Laboratory Management
Candida endocarditis
General Laboratory Management
Fellows receive structured, hands-on training in clinical microbiology laboratory management throughout the fellowship. Fellows attend the weekly microbiology laboratory administrative meeting at Beth Israel Deaconess Medical Center (Wednesdays, 10:00–11:00 AM), which is attended by microbiology attendings, the laboratory manager, lead technologists, and microbiology fellows. Fellows actively participate in discussions of laboratory operations, including personnel management, quality assurance activities, workflow optimization, and evaluation of new diagnostic methodologies.
During the annual budget cycle, fellows learn how to develop and manage a laboratory budget, including cost accounting for reagents, technologist time, and indirect costs. Fellows participate in meetings with vendors related to evaluation, implementation, or reassessment of diagnostic platforms and observe negotiation processes during contracting. Training also includes exposure to laboratory design, space planning, and workflow considerations.
Fellows learn the processes involved in hiring and retaining laboratory personnel, including development of job descriptions, interviewing, performance evaluation, workload assessment, and strategies to foster technical excellence and staff engagement.
Every other year, fellows participate in a College of American Pathologists (CAP) inspection of an external laboratory and review inspection materials required to become competent laboratory inspectors. Fellows read and develop working knowledge of CLIA ’88 and its amendments, become familiar with relevant CAP checklists, and participate in internal self-inspections to ensure ongoing compliance. Fellows also perform an OSHA self-inspection as part of their safety training.
Fellows are trained to practice cost-effective laboratory medicine, including direct or indirect consultation with clinicians regarding appropriate test utilization and avoidance of unnecessary or low-value send-out testing.
Annual Laboratory Management Course
Fellows participate in a department-wide, full-week laboratory management course attended by pathology residents and clinical laboratory trainees. This course provides formal instruction in:
Quality Control and Quality Assurance Programs
Fellows receive comprehensive training in laboratory quality systems and are expected to develop the ability to design, implement, and evaluate quality assurance programs. Fellows participate in selection and review of quality metrics (e.g., blood culture bottle fill volume, Gram stain amended reports), review CAP proficiency testing results, and provide educational feedback to the laboratory.
Fellows review ongoing quality assurance activities, including QC of antimicrobial susceptibility testing methods, and develop a working understanding of QA requirements as defined by CLIA ’88, CLSI standards, and Cumitechs. Fellows are challenged to identify areas for quality improvement and participate in implementation of corrective actions. Training includes application of statistical methods relevant to laboratory medicine, including sensitivity, specificity, positive predictive value, accuracy, precision, and methods for verification and validation of both qualitative and quantitative assays.
Fellows attend weekly laboratory medicine conferences and monthly department-wide Morbidity and Mortality (M&M) conferences, where laboratory quality, management issues, and patient safety are discussed. Fellows participate in root cause analyses and are expected to present at least one M&M case per year.
Laboratory Information Systems (LIS) and Informatics (ongoing)
Fellows receive training in laboratory informatics and data analysis. They learn to interrogate clinical microbiology databases to identify trends in organism detection and antimicrobial resistance patterns. Current tools include WHONET, with additional data mining approaches introduced as systems evolve. Fellows become familiar with front-end physician order entry systems and participate in optimization of test menus and decision support. They contribute to development of educational comments in the order entry system and assist in updating the online laboratory manual.
The laboratory transitioned to EPIC/Beaker in June 2024, and fellows are trained to use this HIS/LIS system effectively for clinical, operational, and quality purposes.
Ethics and Safety Training
Fellows complete institutional training in the Responsible Conduct of Research and HIPAA compliance through the CITI program. At the start of the academic year, fellows attend required departmental safety training, including:
Fellows receive structured, hands-on training in clinical microbiology laboratory management throughout the fellowship. Fellows attend the weekly microbiology laboratory administrative meeting at Beth Israel Deaconess Medical Center (Wednesdays, 10:00–11:00 AM), which is attended by microbiology attendings, the laboratory manager, lead technologists, and microbiology fellows. Fellows actively participate in discussions of laboratory operations, including personnel management, quality assurance activities, workflow optimization, and evaluation of new diagnostic methodologies.
During the annual budget cycle, fellows learn how to develop and manage a laboratory budget, including cost accounting for reagents, technologist time, and indirect costs. Fellows participate in meetings with vendors related to evaluation, implementation, or reassessment of diagnostic platforms and observe negotiation processes during contracting. Training also includes exposure to laboratory design, space planning, and workflow considerations.
Fellows learn the processes involved in hiring and retaining laboratory personnel, including development of job descriptions, interviewing, performance evaluation, workload assessment, and strategies to foster technical excellence and staff engagement.
Every other year, fellows participate in a College of American Pathologists (CAP) inspection of an external laboratory and review inspection materials required to become competent laboratory inspectors. Fellows read and develop working knowledge of CLIA ’88 and its amendments, become familiar with relevant CAP checklists, and participate in internal self-inspections to ensure ongoing compliance. Fellows also perform an OSHA self-inspection as part of their safety training.
Fellows are trained to practice cost-effective laboratory medicine, including direct or indirect consultation with clinicians regarding appropriate test utilization and avoidance of unnecessary or low-value send-out testing.
Annual Laboratory Management Course
Fellows participate in a department-wide, full-week laboratory management course attended by pathology residents and clinical laboratory trainees. This course provides formal instruction in:
- Risk management
- Budgeting and billing
- Compliance and contracting
- CLIA ’88 regulations
- Assay validation and verification
- Quality assurance and quality control
- Statistics for laboratorians
- Accreditation and laboratory inspection
Quality Control and Quality Assurance Programs
Fellows receive comprehensive training in laboratory quality systems and are expected to develop the ability to design, implement, and evaluate quality assurance programs. Fellows participate in selection and review of quality metrics (e.g., blood culture bottle fill volume, Gram stain amended reports), review CAP proficiency testing results, and provide educational feedback to the laboratory.
Fellows review ongoing quality assurance activities, including QC of antimicrobial susceptibility testing methods, and develop a working understanding of QA requirements as defined by CLIA ’88, CLSI standards, and Cumitechs. Fellows are challenged to identify areas for quality improvement and participate in implementation of corrective actions. Training includes application of statistical methods relevant to laboratory medicine, including sensitivity, specificity, positive predictive value, accuracy, precision, and methods for verification and validation of both qualitative and quantitative assays.
Fellows attend weekly laboratory medicine conferences and monthly department-wide Morbidity and Mortality (M&M) conferences, where laboratory quality, management issues, and patient safety are discussed. Fellows participate in root cause analyses and are expected to present at least one M&M case per year.
Laboratory Information Systems (LIS) and Informatics (ongoing)
Fellows receive training in laboratory informatics and data analysis. They learn to interrogate clinical microbiology databases to identify trends in organism detection and antimicrobial resistance patterns. Current tools include WHONET, with additional data mining approaches introduced as systems evolve. Fellows become familiar with front-end physician order entry systems and participate in optimization of test menus and decision support. They contribute to development of educational comments in the order entry system and assist in updating the online laboratory manual.
The laboratory transitioned to EPIC/Beaker in June 2024, and fellows are trained to use this HIS/LIS system effectively for clinical, operational, and quality purposes.
Ethics and Safety Training
Fellows complete institutional training in the Responsible Conduct of Research and HIPAA compliance through the CITI program. At the start of the academic year, fellows attend required departmental safety training, including:
- OSHA training
- Bloodborne pathogen training
- Biohazard and chemical safety
- Fire safety