Inside Halifax’s pathology department, one physician works in a room with a pipe that drips into a bucket.
In another room, staff wear expensive safety suits to protect themselves from toxic fumes because of ventilation problems.
Located inside the Mackenzie Building on the Victoria General site, the head of pathology says their crumbling infrastructure is putting patient care at risk.
The pathology lab is a crucial, yet often overlooked, part of the healthcare system, says Dr. Laurette Geldenhuys.
Her concerns are echoed by a Nova Scotia Health review that also warns the state of the laboratory’s facilities are failing.
The team processes about 100,000 samples a year for patients across the Atlantic region. While the volume of work is enough for them to be swamped, problems with the building are pushing the team to the brink, says Geldenhuys.
“As the pressure keep mounting and mounting, no amount of collegiality is going to make up,” she said of the stress put upon her team. “I’m concerned once we start losing pathologists, once people resign, it will have a negative spiraling effect.”
She says there have been several floods. One was “within inches” of sensitive equipment in the lab that processes cancer samples.
In another office, “there is a pipe coming from the ceiling into a big bucket of water and that is not fixable. So the pathologist has to work under those conditions.”
Geldenhuys says her team is constantly worried about more flooding.
“That can have a very significantly negative impact on patient care. So it is just really a disaster waiting to happen.”
Geldenhuys’s concerns are mirrored in an review of the department that was released in March. It says “there are significant structural concerns about the Mackenzie Building” with “potential for serious disruption of the service.”
The ventilation system in the building is also woefully inadequate, Geldenhuys says. Some staff must wear bulky safety gear in order to protect themselves from toxic fumes.
“They have to wear these suits with … a hood and a special filter that costs a large amount of money. That’s completely unrecyclable. They just go in the garbage,” she said.
Geldenhuys says they’ve been working with Nova Scotia Health engineers for years to come up with a solution, but any improvements will be years away.
The pathology department hoped a permanent solution was in their future as they anticipated being part of the QEII redevelopment project.
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Not included in redevelopment plans
The Halifax Infirmary expansion includes moving nine operating rooms from the Victoria General site to the new facility. The pathologists work closely with the surgeons, and often transport samples back and forth as part of their work.
Geldenhuys says they were shocked to learn that pathology will be staying in the Mackenzie Building permanently.
“This means the very highly specialized subspecialists would need to drop everything they are doing, go all the way over to the HI, provide their opinion and come back,” she said, adding that makes it more likely for a specimen to be lost.”
‘Ongoing discussions’ to modernize
Nova Scotia Health declined several requests for an interview about the concerns. Instead, it sent statements that did not explain why pathology is not being relocated.
“Nova Scotia Health and the Government of Nova Scotia continue to evaluate health care infrastructure needs and are committed to modernizing and upgrading facilities across the province,” the statement read.
“The Mackenzie Building is part of these ongoing discussions.”
The health authority also sent a five year plan for maintenance work on the Mackenzie Building. It included new windows and work on the heating, ventilation and air conditioning systems, but it did not say if those projects would directly address the concerns of the pathology department.
The review of the pathology department also addressed the antiquated computer system, which relies on Windows 7 operating systems.
Geldenhuys says it’s so unreliable, some pathologists have resorted to manually typing out their lengthy reports instead of dictating them.
“That takes forever,” she said. “Then you have to keep rereading it to make sure that you don’t have typographical errors. It really is very frustrating.”
Nova Scotia Health said in a statement that 84 per cent of the health authority’s computers have been upgraded to Windows 10. It expects the entire network — including pathology — to be done by the end of the year.
Burnout a concern
Faced with all these challenges, Geldenhuys says staff are suffering from burnout. She says they stay because they have a terrific sense of camaraderie, but that can only go so far.
She says both sides of the department — pathologists and technologists who prepare the samples — are working overtime just to stay afloat and process samples in an acceptable time frame.
She says they have no time to learn new testing methods that can help determine whether patients can take newly developed medications. Some of those samples are being sent away to other labs.
“There are other areas that suffer, but patient care is a priority so that for the most part, as far as we are able, we just keep doing that,” Geldenhuys said.