Details of merged N.B. hospital lab testing revealed in internal document
New service delivery model approved by joint committee, must be tested, approved by government
Almost all outpatient blood samples from across New Brunswick may soon have to be shipped to Fredericton or Bathurst for testing, an internal document reveals.
On May 26, a governance committee made up of representatives of the Department of Health and Horizon and Vitalité health networks approved the centralization of "routine, high volume outpatient testing" at labs in those two cities.
It's Phase 1 of a "lab modernization initiative," with a transition plan expected to be approved this fall, according to the document.
"The service delivery model and associated recommendations are subject to validation and final government approval," it notes.
The New Brunswick government previously announced plans to merge its hospital testing laboratories into a single system, due to an anticipated shortage of lab staff, with a main provincial lab at Vitalité's Dr. Georges-L. Dumont University Health Centre in Moncton.
But which tests will be done at which hospitals has not yet been made public.
Dumont doctors 'very concerned'
All doctors at the Dumont are "very concerned" about the lab changes, according to Dr. Luc Comier, past president of the medical staff organization at the hospital and member of a new committee struck to address the changes.
He declined Friday to elaborate, saying the committee is scheduled to meet on Monday and will make a statement on behalf of the roughly 280 doctors "in the next few days."
No plans to close labs or reduce staffing
The integrated medical laboratory system model, developed by a joint steering committee, "would see some lab samples transferred to laboratories in Bathurst and Fredericton for testing, and it would see many microbiology testing services centralized at the Dr. Georges-L.-Dumont University Hospital Centre," confirmed Department of Health spokesperson Sean Hatchard.
Although the new model was approved by the partners in late May, "before any significant changes are made within the existing system, the plan will have to first be tested, and a detailed implementation plan will have to be developed and presented to government for approval," he stressed.
"Citizens will still be able to have their laboratory samples collected close to home and results will continue to be provided in a timely manner," Hatchard said in an emailed statement.
He did not respond to questions about what the turnaround times are expected to be or about contingency transportation plans in the event of bad weather.
"Urgent testing will continue to be completed in labs across the province, while other more routine testing will be completed using the most appropriate lab resources within the network, as required," he said.
"To be clear, the model doesn't include plans to close labs or reduce staffing levels. The model is designed to ensure the long-term sustainability of the system and that lab services are operating as efficiently as possible."
Lab staff can provide feedback
This kind of model is considered a best practice and is in line with how systems operate in other jurisdictions, according to Hatchard. He did not cite any examples.
The steering committee "consulted and briefed laboratory professionals across the province on multiple occasions to better understand the challenges they face, and to gather their ideas for the best path forward," said Hatchard.
Lab staff will also have the opportunity to ask questions and provide further feedback, he said.
The New Brunswick Union Syndicat, which represents lab workers, and the New Brunswick Society of Medical Laboratory Technologists, which is the regulatory body, did not respond to requests for comment.
Pilot testing to validate model
There are two primary ways the new service delivery model will be validated, leading up to the final approval of the detailed transition phase, according to the internal document.
The first includes data collection and analysis, which will be used to develop preliminary transition plans.
The second is through pilot testing "under real-world conditions," it says.
Validation will take into consideration obligations set out in the Official Languages Act, training, academic relationships, research activities, and clinical program requirements.
Phases 2 and 3
According to the document, Phase 2 will see most microbiology tests, such as stool specimens, as well as subspecialty tests, such as parasitology, sent to the Dumont, but up to 30 per cent of inpatient microbiology will remain at up to six sites "based on clinical need."
To create enough space at the Dumont for this influx of testing, all routine inpatient testing will be moved to the Moncton Hospital "unless otherwise clinically necessary," the document indicates.
A short turnaround time lab will remain at the Dumont for "urgent" tests, it says.
Under Phase 3, there will be changes to where tissue processing and cytology specimens, such as Pap smears, will be centralized.