DOP Update: Looking Forward and Back

By Jeffrey Myers, MD | 6 April | Department of Pathology Update Vol. 3.5

Teammates,

Today brings another edition of DOP Updates, an email sent to members of our Department of Pathology (DOP) team and interested stakeholders to keep you abreast of issues of common interest.  Updates are also [linked] as a PDF file to preserve formatting across whatever mobile devices you are using to read it.  Please send me a note if you have something to include next time.

58 Days . . .

Aerial Shot of the North Campus Research Center (NCRC).Today marks 58 days until our first patient specimens make their way to the North Campus Research Center (NCRC) as the first phase of our Pathology Relocation and Renovation (PRR) becomes a reality.  This is a journey that began over 4 years ago when we were confronted with the opportunity to co-locate clinical operations, staff and faculty in a place challenged by its distance from the home to which we have become accustomed for over 30 years!

From the beginning, there was understandable and valid skepticism about the wisdom of such a move.  And despite whatever your personal skepticism all of you have worked hard to sustain our commitment to delivering world-class care from a shifted paradigm that was hard to imagine in our earliest days.  With the help of Christine Baker, Duane Newton, PhD and their remarkable Lean design and implementation teams we learned the power of harnessing the experience and creativity of those who do the work to design and build our future, a future designed with the flexibility to respond to the rapidly changing landscape of laboratory medicine in particular and academic medicine in general.

This is an exciting and intimidating moment in our history that stands to change the way we care for our patients and one another in very substantial ways.  The work that you have done to get us here will stand as a durable tribute to our determination to do better tomorrow what we already do well today, not because it was easy but because it was hard.  Celebrating victories that come at no cost is the stuff of everyday politics; creating unique value in a place from which critics said no value could emerge is altogether different and the sort of breakthrough worthy of celebration by those who discern the things that distinguish great from the merely good.  And as we are reminded from time to time, achieving these sorts of breakthroughs rests not on the shoulders of individuals but on the shoulders of the team, the team, the team!

As we find our way to the rapidly approaching finish line, it is critically important that all of us – frontline staff, administrative support, technical leads and supervisors, managers, medical directors, trainees, students, and faculty – remain focused on our purpose which is to transform the experiences of our patients, their families, their providers and one another in ways that delight and surprise them and us.  There is no doubt that much of what we’ve planned will prove wrong while also serving as the learning opportunities essential for getting it right in the spirit of P-D-C-A.  We will discover unanticipated challenges that will require innovative responses while also learning the power of working together in an environment that celebrates collaboration and creativity.

Should you ultimately decide that this is not the place for you we will understand, but wait until we get there to pass judgment.  The truth is you cannot know unless and until you walk the walk.  Between now and then we ask that all keep their eyes on the collective prize that has been years in the making.  This is your time . . . make the most of it!

104 Days . . .

On December 13, 2017, we had our first discovery meeting to understand the challenge of bringing on our MidMichigan Health (MIDM) patients and colleagues, including all of their affiliated hospitals, as a reference laboratory client.  Our purpose was to do what had never been done in so short a time – to build functional orders and reporting interface, an online handbook, and the infrastructure and workflows that would allow us to serve their reference laboratory need going forward.  . . . and to do that in a little more than 3 months!  By way of comparison, the time required to do this work is traditionally more like 6-12 months.  Responding to this opportunity while also doing the work required for our move to NCRC seemed nearly an impossible task, and yet on March 27, 2018, at 07:00 we went live as the reference laboratory provider for MIDM!

As is always true in a project intended to deliver a “minimum viable product (MVP)” that safeguards the interests of our patients at launch while serving as the platform from which to learn and grow, we have learned an enormous amount since our go-live date.  Our teams are working hard to rapidly implement countermeasures while memorializing lessons learned.  The information captured both before and since go-live by Julia Dahl, MD and her cross-functional, multidisciplinary team will allow us to not only continuously improve the services provided to MIDM but also to replicate the work in a more sustainable and scalable fashion as Michigan Medicine continues to expand our integrated network to sustain our viability as an academic health care system going forward.

And as with NCRC and PRR, our collective success in doing this is necessarily the work of the team, the team, the team!  In this case, the team includes not only those who dedicated weekdays, weekends, mornings, afternoons and evenings to building it but also to the staff and faculty who have responded with hard work and creative ideas since going live on March 27th.  THANK YOU to the countless individuals who together account for this remarkable success story!!  There can be no better example of what it means to reap the reward realized from working together to accomplish what others predicted was impossible – that truly is the Michigan Difference!

50 Years . . .

Civil rights members pointing in direction of the assailant who shot Martin Luther King Jr. / Photo: Joseph Louw/The LIFE Images Collection/Getty Images.On Wednesday we paused to remember April 4, 1968, the day on which Martin Luther King, Jr. was assassinated by James Earl Ray as he stood on a balcony at the Lorraine Hotel in Memphis, TN just after 6 pm as he prepared to join friends and supporters for dinner.

I was 13, living a privileged life in Sioux Falls, SD, a place well removed from the racial tension of Memphis.  I remember the moment as news-worthy rather than something that touched my life or heart as it did those suffering the consequences of racism and hate.  On Wednesday StoryCorps pinged my email box with a message to commemorate the anniversary.  The text read, “On the 50th anniversary of the assassination of Dr. Martin Luther King, Jr., we remember his legacy as told by StoryCorps participants.”

“Participants” included Dion Diamond who at 15 began his own non-violent protest of private “sit-ins” in response to a lifetime of “whites only” signs in Arlington, Virginia.  With the unimaginable courage of the sort that seems less common today, he modeled the strategies of Martin Luther King, Jr by sitting where he wasn’t welcome to spark the dialogue that would eventually change the law, even if not the culture.  At 76 he looks back and acknowledges that his grandchildren may not be, “the least bit interested” but he remains proud that in the book of world history, “a period or a comma in that book is my contribution.”   His experience challenges us to remember that, “The good you do today will be forgotten tomorrow.  Do good anyway.” (Kent Keith.  The Paradoxical Commandments)

“Participants” included Lawrence Cumberbatch who shares with his son Simeon what it was like to walk for 13 days to make his way from New York City to Washington, DC to bear witness to Dr. Martin Luther King, Jr’s “I Have a Dream” speech.  He tells about being marched for 30 miles through the state of Delaware with state troopers in front and behind to make sure that they did not stop for any reason.  When asked what he thought about the speech he responded that, “‘Nobody who was on that podium was thinking about the speech.’ It was just mind-blowing to look at this sea of people.  You’ll never see this again.”  More than 50 years later, Dr. King’s dream remains just out of reach as we continue to judge others not by the content of their character but by the color of their skin, the place that they call home, their place in the hierarchy of socioeconomic class, or any other differences that set them apart from those with whom we’ve grown comfortable.  For Simeon, his father’s march made him, “a hero of mine.”

Listen to Martin Luther King, Jr's last Sermon.And the participants included Bessie and Taylor Rogers who on April 3, 1968, were in the Mason Temple in Memphis when Martin Luther King, Jr. declared that he had been to the mountaintop from which he could see the promised land.  In a message that was eerily prophetic, he assured those in attendance that they would get there even if he himself might not get there with them.  He comforted them that he was, “happy, tonight.  I’m not worried about anything.  I’m not fearing any man.”  It was his last speech.  For Taylor, it was, “kinda like you lost a part of your family.  You really can’t describe it.  He stopped everything, put everything aside to come to Memphis to see about the people on the bottom of the ladder, the sanitation workers.”

Anniversaries of this sort are cause for nostalgia and reflection.  But until nostalgia and reflection translate into real change the promised land for many remains a cruel dream.  Those like me who are insulated from the reality of persistent discrimination and hate might easily conclude that the world is a better place compared to 50 years ago.  And perhaps in some ways it is.  But in many other ways, we continue to avoid the work that will take us to that place in which we are each of us judged not for our differences and our weaknesses and failures but for the victories to which every human being can lay claim as a precious and once-in-a-lifetime inhabitant of this place.

It starts here.  Never underestimate your own capacity to change the world.  Start with the ways in which you treat one another, and especially the way we treat those who look to us for comfort when confronted with disease and discomfort.  It starts with you.

That’s the news to the moment.  Send me an email if you have something that you would like to share with others.  Until the next time, let’s be careful out there . . .

—Jeff