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Zoom Meeting ID: 916 2918 1754 | Passcode: QIDAY2024

Please join us for Quality Improvement Day 2024! The Quality Improvement Program in the Department of Pathology and Laboratory Medicine at the David Geffen School of Medicine at UCLA is excited to present the 2024 Quality Improvement Day and Daljit S. and Elaine Sarkaria Keynote Lecture on Quality Improvement to the Bruin community. This year's theme is "AI and Data Integration of Pathology and Lab Medicine Data Across Clinical Specialties." 

Dr. Liron Pantanowitz will kick off the event with his Keynote Lecture titled "Data-Driven Decision-Making in Support of Managing Pathology Laboratories." Followed by a series of enlightening workshops focusing on the intersection of technology and pathology. Discover how data analytics and AI/ML performance monitoring are revolutionizing clinical laboratory operations, and explore the benefits of custom software development in pathology at our sessions led by esteemed experts. The day will end with trainee presentations exploring real-time genomic surveillance of pathogenic microorganisms, advancing precision in immunogenetics, and the vital role of communication in pathology.

 We will host virtual events from 8:00 a.m. to 1:00 p.m. on 2/9/2024 via Zoom. If you have any questions or concerns, please email Monique Trinh at MMTrinh@mednet.ucla.edu!

Please see below for an overview of our agenda:  

8:00 a.m. - 9:00 a.m. 2024 Daljit S. and Elaine Sarkaria Keynote Lecture on Quality Improvement 

9:00 a.m. - 9:30 a.m. Break

9:30 a.m. - 11:00 a.m. Workshops

11:00 a.m. - 12:00 p.m. Break

12:00 p.m. - 1:00 p.m. UCLA Pathology and Laboratory Medicine QI Project Presentations

Table of Contents

2024 Daljit S. and Elaine Sarkaria Keynote Lecture on Quality Improvement

Time: 8:00 a.m. to 9:00 a.m. 

Title: "Data-Driven Decision-Making in Support of Managing Pathology Laboratories"

Description: Pathology laboratories generate large amounts of patient and operational data, usually housed in laboratory information systems. Linking that information to other data sources for data mining and analytics is essential to inform decision-making by multiple stakeholders to effectively manage the pathology laboratory. I will review and illustrate examples of how data-driven decision-making can support laboratory operations, resource management, personnel performance and productivity, quality assurance, and business activities. The application of dashboards and informatics tools for data-driven decision-making in pathology will also be highlighted.

Speaker: Liron Pantanowitz, MD, PhD, MHA | Chair of the Department of Pathology at the University Pittsburgh School of Medicine

Professor Liron Pantanowitz is Chair and Professor of Pathology at the University of Pittsburgh in the USA. He received his medical degree and PhD from the University of Witwatersrand in South Africa. He completed his anatomical and clinical pathology residency training at Beth Israel Deaconess Medical Center, Harvard in Boston. He subsequently completed a hematopathology fellowship at Harvard and Cytopathology fellowship at Tufts. He is also board certified by the American Board of Pathology in clinical informatics and completed his MHA at Ohio University. Dr. Pantanowitz is an Editor-in-Chief of the Journal of Pathology Informatics. He is the president of the Digital Pathology Association, president of the American Society of Cytopathology, and a past president and current council member of the Association of Pathology Informatics. He is widely published in the field of pathology informatics and cytopathology. His research interests include digital pathology and artificial intelligence, as well as non-gynecologic cytopathology.

Workshops

Time: 9:30 a.m. to 10:00 a.m. 

Title: "Improving Pathology Operations Through Custom Software Development"

Description: This talk will outline the advantages and barriers to custom software development, emphasizing how even a small team can make a significant impact on clinical operations and patient safety. No commercial solution is ideal for any specific environment, but these systems can be supplemented by integrated or stand-alone solutions specifically designed for your practice.

Speaker: John Sinard, MD, PhD | Medical Director, Pathology Informatics, Pathology; Professor of Pathology and of Ophthalmology and Visual Science, Yale


During his 30+ years at Yale, Dr. John Sinard has held many roles within the pathology department. He ran the autopsy service for 17 years, built the pathology informatics program and directed it for 17 years, and directed the residency program for 6 years.  He was Vice Chair for 8 years, including 7 as director of Anatomic pathology.  He remains the medical director of the pathology informatics program, and working with a small development team continues to develop custom software solutions for clinical use.

Time: 10:30 a.m. to 11:00 a.m. 

Title: "Improving Clinical Laboratory Operational Performance through Data Analytics"

Description: Given the size and depth of data available to clinical laboratories, theoretically the raw materials for data-informed decision making have never been more plentiful. Many institutions are motivated to better utilize their data assets and are investing in this area. Proliferation of open-source software and low-code or no-code tools is making data analytics widely accessible. But, we will limit our effectiveness without appropriate capacity for data analytics and strengthened data literacy skills. This session will describe ways data analytics is transforming clinical laboratory services and discuss the potential impacts of newly emerging technologies and trends.

Speaker: Shannon Haymond, PhD, MSPA | Vice Chair for Computational Pathology; Director, Mass Spectrometry, Ann & Robert H. Lurie Children’s Hospital of Chicago; Associate Professor of Pathology, Northwestern University Feinberg School of Medicine


Dr. Shannon Haymond is Vice Chair for Computational Pathology and Director for Clinical Mass Spectrometry at Ann & Robert H. Lurie Children’s Hospital of Chicago. She is Associate Professor of Pathology at Northwestern University Feinberg School of Medicine. Dr. Haymond is the Immediate Past-President of ADLM (formerly AACC).

Dr. Haymond’s computational pathology efforts are aimed at building the capacity for advanced data analytics in her department through innovations in infrastructure, education, and research to facilitate data-informed decision making for clinical care, operations, and quality assurance. She completed a Master of Science in Predictive Analytics from Northwestern University.

Time: 10:30 a.m. to 11:00 a.m. 

Title: "Performance Monitoring of Deployed AI/ML models in a Clinical Laboratory"

Description: In pathology and laboratory medicine, AI/ ML technologies have demonstrated promising advances, ranging from microscopic image analysis to clinical data interpretation. However, without consistent and rigorous performance monitoring, the benefits could be overshadowed by inaccuracies, inefficiencies and patient harm. Performance monitoring is not just a technical necessity but an ethical one, ensuring that patient care remains uncompromised and that the benefits of AI integration are realized without inadvertently introducing harm. Several notable methodologies have emerged for performance monitoring. Techniques like statistical process control, which has its roots in manufacturing, have been repurposed to monitor the performance of AI/ML models in healthcare settings. Similarly, reliability diagrams and calibration plots are used to assess the confidence of probabilistic models, ensuring that their predictions align with real-world outcomes, and multivariate drift detectors are being used for detection of covariate or input drift. These techniques offer tangible metrics to quantify model performance, providing a foundation for trust. This talk delves into the necessity of overseeing the operation of AI/ML models in pathology and laboratory medicine and outlines methods and techniques for monitoring model performance.

Speaker: Jansen N Seheult, MB BCh BAO, MSc, MS, MD | Senior Associate Consultant & Assistant Professor; Division of Hematopathology & Division of Computational Pathology and Artificial Intelligence, Mayo Clinic


Jansen Seheult, MB BCh BAO, MSc, MS, MD has over eight years of experience in the development, performance evaluation and monitoring of AI/ML models used in the clinical laboratory. He currently serves as the Medical Director of Digital Pathology and AI in the Division of Hematopathology, Department of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, MN. His team develops and implements automation and ML-enabled software tools for hematopathology diagnostics, including in the domains of flow cytometry, morphology and genomics. Dr. Seheult has contributed to CAP white papers on machine learning in pathology and laboratory medicine, including recommendations for performance evaluation of these models prior to deployment. His hands-on experience in method design and statistical analysis of performance evaluation studies for AI/ML-enabled IVDs has provided unique insights into the challenges facing laboratories trying to deploy these technologies safely and effectively and has led to a concerted effort to improve education and access to tools that simplify performance evaluation and monitoring of AI/ML in pathology and laboratory medicine.

UCLA Pathology and Laboratory Medicine 

QI Project Presentations

Time: 12:00 p.m. to 12:20 p.m. 

Title: "NGS and Carbapenemase Screening for Highly-Resistant Pseudomonas Aeruginosa"

Description: Carbapenemase-producing carbapenem resistant Pseudomonas aeruginosa (CP-CRPA) present treatment challenges due to extensive drug resistance (XDR).  Until 2022, these CP-CRPA were very rare in the US and not routinely screened for in our laboratory. In early 2023, through an active real-time genomic surveillance of highly drug resistant Pseudomonas aeruginosa isolates, an XDR CRPA strain producing NDM carbapenemase was identified and characterized genomically. This finding resulted in the successful and timely implementation of routine carbapenemase screening for all CRPA isolated in our lab, which enabled detection of additional NDM positive isolates and an effective infection control protocol that stopped its spread in our hospital. 

Speaker: Hannah Gray, PhD | Clinical Microbiology Fellow

Dr. Hannah Gray earned her undergraduate and master’s degrees in Environmental Engineering from USC, and completed her PhD from the Department of Environmental Health and Engineering at Johns Hopkins University, where she studied antibiotic resistance in wastewater. She then spent two years as an APHL Antibiotic Resistance Laboratory Network (ARLN) Fellow at the Washington State Public Health Laboratory. She is currently a Clinical and Public Health Microbiology CPEP Fellow at UCLA.

Time: 12:20 p.m. to 12:40 p.m. 

Title: "Assessing The Need For High Resolution HLA-DP Antigen Typing"

Description: The objective of this presentation is to demonstrate ambiguity resolution of HLA-DPB1 typing, and its importance in solid organ transplantation. By the end of this presentation, the audience will have a general understanding of the technical challenges and platforms available to characterize challenging HLA-DP antigens. Specifically, HLA-typing of class I and II antigens by using sequence specific oligo hybridization (SSO) and Next Generation Sequencing are discussed in terms of their advantages and limitations for deceased donor typing. In summary, this presentation outlines the process on how the UCLA Immunogenetics Center applies quality improvement (QI) measures to assure timely and accurate HLA typing for patients and potential donors.

Speakers: 

Dr. Mario A. Pulido, a clinical fellow in the UCLA Immunogenetics Center, is learning state-of-the-art Histocompatibility and Immunogenetics testing for solid organ and stem cell transplantation, pre and post-transplant immune assessment and testing for diagnosis of diseases with associations to Human Leukocyte Antigens (HLA). Previous research experience at the Norris Cancer Center of USC in lung cancer immunotherapy generated evidence for harnessing the human immune response for small-cell lung cancer treatment. In the biotech industry, Dr. Pulido developed expertise in the fields of Cell and Gene Therapy.  Dr. Pulido enjoys mentoring undergraduate and medical students. 

Dr. Yuxin Yin is a clinical fellow at the UCLA Immunogenetics Center. Dr. Yin’s ongoing research primarily revolves around the development of immunologic assays for clinical research and diagnostic testing for transplant pateints. Dr. Yin is also engaged in the design and management of HLA genotyping projects utilizing high-throughput next-generation sequencing (NGS) techniques.

Time: 12:40 p.m. to 1:00 p.m. 

Title: "The Many Faces of Pathology QI - Taking Pathology for Surgeons to the Next Level"

Description: When I thought of quality improvement in Pathology and Laboratory Medicine, I thought of precision and correctness in diagnostic procedures and results, I thought of turnaround time (TAT) and efficiency optimization, and I thought of quality assurance protocols.  But what about communication?  We are communicators of diagnostic information.  What kind of quality improvement is going into our diagnostic communication?

Speaker: Kenechukwu Ojukwu, MD, MPP | Bone and Soft Tissue Surgical Pathology Fellow

Dr. Kenechukwu  Ojukwu is a current dual surgical pathology and health services research fellow in the UCLA Department of Pathology and Laboratory Medicine and UCLA National Clinicians Scholar Program. She is interested in designing inclusive curricula and collaborating in a multi-disciplinary manner to disseminate innovative methods of medical education for healthcare providers, medical trainees, patients and community members.