Rogers, Children's pathology unit cited for lab expertise

By LaKisha Ladson

To Dr. Beverly Rogers, professor of pathology at UT Southwestern, having no problems is a problem.

“There is always something you can improve on, and if you don’t recognize it, that’s an issue,” she said.

But there is, in her opinion, one thing worse: “burying the problem because you’re afraid to say anything,” she said.

Dr. Beverly Rogers, professor of pathology at UT Southwestern

That’s part of the attitude cultivated among pediatric pathology faculty and hospital staff in the clinical laboratory at Children’s Medical Center Dallas, where Dr. Rogers is chief of pathology and director of the division of pediatric pathology. It has led not only to service improvements for patients but national recognition by Medical Laboratory Observer magazine, a peer-reviewed management source for laboratory professionals that named the group Laboratory of the Year.

Teamwork was one of the judging criteria that stood out.

“It’s taken years for people who work on the bench every day to really understand that they have something very valuable to contribute,” Dr. Rogers said. “It’s a culture of no blame and honesty, where responsibility is given and accepted equally.”

A pediatric pathologist with a strong focus on molecular pathology, Dr. Rogers took over the lab in the fall of 2001. Laboratory work has expanded rapidly along with the patient population, from 995,000 tests in 2004 to 1.5 million last year. In addition, the division of pediatric pathology oversees the medical direction of the lab at the Children’s branch in Plano. The lab includes an onsite test development laboratory and infrastructure to support work for UT Southwestern researchers, and it serves as a reference laboratory for many regional hospitals and clinics while maintaining cost-effective operations based on national benchmarks.

Dr. Rogers and her senior director of operations, Jim Adams, have worked hard to change the culture to patient-focused medicine.

“The reality is we are here to serve the patient,” said Dr. Rogers, who holds intellectual property in the only “walk-away” polymerase chain reaction (PCR) test to detect enterovirus meningitis, continual testing availability. “Being a clinical laboratory at an academic institution, I think it’s our responsibility to do that with an innovative focus, to stay on the bleeding edge of laboratory medicine, which includes a new type of management.”

Added to the innovative focus is the LEAN management philosophy that could be summarized as eliminating waste and respecting employees as efficient, effective, patient-focused and fiscally responsible. Another key component of the culture shift is being a learning organization: Lab members host a weekly book discussion, including a recent session focused on The Anxious Organization by Jeffrey Miller. A lending library, with books on topics such as compliance, management, phlebotomy and education, is also available.

“A learning organization is one in which all employees are continually assessing current reality in an honest, open way,” said Dr. Rogers. “Every voice is heard; solutions result from examinations of processes by people who are closest to the action; and management’s job is to remove barriers and facilitate the success of the individual and the group.”

All around the 29,000 square feet of lab space on the Dallas campus are bulletin boards where employees write about a particular problem and its solution. The ideas are tracked and posted — 20 ideas have been implemented so far this year.

Medical Laboratory Observer
judges noted that lab members together do community service such as collecting coats for families, fundraising for Susan G. Komen for the Cure and coordinating the creation of handmade blankets for patients in intensive care.

Dr. Rogers and her staff seek doctors’ input on ways to serve them. If the turnaround time of a particular test is a concern, the lab improves the time. Turnaround times are posted on a public board in the lab and reviewed daily at the beginning of each shift.

The efforts to improve “customer service” are paying off. The Children’s laboratory ranked No. 2 in the 2008 Press Ganey survey of physician satisfaction — second only to the Intensive Care Unit.

“That speaks to the quality of the pathologists and Ph.D. scientists who work in the lab,” Dr. Rogers said. “People don’t doubt our diagnoses. They don’t worry when we tell them there is no tumor in this sample.”

During Dr. Rogers’ fellowship in the late 1980s, she was a pioneer in the field of PCR methods to amplify DNA and ribonucleic acid (RNA).

“I’ve never let that technology part of me go,” she said. “That’s bringing the latest in science to the bedside.”

In the lab’s test development area, technicians work to develop and implement innovative technology to further improve service.

Dr. Rogers’ impact isn’t just felt in the lab at Children’s. As the newly appointed vice chairman for clinical affairs of the Department of Pathology at UT Southwestern, she said she hopes to “provide the highest quality laboratory services in an efficient and innovative environment, all focused on what is best for the patient and caregiver.”

“Bev Rogers is one of the most organized and conscientious laboratorians I know,” said Dr. Errol C. Friedberg, chairman of pathology. “She will make important contributions to the clinical impetus that is gathering steam at UT Southwestern.”

Dr. Friedberg is holder of the Senator Betty and Dr. Andy Andujar Distinguished Chairmanship in Pathology.