Another Eastern Health clinical chief resigns

CEO announces action plan to improve pathology lab

Deana Stokes Sullivan dss@thetelegram.com
Published on March 16, 2010
Dr. Jim Hutchinson

Another clinical chief has resigned an administrative position with Eastern Health amid continued controversy surrounding problems in its pathology department.

Dr. Jim Hutchinson tendered his resignation Friday as clinical chief of infection control, but will continue working as a microbiologist.

Another clinical chief has resigned an administrative position with Eastern Health amid continued controversy surrounding problems in its pathology department.

Dr. Jim Hutchinson tendered his resignation Friday as clinical chief of infection control, but will continue working as a microbiologist.

Eastern Health CEO Vickie Kaminski confirmed the latest resignation during a media briefing Monday regarding a review of the pathology lab.

Since Dr. Nash Denic, clinical chief of laboratory medicine, and two site chiefs at St. Clare's and the General Hospital tendered their leadership resignations last week, several other pathologists have been on sick leave.

Dr. Oscar Howell, Eastern Health's vice-president of medical services and diagnostics, said four or five are off sick this week.

Kaminski said concerns about the sick leave, which is presumably related to what's going on in the lab, have prompted the health authority to talk to University Health Network (UHN) in Ontario about the ability to do some telepathology work to prevent an interruption in workflow.

The report released Monday was based on a review of the pathology lab by the Institute of Quality Management in Healthcare (IQMH) in Ontario, arising from issues raised prior to the public release last month of cyclosporine testing errors due to equipment not being properly calibrated.

In a memo to Howell, dated Feb. 17, IQMH CEO Dr. Gregory Flynn said, "The key findings confirm that a dysfunctional relationship has evolved between the leader and some members of the group. It is rooted in poor communications and a lack of transparency around decisions that are then characterized as autocratic."

Team members 'hostile'

Flynn cited low morale, suspicion and distrust in the group, and rather than being collegial, some team members were "setting scores, being passive aggressive, hostile and intimidating."

Flynn went on to comment about workload, saying reductions for some pathologists but not others "deepens the building resentment and reinforces an oft heard observation that 'there is an inner circle who receives special treatment.'"

Kaminski said the findings are reason for concern, but present an opportunity to work with staff to improve working conditions.

She said Eastern Health will immediately put an action plan in place to address the report's recommendations.

"We will immediately begin a nationwide leadership search using a search firm for a clinical chief for our area," Kaminski said. Eastern health will also complete a review with UHN and incorporate its recommendations.

Consolidate labs, reduce paperwork

She said external consultants will be contracted to help with team and consensus building in "what has been deemed a dysfunctional area," a one-site consolidation of the labs under Eastern Health will be expedited as soon as possible and an electronic laboratory information system will be purchased and implemented to reduce paperwork.

In addition to doing the lab review, Kaminski said UHN has agreed to take on a supervisory role. Dr. Bayardo Perez-Ordonez, UHN's director of surgical pathology, was expected to arrive in St. John's Monday night to begin a senior leadership role in Eastern Health's laboratory medicine program with a focus on day-to-day operations.

"Our pathologists have, indeed, been under a significant amount of stress.

"They are certainly working in adverse conditions and they continue to provide care and support to the patients of Newfoundland and Labrador, and for that we are grateful," she said.

Asked his response to Health Minister Jerome Kennedy's concern last week that Kaminski should have been told about the IQMH report much earlier, Howell said the external review was requested after discussions with the chief of laboratory medicine and Flynn, who came in on short notice during the week of Feb. 8, met with the laboratory leadership team Feb. 12 and the pathologists Feb. 15.

Flynn e-mailed his final report to Howell Feb. 18.

"Normally, I would have read it that weekend," Howell said.

"I did not because I got involved in the cyclosporine issue and then I went on vacation on the 23rd of February, and, in fact, I only read the final report in detail this past weekend, but actions were already underway.

"When I returned from vacation on the 10th of March, I shared a copy with the CEO. The other part, for me, is that I had committed to the pathologists that I would, in fact, once I received the report, share it with them and meet with them. But much of the content had already been discussed with them on the 15th of February."

Howell planned to meet with the pathologists Monday afternoon following the media briefing.

dss@thetelegram.com