Lab waits in Medicine Hat drive patients to emergency room for tests

Doctors in Medicine Hat say long waits for lab tests are putting extra pressure on their hospital.

DynaLife, a private company, took over community lab services in the south zone at the end of February, after being contracted by Alberta Health Services (AHS).

Ongoing concerns in Calgary and nearby areas, which transitioned earlier to the new service provider, prompted an AHS promise to fix wait times.

Medicine Hat now has just one community lab, and appointments for routine testing have generally been booking at least a month out.

"It's been a pretty rough transition," said Dr. Gerry Prince, a family physician in Medicine Hat.

"Maybe a day or two is not unreasonable. A week or two is really marginal. A month is unacceptable."

According to Prince, it's hard on patients. While some tests can wait, he said, others cannot.

And he said some semi-urgent patients — who in the past would have had access to timely tests in the community — are being sent to the emergency department at the Medicine Hat Regional Hospital.

"They need a heart tracing, they need some blood work. They need it either back later today or tomorrow. If they go to the lab looking for that, then the lab just sends them to [emergency] to get it done, which is just a huge burden that emergency just does not need to have," said Prince.

"That's just an expanded patient load that just really does not need to go there."

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Dr. Paul Parks, a Medicine Hat ER physician, has never seen anything like it.

"Very simply, it's very bad for patients," he said.

"If a lab tests needs to be done in less than four or five days, that's kind of become non-existent, and they're all being redirected to the emergency department."

According to Parks, the situation has deteriorated in the last few weeks. He's seeing patients sent to the ER by both family physicians and DynaLife.

"We're seeing really frustrated, upset people presenting to our [ER] who are stable — so they would definitely be lower acuity — with a blood requisition from a doctor they've seen. And they have to wait in the queue [and] get triaged and wait to see an emergency physician so they can get their blood work done," he said.

"It's exactly opposite to what the mandate is now provincially in terms of trying to decrease emergency department volumes and flow."

Recruitment underway

AHS said five patients have gone to the Medicine Hat ER for lab tests in the past week

"DynaLife is working hard to improve wait times and is actively recruiting new staff to fill existing vacancies at the Medicine Hat lab," spokesperson Kerry Williamson said in an emailed statement on Monday.

"Currently, 80 per cent of patients who visit the Medicine Hat lab are served within 40 minutes and we are working to improve this service time."

According to AHS, there are more than 20 employees working at the lab, two more are in training and DynaLife is working to find more.

Williamson cautioned that going to the emergency room is not a shortcut to accessing lab services. Patients must still wait to be assessed by an ER doctor before any tests can be performed.

"Wait times in the [ER] vary and patients presenting for non-emergency related visits such as access to lab services may experience longer than normal wait times," he said.

AHS is encouraging patients to use the virtual "save my space" option, which notifies people when a walk-in appointment is available so they don't have to wait at the clinic.

Williamson said patients needing short-notice appointments can also call the booking line at 1-877-702-4486.

A search on Monday turned up no appointments in Medicine Hat until the first week of June. On Tuesday, the same search identified appointments this week.

Prince said that while he is seeing early signs of improvement, there are other concerning impacts.

Some patients, he said, are getting lab work done in smaller communities, such as Brooks or Bow Island, because they can get in more quickly.

"[It's] to the point where it's overloading their systems. They don't have the staff and don't deal with that kind of volume."

And he said he's had delays receiving urgent test results because samples are being sent to Calgary for processing.

For instance, he received a call in the middle of the night about a patient with critically high blood sugars about 12 hours after the test was done. Under the old system, he said, tests were processed locally and within a few hours.

"At 3 o'clock in the morning, I don't have much ability to fix that. The way the system is designed, that's going to continue to be a problem," said Prince.

"The system has to be improved."