Lab service centralization increasing wait times for diagnoses

Letter criticizes VIHA for moving histopathology services to Victoria

The centralization of laboratory services that detect disease is compromising patients’ quality of care, doctors at Campbell River hospital say.

Medical staff at the hospital wrote a letter to the Vancouver Island Health Authority (VIHA) last Thursday criticizing VIHA for moving histopathology services to Royal Jubilee Hospital in Victoria.

“VIHA’s centralization of the histopathology has significantly increased the turn-around time for diagnosis,” says the letter, unanimously signed by all the doctors at Campbell River hospital. “Before centralization, some of these histology tests could be done in as little as two hours. More than 80 per cent were done in two days. Now, the average time needed before we can get results is more than five days and in some instances, more than two to three weeks.”

Currently, the surgical procedure to remove tissue from the body occurs in Campbell River, but then the specimen is sent to Victoria for examination.

The results are then sent back to Campbell River. That procedure has been followed for the past five years.

Doctors at Campbell River hospital say sending the specimen to Victoria is drastically increasing the wait times for diagnoses.

“This extra waiting time is hard for patients and significantly slows diagnostic evaluation,” the letter says. “The guidelines established by the Canadian and American Pathology Associations mandate specific time frames for biopsy analysis. Since the centralization of histopathology to Victoria, these guidelines are no longer respected.”

Dr. Gordon Hoag, VIHA’s medical director of laboratory medicine, says VIHA has been trying to make the process as timely as it can for patients while at the same time ensuring diagnoses are as complete and accurate as possible.

He also said there are various benchmarks for practice and timelines available and although the Canadian and American Pathology Associations are appropriate, there are guidelines from other colleges available for VIHA to abide by.

“We try to determine with our colleagues what the appropriate time for patients on the Island is and we try to make it a collaborative function,” Hoag says. “We’ve started to look at the steps in the process to ensure quality in every step. We’re trying to provide a greater depth of analysis to make it easier to identify times for each step in the process rather than overall turnaround time.”

Campbell River doctors say the long delays have not decreased the accuracy of the final diagnosis but the delays should not be tolerated.