 2015

Time Course

8:30-9:30a Phlebotomy “Hot” Topics 612-233-15 8:30-9:30a Lung Mass: What Could It Be? 612-220-15 9:45-10:45a From the Morgue to the Molecular Lab 612-205-15 9:45-10:45a Adventures of a Floating Laboratory 612-230-15 9:45-10:45a Quality Lab Practice: Pre-Analytical Phase 612-237-15


http://vols.pt/eb8ujK

44

REGISTRATION (continued)

TUESDAY, NOVEMBER 3, 2015 (continued)

Time Course

11:00-11:30a Patent Medicine: Selling The Cure 612-207-15 11:00-12:00p New Syphilis Serology: A Paradigm Shift 612-219-15 12:00–12:45p Lunch 1:00-2:00p Value of Postmortem Microbiol. Cultures 612-204-15 1:00-2:00p Get Computer Security Savvy 612-221-15 2:15-3:15p Parasite Look-Alikes 612-208-15 2:15-3:15p Interventions to Alter Testing Behavior 612-212-15 3:30-4:30p Blood Transfusion, The History of 612-223-15

WEDNESDAY, NOVEMBER 4, 2015

Time Course

8:30-9:30a William Welch and Medicine in America 612-214-15 8:30-9:30a Tumor Immunology & Anatomic Pathology 612-234-15 9:45-10:45a Pharmacogenetics: Metabolization 612-222-15 9:45-10:45s Positively Pathology: Are You Passing It On 612-217-15 11:00-12:00p Blood Collection & Component Mfg. 612-224-15 11:00-12:00p Lab Errors 612-226-15 12:00–12:45p Lunch 1:00-2:00p Anti-Thrombotic Therapy Monitoring 612-211-15 1:00-2:00p Lab Management & Lab Leadership 612-235-15 2:15-3:15p Autoimmune Hemolytic Anemia 612-210-15 2:15-3:15p Separating the Wheat from the Chaff 612-227-15 3:30-4:30p Cervical Cancer 612-232-15 3:30-4:30p Tissue Donation for Post-Mastectomy 612-236-15

third annual pathology educational...

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