Worried about the many malfunctions of the centralized laboratories used by Quebec hospitals, the two main federations of doctors in Quebec called on the Minister of Health, Christian Dubé, to ask him for an emergency intervention. According to doctors, the situation has deteriorated and “risks compromising patient safety”. They call for a “recovery plan” urgently.
“In too many regions of Quebec, we are still unable to provide safe and quality care to our patients,” writes Dr.r Vincent Oliva, president of the Federation of Medical Specialists of Quebec, and Dr.r Marc-André Amyot, president of the Federation of General Practitioners of Quebec, in a letter sent Wednesday and obtained by The Press.
Five years ago, Quebec began bringing together Quebec hospital laboratories with its Optilab project. Thus, in each region, certain “server” laboratories process samples from several neighboring hospitals. In Montreal, for example, all the hospitals have their samples processed by the server laboratories of the McGill University Health Center (MUHC), the University of Montreal Hospital Center (CHUM) and the CHU Sainte-Justine. However, physicians are concerned about “unacceptable gaps in the time required to obtain results […] in hospitals with the status of server laboratories and those of the facilities served by these laboratories”.
PHOTO HUGO-SÉBASTIEN AUBERT, LA PRESSE ARCHIVES
The President of the Federation of General Practitioners of Quebec, Dr.r Marc-Andre Amyot
In their letter, the Drs Oliva and Amyot write that a patient undergoing an analysis for a possible diagnosis of cancer will have his result within four weeks at the Verdun hospital and more than two months at the Maisonneuve-Rosemont hospital. But at the CHUM, which serves as a server lab for much of the Montreal area, that delay is only 24 hours. “The inefficiency of the computer systems, the delays in transporting and processing the sample and the shortage of personnel” explain this situation, according to the presidents of the two federations, who deplore that all of this results “in a delay in diagnosis and treatment “. “We cannot tolerate, as citizens and as doctors, that there are therefore two classes of hospitals, and therefore of patients,” they write.
Biopsy quotas
The doctors also deplore the problems of “global organization” of the Optilab laboratories. The authors of the letter to Christian Dubé write that in December, when emergency rooms were overflowing in Montreal, St. Mary’s Hospital Center sent a directive to family medicine groups (FMGs) and doctors in its territory asking them not to send any more samples to the laboratory as of Friday. A request which “then directly contravened the objectives of the ministerial plan to unclog emergencies”.
The federations deplore that certain laboratories also impose biopsy quotas on doctors.
In dermatology, doctors are thus refused specimens because of these quotas […] A completely unacceptable situation when the indication for the biopsy aims to determine whether the patient has melanoma.
Excerpt from the letter of Dr Vincent Oliva and Dr Marc-Andre Amyot
The letter also mentions the “failed deployment of the new provincial laboratory information system (SIL-P)” used in the Optilab laboratories whose The Press spoke in december1.
Longer than ever lead times
Chef at GMF du Suroît, the DD Lynn Dominique says that the delays in obtaining lab results for her patients have never been greater than since the deployment of SIL-P. Results were sent to the wrong clinic and several days passed before the DD Dominique does not end up getting them. “It considerably increases the work of the secretaries and everyone else. And patients wait too long. As doctors, it affects us,” she says.
Hemato-oncologist at the CHUM, the Dr Normand Blais believes that with the implementation of SIL-P and other new administrative standards in Optilab’s laboratories, the teams, too few in number, are overwhelmed. And have less time to devote to analysis processing. Result: It can take up to six weeks for a patient who has had a lung biopsy to receive their results.
In no country in the world is this kind of delay considered acceptable.
The Dr Normand Blais, hemato-oncologist at the CHUM
This is not the first time that the federations of doctors challenge the government about the failures of the Optilab laboratories. But they believe that their alarm signals “repeatedly expressed to the responsible authorities, about failures relating to the hypercentralized organization of Optilab, are far from having given the expected results. In fact, the situation has deteriorated”.
Doctors want the performance of Optilab laboratories to be measured. They go so far as to ask for a “recovery plan”, “a reframing” and a “certain decentralization of the project in the Montreal region”.
In Minister Dubé’s office, they say they want to “take the time to analyze all the elements of the letter”, but “understand very well the issues raised”. “If we need to take additional steps to improve care for Quebecers and improve speed, we will do so,” says a press officer for Mr. Dubé, Antoine de la Durantaye, who points out that the Optilab project “has been put in place by the Liberal government” and that changes have since been made.