Pathways to Excellence | Winter 2021

Pathways to Excellence URMC DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE | WWW. PATHOLOGY. URMC. EDU | WINTER 2021

hospital labs celebrate successful moves After 45 years, it’s a farewell to windowless space on the ground floor How do you move essential instrumentation from one end of a hospital to the other without delaying patient care? The answer is, very carefully.

After many months of meticulous planning and preparation, four clinical areas got new homes at Strong Memorial Hospital in August as part of the department’s system wide relocation and consolidation project.

“Little did we know that you would be moving in the middle of one of the worst pandemics of the century, and you did that without disrupting a single test for any of our inpatients or outpatients that depend on you,” said Kathy Parrinello, hospital COO, in a video message to staff recorded in lieu of a ribbon cutting.

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IN THIS ISSUE From the Chair.................................................................. 3

Centennial Book............................................................... 4

Alumni Gathering............................................................. 3

Research News.................................................................. 5

Education Update............................................................. 4

Focus on Faculty................................................................ 6

HOSPITAL LAB RELOCATIONS

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The groups collectively moved into hospital space that was recently renovated – a construction project that continued in spite of the pandemic. Automated Chemistry, Specimen Management (SMS), and a new Microbiology STAT lab moved into a shared workspace in 1-2100. Below them, the Blood Bank moved from its longtime home to a more spacious suite in G-2100. Both suites are about 10,000 square feet and have windows.

MOVE TOWARD MODERNITY

The 1-2100 area at Strong Memorial Hospital is now home to SMS, Automated Chemistry, and a Microbiology Stat Lab.

A construction photo of what is now the new Blood Bank area in G-2100.

This is the first major renovation the area has gotten since 1975.

The last time these laboratories got “new” space was 1975, so this summer marked a milestone that’s been a long time coming.

Debbie Masel, chief supervisor of Blood Bank and Transfusion Medicine, has spent the last few decades watching the lab grow, in terms of staff and services that it provides to the hospital.

“We never really went through a major renovation in all that time,” said Masel. “Even though the Blood Bank changed a lot in 45 years, our space remained the same.”

The newly renovated suites on the ground and first floors are a OVERCOMING OBSTACLES reflection of the hospital’s vision for the future. As more services Each move had its own unique set of challenges, from move offsite, including but not limited to all of the outpatient maintaining operations through long periods of equipment testing that moved to the downtime to rethinking how Central Laboratory on Bailey to establish daily workflow in a “There was a really dynamic sense of Road in 2019, the hospital’s brand new setting. teamwork through the whole process.” footprint is on the cusp of The coordinated effort to - Kristi VanDeWalle, chief SMS supervisor at SMH big changes as it prepares move SMS and Automated to expand its emergency Chemistry meant that both department in the coming years. One thing remains clear – having groups needed to work closely to validate three new platforms. efficient inpatient testing onsite will be part of inpatient care for Starting in May, the whole front-end SMS system went many years to come. manual for the next four months. During that time, the SMS Having a permanent home for the onsite labs will allow our and Chemistry teams implemented workflows that pivoted department to grow and thrive in their new space. dramatically from the normal routine, explained Kristi “You were able to keep everything running smoothly and most VanDeWalle, chief SMS supervisor at SMH. everyone in the hospital did not even know it was happening,” said “The staff were willing to try anything to make us successful Parrinello. “It was an enormous feat for all of you, and thank you and that attitude and effort translated really well in the new for everything you do for our organization.” space,” she said.

SECOND FLOOR SUITE GETS FACELIFT As part of our renovation and reorganization of space at the Medical Center, the second floor 2-2100 suite houses a number of AP faculty who previously occupied the ground floor. Additionally, office space and a common area for the residents was completed over the summer.

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FROM THE CHAIR

G

Bruce Smoller, M. D.

reetings from Rochester where we just had the warmest week in a November for more than 50 years! I hope that may suggest a mild winter (knowing how unrealistic that is)! We are thriving on all fronts here in the Department of Pathology and Laboratory Medicine. Our test volumes in anatomic pathology are already exceeding those from before the COVID-19 shutdown and on the clinical pathology side, our test volumes are higher than ever.

We are busily recruiting to fill many faculty positions, some of which are meant to backfill retired and retiring faculty members such as Tai Kwong and Paul Rothberg and some are incremental, in attempt to keep up with the continuously expanding business. Dr. Li Zha, a recent graduate of Harvard University, joined the Clinical Chemistry faculty in October and there will many others joining us in July, 2021. More will follow about these newcomers as we finalize our negotiations.

We welcomed a huge class of first year residents and a large number of fellows in July and this cohort of trainees has gotten off to a terrific start. Our training programs are as robust and diverse as they ever have been. We are about to welcome and initiate our first class of phlebotomy students as we enhance our programs and expand upon the medical technology training program which continues to excel in all ways. We are hopeful that these new training programs will help us to develop a pipeline resulting in fewer workforce shortages moving forward.

Our anatomic leadership team, headed by Dr. Christa Whitney-Miller, has started working on plans for a partial move to Bailey Road, joining many of our clinical laboratory services. This will involve extensive planning and forethought in order to maintain patient care without significantly altering turnaround time, while at the same time expanding our footprint and ensuring a superb learning environment for our residents and fellows. The hope is to begin the building construction in the summer of 2021 and to finish the project over the following year.

The department has begun discussions with Geneva Hospital’s Department of Pathology as URMC enters into a Management Service Contract with their institution. There are many possible channels for a productive collaboration.

Fortunately, as we have developed an entire Enterprise Development Committee, we are well-equipped to address the rapidly changing healthcare landscape. Laboratory consolidation efforts with our affiliated hospitals are vastly completed and the concept of a centralized laboratory is functioning remarkably smoothly, an especially pleasant outcome, given the enormous effect that Covid testing has had on our entire operation.

I wish you all a very happy and healthy New Year!

Li Zha, Ph.D.

JOIN US FOR VIRTUAL ALUMNI MIXER THIS SPRING! Over the summer we were pleased to host a successful Zoom gathering of faculty and friends from the past and present. This spring (2021) we look forward to another virtual gathering this spring. Please watch for a date in the April issue of this newsletter.

We also want to encourage alumni to connect with us via the Meliora Collective, a new online networking and mentoring platform exclusively for the University of Rochester. Get started at https://thecollective.rochester.edu/ 3 URMC DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE

FOCUS ON FACULTY him to lead the Thoracic Pathology Service – which he accepted.

Since joining URMC in 2017, Dr. Velez additionally serves as the Associate Director of the Immunohistochemistry Lab under the mentorship of David Hicks, M.D. Velez maintains a number of research collaborations in addition to the clinical workload. Currently, he is conducting research on a joint study with NIH on small cell lung carcinoma, examining NOTCH-signaling and response to immunotherapy. He recently collaborated with a fellow URMC Rheumatologist on a study examining interstitial lung disease. Without diminishing the importance of academic publishing, Velez says his impact in the clinical realm is

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incredibly rewarding. Most notably, Dr. Velez and Sierra Kovar (IHC Supervisor) are leading a push to provide research and development lab services while validating new antibodies to get more precise diagnoses rather than relying solely on morphology. “There’s always room for progress,” he exclaimed.

Outside of work, he and his wife live in Pittsford with their kids Elia (6), Sebastian (4) and Joel Santi (2). Together they have joined many families who have embraced the outdoors during COVID with activities like hiking, apple picking and, in the winter, skiing.

“I feel like I live in a place that you would normally drive to stay at a bed and breakfast, all within a 20 minute drive from the city,” he said. “Rochester is beautiful.”

CELEBRATE THE CENTENNIAL WITH NEW BOOK This year marks 100 years since the department was founded at the School of Medicine & Dentistry in 1921.

To commemorate this milestone, chairman Bruce Smoller, M.D. has written a colorful and comprehensive history that includes photos from the archives, interviews of faculty (past and present), and much more.

Would you like to read the Christmas poem past chair Roger Terry wrote for George Whipple? Or learn about the

origins of our educational, research, and clinical programs? A Pathway to Excellence (Meliora Press, 2020) chronicles the challenges faced in the early days that helped shape the vast enterprise we have today.

To request a copy, email Bethany_ Bushen@urmc.rochester.edu.

EDUCATION NEWS MAKING MEANINGFUL CONNECTIONS, EVEN IN A PANDEMIC So many times I will hear people reflect This fall the Clinical/Medical Technology on education within our department and (CMT) Program matriculated its fourth it always rings loud and true: educating is class of students with a virtual kick-off to at the core of who we are and what we do. start the year, which has been followed Being able to follow in Dr. Scott Kirkley’s

by Zoom lectures coupled with in-person footsteps and take on the role of Vice experiential laboratory learning. Likewise, Chair of Educational Programs is truly a the residency, fellowship, and Ph.D. delight. I am hopeful to be able to share programs have explored ways to connect our coming successes in this space and with applicants in the virtual realm. highlight ways in which our educational Virtual open-houses this fall saw upwards programs are adapting, evolving and of 70 attendees each session logging in to improving. Truly Meliora! hear about our residency program. And With that in mind, it is a delight to the administrative staff has taken on the be able to see that, even in these times of complex task of figuring out how to make Jennifer Findeis-Hosey, M.D. uncertainty and changing tides related it all work behind the scenes, but ultimately to the COVID pandemic, our educational programs keep making it look easy. moving forward. With in-person anything brought to a While I am hopeful that we will not always have to teach screeching halt this spring, many of our educational programs remotely, we have certainly become savvier with the use of have had to re-imagine how education is done. While Zoom, virtual teaching platforms and, perhaps, we will see their use breakout rooms, and webcams have become a staple of the persist to some degree even after the in-person restrictions educational vernacular, our programs are still trying to make pass. It is a testament to the resilience of the members of our meaningful connections with our trainees, even in the virtual, department that we have been able to adapt and stay true to remote and distanced way. our educational mission. For that I am very grateful.

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SUSKIE NAMED CO-PRESIDENT OF APF Congratulations to Kelley Suskie, vice chair for administration, for being named the new copresident of the American Pathology Foundation.

Kelley, who joined URMC in 2017, is a longtime member of APF and began her 2-year term on Sept. 8.

RESEARCH NEWS PRODUCTIVITY CONTINUES DESPITE CHALLENGING YEAR I’m amazed to say that it has been an incredibly scientific literature. These colleagues include Dongwei productive year for our faculty in terms of research Zhang, frequently in collaboration with Dr. Xiaoyan Liao, output. Our primary faculty have co-authored more than describing work on pathology of gastrointestinal diseases, 125 published manuscripts, an average of two papers Huina Zhang, a breast and gynecologic pathologist, and per faculty member! Including all of our faculty and Aaron Huber, who co-authored multiple manuscripts staff, the department has a hand in about 250 published based on mentored work with our residents, including manuscripts in 2020. That trend in research output case reports on a variety of unique patients with colon or is about double what it was when we small bowel diseases. Clearly, Dr. Huber is welcomed Dr. Smoller as chair in 2013. not only an impressive pathologist but also We should all be proud of the fact that we an excellent teacher. continued to explore new worlds, going Not to outdone by their anatomic “where no one has gone before,” despite the pathology colleagues, Majed Refaai, a challenges we’ve faced. transfusion medicine specialist and coOur most prolific faculty this year director of our residency program, and include Hiroshi Miyamoto, a clinicianMing Qi, a molecular genetic pathologist, scientist and co-author on nearly twenty each made numerous contributions to published manuscripts in 2020, ranging the literature this year as well. Last but from clinical studies of cancer diagnosis to certainly not least, I think it’s important more basic science research into the role to highlight the incredible work of our of specific molecular pathways in bladder clinical microbiologists, Nicole Pecora and cancer. Eleven of these studies were led by Dwight Hardy, for adding to the available Dr. Miyamoto as senior author and involve information about SARS-CoV-2 testing Helene McMurray, Ph.D. members of his team. via a joint publication and an additional Similarly productive was Chawnshang Chang, whose paper from Dr. Pecora and a fellow in the microbiology laboratory has a long-standing interest in the role of laboratory. Moreover, Drs. Pecora and Hardy also androgen receptors in prostate cancer progression and as published work on genomic surveillance for antibiotica target for treatment and Lianping Xing, who studies resistant E. coli. regulation of bone cell function and bone erosion in the Kudos to all of us for pressing on with research context of auto-immune disease. Several of the studies in and writing while balancing a great deal of clinical and both Dr. Chang and Dr. Xing’s laboratories were led by educational work. Whether you, like me, published a graduate students from our Ph.D. program, three of whom paper or two, or if you were among the most prolific, each successfully completed their theses and graduated this year. of your contributions adds important information to the Among our clinical faculty, several managed to body of biomedical knowledge. I’m excited to see what contribute more than a half dozen papers each to the our studies will reveal in the year ahead.

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Department of Pathology and Laboratory Medicine University of Rochester Medical Center 601 Elmwood Avenue, Box 626 Rochester, NY 14642

FOCUS ON FACULTY: MOISES VELEZ, M.D. Being a pathologist – determining a patient’s diagnosis largely on your own – might seem like too much responsibility for one person. If you ask Moises Velez, he’ll tell you that’s what makes the job meaningful.

“There’s no one else signing out the specimens. It’s just you,” he says. “That can be sort of frightening if you think about it from a trainees perspective, but I’ve always felt honored and privileged to own the responsibility to make an accurate diagnosis. I still carry that to this very day. Pathology also requires frequent collaboration with colleagues which makes the job exciting and allows you to stay up to date with recent advancements.”

Velez grew up in New York City’s East Village in Manhattan.

Back in the ‘80s, this was a neighborhood fraught with drugs and poverty. His parents, who came from Puerto Rico, encouraged him and his three siblings to pursue higher education. He credits them with instilling the value of hard work and self-motivation. “The only way that I saw to rise above it all was through medicine,” he said.

His desire to become a doctor started at a young age when Velez had a few visits to the ER for asthma attacks, and an occasional

need for stitches. He remembers finding comfort from the doctors who cared for him each time. That left a lasting impression.

Being part of a community has also been a theme in his success story. In high school, Velez was part of the local nonprofit Henry Street Settlement, where following college he returned as a Case Manager and mentored teens.

While in high school, he became a volunteer intern in the ER of Bellevue Hospital. When it came time for medical school, he chose to attend the American University of Antigua (AUA) to start his journey toward a career in medicine. It was there that he met his future wife, Mara Weinstein Velez, M.D. (who is a dermatologist at URMC). Velez completed his AP/CP residency at Akron City Hospital through the Northeastern Ohio Medical University while she trained in Dermatology at Cleveland Clinic.

After residency, Velez completed a Surgical Pathology fellowship at Tufts Medical Center in Boston, followed by a Thoracic Pathology fellowship at Memorial Sloan Kettering where collaborative efforts led to a publication in the New England Journal of Medicine where they described Pathologic features of response to neoadjuvant anti-PD-1 in resected NSCLC When it came time to settle down with his family (which by then included two young children), Velez says he was attracted to Rochester’s family friendly atmosphere and proximity to his family and home in NYC. Professionally, URMC also presented an opportunity for

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