Hospital lab services to go under the microscope

A review to determine whether microbiology lab services will be removed from the Campbell River hospital gets underway in less than a week.

A review to determine whether microbiology lab services will be removed from the Campbell River hospital gets underway in less than a week.

Three microbiologists – one hand picked by doctors from Campbell River – will spend four days speaking with doctors at both Campbell River and District Regional Hospital and Nanaimo Regional General Hospital to find out whether or not it is feasible to centralize services to Victoria.

“We’re hoping to centralize because as we move forward microbiology is becoming increasingly specialized and requires special equipment that we can’t afford to put in all hospitals.

But the microbiologists in both Campbell River and Nanaimo didn’t agree and felt centralizing would impact the quality of patient care so we’ve ordered an independent review,” said Neil Sweeney, spokesperson for Vancouver Island Health Authority (VIHA).

After VIHA announced last spring that it planned to centralize microbiology lab services, Dr. Aref Tabarsi, director of lab services at Campbell River hospital, expressed his concerns and lobbied to keep the lab in Campbell River.

“My concern is the integrity of the sample could be compromised during transport (to Victoria from Campbell River) and then it’s not a proper sample,” said Tabarsi. “The purpose of testing is to get a reliable result but if you’re doing something to the test, it’s being put in jeopardy and you might as well not even do the test at all.”

Tabarsi said in some cases the delay in testing bacteria taken from a patient in Campbell River could cause the bad bacteria present to die, giving a false-negative result and a doctor misdiagnosing a patient.

Tabarsi said a patient with meningitis could be at risk for such a misdiagnosis.

“The bacteria which causes meningitis needs very strict conditions to survive. You don’t have a long time to prove it’s there because after two hours outside the body it will die. That then produces a false-negative result, in reality the test should have come back positive. That’s my concern. If a patient comes in here with a severe headache and the doctor thinks they have meningitis and needs medication or they will die, the doctor needs to be able to confirm that right away,” said Tabarsi.

Stool samples present a similar problem. Tabarsi said they can produce some “nasty bacteria” but if a culture is not done right away on the stool, the good bacteria may kill the bad bacteria and produce unreliable results.

Sandra Paulsen, a retired registered laboratory technologist, also expressed concerns with having samples travelling such a long distance, in a letter to the Mirror.

She explained that if samples are not transported at the proper temperature they can become contaminated by the overgrowth of organisms, affecting testing and patient treatment.

There is also a risk of samples being damaged or leaked during transport.

Sweeney said VIHA has heard all of those concerns and now wants to determine if they are valid. It will conduct its review of microbiology services Feb. 8-11. He expects the results to come back shortly after the review has wrapped up.

Sweeney said VIHA expects some sort of cost savings if services are centralized, which would be re-invested in both Campbell River and Nanaimo hospitals.

Tabarsi said he has yet to see VIHA prove there would be any kind of savings.

“Until they have it proven, I disagree,” said Tabarsi.

He also doesn’t buy VIHA’s reasoning that lab services should all be housed under one roof since any future specialized equipment will only be available in Victoria anyway.

“Tests that require more advanced equipment already get sent to Victoria or Vancouver, it’s already being done and that works just fine” said Tabarsi.