Working in the lab at Campbell River hospital was like being on a “puppy farm” says a doctor at the hospital.
Dr. Aref Tabarsi, a pathologist at Campbell River hospital, says the failure of the Vancouver Island Health Authority (VIHA) to provide adequate technical support pushed the hospital’s histology service to a critical level over a recent six week period.
In September, Tabarsi says he lost his secretarial assistant and VIHA replaced the employee with a part-time worker who was not trained to do the job.
“I felt the lab was like a puppy farm for six weeks and I was being ignored (by VIHA),” Tabarsi says.
He said things became disorganized and it was not a healthy work environment until VIHA finally brought in a full-time assistant who knew the job.
“As soon as they realized I wasn’t going to put up with it anymore and as soon as they realized I was going to go to public notice, they brought in a person who could do the job,” Tabarsi says.
Tabarsi says the larger problem is the fact histology services have been centralized to Victoria, at Royal Jubilee Hospital, and as a consequence there is less staff now at Campbell River hospital.
Histology deals with lumps and tumours. Currently, physicians at Campbell River hospital will perform surgery on a patient to remove tissue from a lump. That tissue then goes to Tabarsi to be analyzed and cut up into strips. Those pieces of tissue then go into their own separate little blocks, or containers. After the blocks are made, they are then sent down to the lab in Victoria where they are turned into slides. The slides are then sent back to Campbell River for Tabarsi to study and make a diagnosis.
That process has been in existence for the past five years.
“I’m at the mercy of Victoria as to when I’m going to get my slides back,” Tabarsi says. “It used to be after the specimen arrived in the lab that 48 hours later I’d have my diagnosis. Now it can be up to two to three weeks for results.”
But Pam Ganske, VIHA’s manager of laboratory services, says samples from Campbell River arrive in Victoria at 10 p.m. and are sent back to Campbell River around 3:30 p.m. the following day. Larger samples take 12 hours from the Victoria lab to process.
Ganske says VIHA will be conducting a working group with physicians at Campbell River hospital to determine why it’s taking so long for results to come back.
“We’ll be doing a systems review to see where the bottleneck is, what the obstacles are, are the technical staff properly trained and do they have the tools the need to do the job,” Ganske says.
Tabarsi says centralization is not working.
“I could see it if there was no pathologist here, then yes send it there and make the diagnosis there,” Tabarsi says. “But the fact we send the tissue there and then they send it back here is just bizarre.”
Tabarsi says five years ago he had three technicians working in the lab. After two of them retired, VIHA made the move to centralize histology to Victoria and did not replace the two employees, leaving Tabarsi with just one lab tech.
He said if that person calls in sick or goes on vacation, the lab becomes unsustainable.
“Then I have to send even the tissue to Victoria which increases the times further because they’re not expecting the specimen, they don’t know the technician is going to call in sick,” Tabarsi says.
Tabarsi says that then causes an “erratic workload.” If the tissue has to be sent to Victoria on a given day, then Tabarsi is left with not a lot of work back in Campbell River, but the day the slides arrive back in Campbell River, Tabarsi says then he’s overloaded with work, creating a backlog.
Tabarsi says his record is 73 trays in one day that he had to analyze and diagnose.
“It’s not a constant flow and that’s unacceptable,” Tabarsi says. “I have no control over my workload. I’m dying here, I can’t practice like this.”