VCMH, NSHA respond to lab services concerns
Difficulty recruiting lab techs to rural facilities, contingency plans needed
Local residents and healthcare professionals attended the May 7 Victoria County council meeting to get direct answers from NSHA about changes to lab services at Victoria County Memorial Hospital.
Victoria County Memorial Hospital Facility Manager Rose Macisaac, Director of Pathology and Laboratory Medicine – Eastern Zone Meredith Forrest-parks and Diagnostic Services Manager – Rural Sites Eastern Zone Anita Parsons were on hand to respond to questions from council and residents.
“The laboratory at VCMH is currently fully-staffed and the model of service will continue for the time being. However, the provincial program of pathology and laboratory medicine must have contingency plans to avoid unplanned service disruptions that have been experienced elsewhere and ensure high quality, safe and sustainable laboratory testing is available where it is needed, when it is needed,” said Forrest-parks, reading aloud from a letter sent to Council in response to concerns raised by Council in late March.
Part of the contingency planning has involved “very preliminary” discussions with staff at VCMH regarding point-of-care testing (POCT). POCT allows for quick specimen testing by medical laboratory technologists, registered nurses, licensed practical nurses and pharmacists.
So far, POCT has been implemented at nine sites across the province with success.
“Feedback from physicians and the nursing staff performing POCT sites in Nova Scotia has validated that this service delivery model improves patient care by significantly reducing the time it takes to obtain a result,” said Forrest-parks. She said blood testing on the POCT devices takes anywhere from one minute to fifteen minutes.
Macisaac suggested that some people may be misunderstanding the difference between walk-in lab collection and emergency lab work. She said walk-in lab collection and the availability for physicians to have blood and lab work tests available for admitted in-patients will remain the same.
“That is always going to be available. It's the ER portion and the on-call portion that may look different. You will still have access to those same tests, it just may be different people doing them. In particular, for a troponin test [test that measures proteins released when heart muscle is damaged], if somebody comes in and they need to have lab work done, we have to call somebody in. And, you know how far people have to come into work. We have to wait for them to arrive. We have to wait for them to get their analyzers on, draw the blood, and run the test. [With POCT] the nurses, or the physician, or the LPN takes your blood and puts it through a point-of-care machine.”
Difficulties with recruitment of laboratory technologists is what prompted NSHA to begin preliminary discussions related to contingency plans to sustain and support lab services. There are currently two full-time lab technologists at VCMH with one close to retirement.
District #8 Councillor Macdonald inquired about numbers graduating from lab technology programs. Forrest-parks responded that last year there was no graduating class because it went from a two-year program to a three-year program. This year, they hired seven from the graduating class. Unfortunately, none expressed interest in working at rural sites.
“Recruiting to rural facilities has been really difficult,” said Forrest-parks. “We’re trying to sustain services for patients that go for bloodwork. We’re hoping this model of care will help us with that. Patients can still go to their blood collection services and get their blood collected. The way those tests are performed could change.”