Inside the Halifax Pathology Department, a doctor works in a room with a dripping pipe in a bucket.
In another room, staff wear expensive safety clothing to protect themselves from toxic fumes due to ventilation problems.
Located inside the Mackenzie Building on Victoria General’s site, the head of pathology says its dilapidated infrastructure is putting patient care at risk.
The pathology lab is a crucial, but often overlooked, part of the health care system, says Dr. Laurette Geldenhuys.
His concerns are echoed by a review by Nova Scotia Health that also warns that the state of the lab’s facilities is failing.
The team processes about 100,000 samples a year for patients across the Atlantic region. While the workload is enough to keep them from flooding, problems with the building are pushing the equipment to the limit, Geldenhuys says.
“As the pressure goes on and on, no collegiality will be compensated,” he said of the stress placed on his team. “I worry when we start losing pathologists, once people give up, it will have a negative spiral effect.”
Dr. Laurette Geldenhuys, head of the pathology division, is concerned about exhaustion in her department. She says staff are struggling with infrastructure issues, all while facing a heavy workload. (Submitted by Dr. Laurette Geldenhuys)
He says there have been several floods. One was found “within inches” of sensitive equipment in the lab that processes cancer samples.
In another office, “there’s a pipe coming out of the ceiling into a big bucket of water and that can’t be fixed. So the pathologist has to work in those conditions.”
Geldenhuys says his team is constantly worried about more flooding.
“This can have a very significant negative impact on patient care. So it’s really a disaster waiting to happen.”
Geldenhuys’ concerns are reflected in a departmental review published in March. He says “there are significant structural concerns about the Mackenzie Building” with “potential for serious service disruption.”
Janine Jackson, an assistant pathologist, processes a lung cancer sample while wearing an electric air purifier or PAPR respirator. (Submitted by Dr. Laurette Geldenhuys)
The building’s ventilation system is also sadly inadequate, Geldenhuys says. Some staff members must carry bulky safety equipment to protect themselves from toxic fumes.
“They have to wear these suits with … a hood and a special filter that costs a lot of money. This is completely unrecyclable. They just go in the trash,” he said.
Geldenhuys says he has been working with Nova Scotia Health engineers for years to find a solution, but any improvements will be far away.
The pathology department hoped for a permanent solution in the future, as they planned to be part of the QEII redevelopment project.
Not included in redevelopment plans
The expansion of Halifax Infirmary includes the relocation of nine operating rooms from Victoria General to the new facility. Pathologists work closely with surgeons and often carry back and forth samples as part of their work.
Geldenhuys says they were surprised to learn that the pathology will be housed in the Mackenzie building permanently.
“This means that highly specialized subspecialists should give up everything they are doing, go all the way to the HI, give their opinion and come back,” he said, adding that a copy is more likely to be lost. “
‘Ongoing debates’ to modernize
Nova Scotia Health rejected several requests for interviewing concerns. Instead, he sent statements that did not explain why the pathology is not being transmitted.
“Nova Scotia Health and the Nova Scotia government continue to assess health infrastructure needs and are committed to modernizing and improving facilities across the province,” the statement said.
“The Mackenzie Building is part of these ongoing discussions.”
The Mackenzie Building will continue to house the pathology department, although surgeons near Victoria General will be relocated to the QEII remodel. (Dave Irish / CBC)
The health authority also sent a five-year plan for maintenance work to the Mackenzie building. It included new windows and work on heating, ventilation and air conditioning systems, but did not say whether such projects would directly address the pathology department’s concerns.
Computers are crashing
The pathology department review also addressed the outdated computer system, which is based on Windows 7 operating systems.
Geldenhuys says it is so unreliable that some pathologists have resorted to manually writing their extensive reports instead of dictating them.
“That takes an eternity,” he said. “Then you have to reread it to make sure you don’t have typos. It’s really very frustrating.”
Nova Scotia Health said in a statement that 84% of health authority computers have been upgraded to Windows 10. The entire network, including the pathology, is expected to be up by the end of the year.
Exhaustion a concern
Faced with all these challenges, Geldenhuys says the staff is exhausted. She says they stay because they have a great sense of companionship, but that can only get this far.
He says both sides of the department, pathologists and technologists preparing the samples, are working overtime just to stay afloat and process samples in an acceptable amount of time.
She says they don’t have time to learn new test methods that can help determine if patients can take newly developed medications. Some of these samples are sent to other laboratories.
“There are other areas that are suffering, but patient care is a priority, so as far as we can, we continue to do so,” Geldenhuys said.